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Home My WebLink AboutX2021-0336 - Permitsw City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIII�IIIIIII II COMB Permit: X2021-0336 't 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 0 3 3 e Project No : 0881-2020 ii Permit Counter Phone (949)644-3288 u. +<C Inspection Requests Phone (949)644-3255 Issued Date : 02/16/2021 r:'irratir?.* Combination Type - BLDG PLUM Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0211712024 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: 434 GOLDENROD AVE NB Description: DEMO FRONT UNIT OF DUPLEX 1008 SF. 2 BEDROOM. SEWER CAP INCLUDED Legal Desc.: CORONA DEL MAR BLK 434 LOT 18 Owner: INJEV VAL Address: 16 SILVERFERN IRVINE , CA 92603 Phone: Applicant: INJEV VAL Address: 16 SILVERFERN IRVINE CA 92603 Phone: Code Edit : 2019 Type of Construction: V-B Occupancy Group: R311.1 Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 1 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Construction Valuation: Building Permit Fee: $120.00 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 : $1.00 TOTAL FEE: $1,603.80 PROCESSED BY: ZONING APPROVAL: Contractor: Address: Phone Con State Lie: Lie Expire: Bus Lie: Lie Exp Date: GRAYSTONE CUSTOM BLDRS INC Architect: 3419 VIA LIDO STE 455 Address: NEWPORT BEACH CA 92663 949466-0900 Phone: 971085 0313112022 BT30040057 03131/2021 Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9216106 Expire: 08/15/2021 Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: I Front: I Left: I Right: / $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.80 State Lie: Engineer: Address: Phone: r.p�® \V State Lic: O �n st'9t \4.Yy 44 NPhone: i*v (�'^�' Spe�t4(9Ps lag QUARTERS TO HAUL DEBRIS Fire 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 $26.00 General Service $219.00 Refund Deposit $1,127.00 Grading Bond: $0.00 $0.00 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $1,503.80 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 items) ction 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 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 cessions 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 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 `) portions of the work, and the structure is not intended or offered for sale (Section 7044, iness 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 rovements 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 roved for the purpose of sale). 1, 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 ly 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). J I am exempt from licensure 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 impro ell a structure 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 applicat 'rofessions Code, 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 .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 of ivi5ion 3 of the Business and Pro nd effect. License Class License No Date Contractor Signature VORKERS' COMPENSATION DECLARATION / / I i 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDR)= DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: law, Section 7044 of the Business and is in full force ($100,000), IN ADDITION TO THE 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 ce of the work for which this permit is issued. Policy No. 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 carrier and policy number are: Ie of Agent _ certify that, in if I should bE of Applicant Policy Number Date Ice of thA work fAr which � I Is issu , I shall not employ any person in any manner so as to become subject to the workers' compel ation laws of California, and agree 7 tot r nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 11 ^1 Date/ b f� TRUCTION LENDING AGENCY I hereby affirm under p al rjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By my signature below, I Certify to ach of the follbaveprovide I am the property owner or auth rized to act Aco elf. I have read this application and he informatit. I agree to comply with all applicable city and ws relating to building construction.I authorize representatives of this city or counified property for inspection purposes. /9 Signature of Property Owner or Authorized Agent Print Pro a Owners or Authorized Agent's Name ACTION DATE BY RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY ✓' REGU TIONS PART 61 OF TITLE 40 AND AOMD RULE 1403 PERMIT EXPIRED [SUB ITTED ASBESTOS NOTIFICATION TO _ PERMIT CANCELLED UFPO PERMIT EXTENDED qnA PERMITFINAL STOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF OPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: