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HomeMy WebLinkAboutX2022-0795 - Permitsw. ,. City of Newport Beach - Building Division r 100 Civic Center Drive, Newport Beach, CA 92660 5 n ` Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2022-0795 Project No : 2665-2021 Issued Date: 03/17/2022 Combination Type - BLDG PLUM , Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0311712025 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: 1720 SKYLARK LN NB Description: DEMO SFR 2449 SF (4 BEDROOMS) LEAVE EXISTING FOUNDATION Legal Desc.: N TR 3097 LOT 7 Owner: BETZLER OLGA/BRETT Address: 15 PARK AVE MILL VALLEY CA 94941 Phone: Applicant: COOMBS RANDALL Address: 17341 GROVEMONT ST SANTA ANA CA 92705 Phone: 714-267-6826 Code Edit: 2019 Type of Construction: V-B Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Construction Valuation: Building Permit Fee: $122.00 Plan Check Fee: $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety : $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $2.00 TOTAL FEE : $2,118.98 PROCESSED BY: ZONING APPROVAL: Contractor: J P CONTRACTING Address: 3419 VIA LIDO #233 NEWPORT BEACH CA 92663 Phone: 714-337.3700 Con State Lic: 620654 Lic Expire: 05/31/2023 Bus Lic: BT30046672 Lic Exp Date: 07/31/2022 Worker's Compensation Insurance Carrier: WC EXEMPT Policy No: (NO EMPLOYEES) Expire: Building Setbacks Use Zone: Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: / Front: / Left: / Right: / 'arkinc Soaces $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.98 Plan Check Fee Architect: COOMBS RANDALL B Address: 17341 GROVEMONT ST SANTA ANA, CA 92705 Phone: 714-744-1972 State Lic:C019185 Engineer: CHEN MING-TARNG Address: 12121 CANDOR DR ' - CERRITOS CA 90703 Phone: 714-521-0169 State Lic:C-054011 Designer: - Address: �� r%!� � ; n Phone: I' _ E - Special Conditions: CERT MAIL RECEIPTS . ATTACHED " Hazard Zone : N Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PAN Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department $0.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $27.00 General Service $266.00 Refund Deposit $1,692.00 Grading Bond: $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $2,118.98 PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: 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 :he pemtit'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 Professions 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 not mare than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business 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 improvements 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 improved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply 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). I am exempt from licensure under the Contractors' State License Law for the following reason: By 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) sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. 1 understand that a copy of the applicable law, Section 7044 of the Business and Professions Cr. de, Is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date 1-22\SED CONTRACTOR'S DECLARATION I hereby affirm u.i&r penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 00 of ' 'siop of the Business and Prof 1 s �e d my license is in full force anH effect. Licen;e Class License No Date LL Contractor Signatur ' - NORKERS' COMPENSATION DECLARATION VAr'NINC: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUN THOU AND DOLLARS ($100,000), IN ADDITION TO THE .:DST CF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I,eruLy affirm Under penalty of perjury one of the following declarations: ` [-have and wil' maintain 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 �enorrnance of the w,r'1 for which this permit is issued. Policy No. I have and will ,naincain 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' urance carrier and pilicy number are: Policy Number of Agent Date I certify that, in4theeormance of rk 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 ttif I should bebj ct k e or rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of AppliCLARATION RI C NSTRUCTION LENDING AGENCY :reby affirm untty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). 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 owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and co my ordina es an state laws relating to building construction. authorize representatives of this city or co t to nter t -identified property for inspection purposes. L mature of Prooertv Owner or Authorized Agent 4q iYl'µ� Print Property Owner's or Authorized Agent's Name O! C )//r'I �AN rJG� _ Dat i%_Z ACTION DATE B -SECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMIT EMENDED AQM D PERMIT FINAL CERTIFICATEOF OCCUPANCYISSUED /_' I .z?j (i lll"`/// VVV SBESTOSNOTIFICATI I OT APPLICABLE TO PRO SED O ITI SIGNATURE: A,-t�