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Home My WebLink AboutX2022-0324 - PermitsCity of Newport Beach - Building Division *X2022-0324* r,?i COMB Permit: X2022-0324 ,r H 100 Civic Center Drive, Newport Beach, CA 92660 '�� Project No: 1303-2021 x Y Permit Counter Phone (949)644-3288 ,. 4. Inspection Requests Phone (949)644-3255 Issued Date : 02/04/2022 Combination Type - MFP A Inspection Area : 4 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 02/04/2025 OR PERMIT WILL BE INVALID Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 1037 GRANVILLE DR NB Description: DELTA 1-*ADDITIONAL SCOPE* STRUCTURAL BEAMS AND FOOTINGS Legal Desc.: TRACT 14839 LOT 2 OF PROJECT 939-63 LOCATED ON AP 442-421-13 ...... Owner: FRENCH ROBERT E Contractor: JON DELAVAN GENERAL CONTRACTOR Architect: - LA ROCHE DENIS A Address: 1037 GRANVILLE DR Address: 17235 CITRON Address: PO BOX 3708 NEWPORT BEACH, CA 92660 IRVINE CA 92612 TUSTIN CA 92781 Phone: Phone: 949-933-3382 Phone: 949-939-3047 State Lic:C013756 Applicant: LA ROCHE DENIS A Con State Lie: 984903 Engineer: Address: PO BOX 3708 Lie Expire: 06/3012023 Address:- TUSTIN CA 92781 Bus Lie: BT30071549 Phone: 949-939-3047 Lie Exp Date: 04/3012022 Phone: State Lie: o ° ° ° ° Code Edit: 2019 Worker's Compensation Insurance Designer: " Type of Construction: V-A Carrier: EXEMPT Address: - Occupancy Group: R2/U Policy No: no employees ° Added /New sq.ft. Bldg: 0 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: / Special Conditions: No of Units: 4 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: Right: / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $8,000.00 Building Permit Fee: $212.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $184.44 Additional Fee : $0.00 Plan check Fee : $52.00 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Investigation Fee: $0.00 Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Record Management : $4.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access: $0.00 PM Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE: $453.44 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Plan Check Fee $0.00 Fee Due at Permit Issuance : $453.44 PUBLIC WORKS APPROVAL: I PLAN CHECK BY: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for ie permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 'rofessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of of more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or nproved for the purpose of sale). I, as owner of J.e property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). : um axempt f. am 'icensure under the Contractors' State License Law for the following reason: ly my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall± 51] R SLrlicture that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Irofe..sions Code, is available upon request when this application is submitted or at the fallowing Web site:http://www.leginfo.ca.gov/calaw.htmi. Iicnatcre of Property Owner or Authorized Agent Date ICENSED CON IF RACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section ) of i isi 3 of the Business and Pr sions e, and lic se is in full force nd effect. Licensd C;&ss License No Date v Contractor Signature VORKPRS' COI1iPENSATION DECLARATION DARNING: FAILURE 70 SEGURE WORKERS' COMPENSATION COVERAGE Is UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED HOUSAND DOLLARS I$100,0001, IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby effirm under penalty of perjury one of the following declarations: I have and wit mai,itain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th erformance of the work for which this permit is issued. Policy No. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatioi Isurance carrier and policy number are: Policy Number Date Tie of Agent Phone # certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre N*[ I should become subject to the w,yckerrs' compe dor'�( provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 9 nature of Applicant n/ Ol�,.�� Date CLARATION REGAROIING—CONSTRIU ON LEN IN AGENCY ider's Name Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. f I authorize representatives of this city or countMtvo�nterpe bove-I ent(Ijed property for inspection purposes.�Q �D - /T % r / n� nature of Prooertv Owner or Authorized Aeent - /�� 71, l� n �( �r /� Print Prooertv Owners or Authorized Aoent's Name x Il-ci� u U� v` Date / ��`�(�f_ ACTION DATE BY DECLARATION OF -COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMIT EXTENDED AQMD PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED IMA3 ASBESTOS NOTIFICATI S NOTA\R\P LICABLE TO ED(DEjJOLITION\ 11.� SIGNATUR . 111JJ '"` ,,,,��fff��f�