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HomeMy WebLinkAboutX2021-2562 - Permitsna City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination T e - BLDG *X2021--2562` COMB Permit: X2021-2562 Project No : 2219-2021 Issued Date : 09/23/2021 yp ,ii' Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 09/23/2024 OR PERMIT WILL SE 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: 20282 RIVERSIDE DR INS Description: DEMO DETACHED KENNEL 245 SF Legal Desc.: Owner: LANGFORD JONATHON Contractor: SLATER BUILDERS INC Architect: DWYER MARK Address: 20282 RIVERSIDE Address: 3100 - B PULLMAN STREET Address: 3244 BROAD ST UNIT A NEWPORT BEACH, CA 92660 COSTA MESA CA 92626 NEWPORT BEACH CA 92660 Phone: 949-322-5333 Phone: 714-615-6108 Phone: 9491887-2292 State Lic:CO23283 Applicant: BUTTS JENNIFER Con State Lic: 675832 Engineer: KIRK MATT Address: 3100-B PULLMAN ST Lic Expire: 08/31/2023 Address: 17520 NEWHOPE ST. STE 140 COSTA MESA, CA 92626 Bus Lic: BT30025319 FOUNTAIN VALLEY CA 92708 Phone: 949-306-6662 Lic Exp Date: 02/28/2022 Phone: 714-460-7259 State Lic:C-051619 Code Edit : 2019 Type of Construction: Occupancy Group: U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 0 No of Units: 0 Bldg Height: 0 Bldg Sprinklers: Flood Zone: Valuation: $2,500.00 Building Permit Fee: $130.00 Plan Check Fee: $113.10 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 : $1.00 TOTAL FEE : $244.10 PROCESSED BY: ZONING APPROVAL: Worker's Compensation Insurance Carrier: CYPRESS INS COMPANY Policy No: SLWC245302 Expire: 02/16/2022 Building Setbacks 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: / king Spa $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Designer: Address: Phone: Special Conditions: Fire 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 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $244.10 PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: e_A� 1 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 tha applicant for :he 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 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 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, 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 licensors 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 legaly sell a structum :hat 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 Professions Code. is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSEE CCNTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section i 3 of the Business and Prof I o e, n li n 's in full force and effect. License Class License No Date Contractor Signatur WORKERS' COM?ENSATION DECLARATION NP PNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS S100,D00), IN ADDITION TO THE COST OF COME ENSAT,ON, DAMAGES AS PROVIDED FOR IN SECTION 37BB OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affir,a ur, Jar penalty of perjury one of the following declarations: have and will 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 ),mance. o, the work for which this permit is issued. Policy No. !cave 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' compensa ranee cams -era policy number are: Policy Number Expiration Date ime of Agent I certify that, in the perforpence 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 workempensation laws of California, and agre It, if I should becom j t s' o soli provisions of Section 3700 of the Labor Code, shall forthwith comply with those provisions. ]nature of Applica Da l2l :CLARATION R G ONSTRUCTION L G AGENCY areby affirm unde natty 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). nder'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 u ordiinanc s and ate laws relating to building construction. /� authorize representatives of this city or couU�W07t d property for inspection purposes. X jet " Y O� ➢Q I U'!� i�Z mature of Prooertv Owner or Authorized ADe Print Property Owner's or Authorized Agent's Name Da ACTION PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED DATE BY J DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE I SUBMITTED ASBESTOS PROPOSED DI TO FOR OFFICE USE ONLY