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HomeMy WebLinkAboutX2021-1726 - Permitswav, City of Newport Beach - Building Division "X2021-1726` A 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644 u. A IInspection Requests Phone (949)644-3255 F CTO Il `'atiratin'b Combination Type - SFP MECH ELEC PLUM COMB Permit: X2021-1726 Project No : 1512-2021 Issued Date : 06130/2022 Inspection Area : 2 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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: 208 ABALONE AVE NB Description: SFR REMODEL MASTER SUITE, ADD ROOF OVER (E) FLOOR DECK/HALLWAY 334 SF Legal Desc.: BALBOA ISLAND SEC 5 BLK 6 LOT 5 Owner: CURCI Address: 208 ABALONE AVE NEWPORT BEACH, CA 92662 Phone: Applicant: WALZ JOHN ROBERT Address: 23 CORPORATE PLAZA #150 NEWPORT BEACH CA 92660 Phone: 949-836-8977 Code Edit : 2019 Type of Construction: VB 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 B!dn Rnrinklers' N Contractor: D B A C INC Address: 101 SHIPYARD WAY #A NEWPORT BEACH CA 92663 Phone: 949-723-0147 Con State Lic: 637651 Lie Expire: 0212812024 Bus Lie: BT00016282 Lic Exp Date: 1013112022 Worker's Compensation Insurance Carrier: INS OF THE WEST Policy No: WSD5051828 Expire: 11/11/2022 Building Setbacks Rear: 0 Front: 5 Left: 3 Right: 3 Architect: WALZ JOHN ROBERT 110 Address: 23 CORPORATE PLAZA #150 NEWPORT BEACH CA 92660 Phone: 949-836-8977 State Lic:C031388 Engineer: BURKE THOMAS 'mil Address: 151 KALMUS DR #140 COSTA MESA CA 92626 Phone: 949-494-0776 State Lic:S-005088 m Designer: 71 Address: M Z Phone: Special Conditions: LIQUEFACTION AREA HIGH DENSITY ZONE Flood Zone: X-0.2PCT Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $45 000.00 Building Permit Fee: $739.00 Excise Tax: $0.00 Planning Department - Fire Department $0.00 Plan Check Fee: $710.93 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 Investigation Fee: $0.00 Grading PC Consultant : $0.00 $0.00 SJH Trans : In -lieu Housing Fee : $0.00 $0.00 Demolition Fee Building Dept Adm $0.00 Record Management: Energy Compliance: $58.00 $61.00 Grading Permit Fee: Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $5.85 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 $0.00 Disabled Access : $0.00 PAN Plan Check : $0.00 Grading Bond: Hazardous Mat $0.00 Electrical %: $51.73 San Dist: $0.00 $0.00 Building Green Fee : $2.00 Mechanical %: $29.56 NMUSD Fee: $0.00 $0.00 Plumbing %: $66.51 TOTAL FEE : $1,776.58 Plan Check Fee : $642.93 Fee Due at Permit Issuance : $1,133.65 PROCESSED BY: M� PUBLIC WORKS APPROVAL: 1r� ZONING APPROVAL: / / 1 K ( PLAN CHECK BY: c r I 6. 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) indica ad 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, demo ish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License L (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 Sectio 17031.5 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 'he property, or my employees with wages as their sole compensation, will do U all of or (_) portions of th work, and the structure is not intended or offered for sale (Section 7044, 3usinPss 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 !mprovements ure not Intended or offered for sale. If, however, the building or improvement is sold within one year of Compl - ion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). a , as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, B isiness and Professions Code: The Contractors' State License Law does not apply ban owrerof property who builds or improves thereon, and who contracts for theprojects with a licensed Contractor pursuant to the Contractors' State License Law). I Ern exempt from licensure under the Contractors' State License Law for the following reason: 9,I my signature Delow I acknowledge that, except for my personal residence in which I must have resided for at least one ye ir prior to completion of the improvements covered by this permit, I cannot legall) sell s s5 ucture that , .iave 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 Cade, s available upon request when this application is submitted or at the following Web site:http://www.leginf ca.gov/calaw.html. Slcaatu-e of Property owner or Authorized Agent Date LICENSED CON"I R.ACTOR'S DECLARATION nererry affirm under oenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Mvi5ion.3 of the Business and Professions nd my license is in full force a,iu affect. Lioansc Cass License No Date Contractor Signature �r �'/ ,4,�! NORKERS' COMPENSATION DECLARATION % y IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUB.IECT AN EMPLOYER TO CRIMINAL PENALTH S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE '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: 7 I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of I idustrial Relations as provided for by Section 3700 of the Labor Code, for th, Z'e ormance 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 part rmance of the work for which this permit is issued. My workers' compensation Isurance carrier and policy number are: :arrier /AN✓xAk%& co DC %F u'(,ST Policy Number W-S.D50 2 Expiration Date (IZ/l/Z04/L lame of Agent Phone # 11 certify that, in the performance of th work for which this permit is issued, I shall not employ any person in any manners as to become subject to the workers' compensation laws of California, and. ogre at, if I should become s,bjecct t/o►�Jlhe rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith omply with those provisions. �1� ignature of Applicant �G , Date 0 -Lo �. ECLARATION REGA ❑ING CONSTRI .TION I FNFIINf: At;FNCV hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which Ender's Name Lender's Address y 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 county ordinanc and state laws relating to building construction. I authorize representatives of this city or county to enter)hey ove-identified property for inspection purposes. ignature of Property Owner or Authorized Agent _ Print Property Owner's or Aut ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED UEPA PERMIT EXTENDED QACIMD PERMITFINAL ASBESTOS. NOTIFICATIOPQSNOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOUTII N OCCUPANCYISSUED SIGNATURE: 1! /1 I ./ . .. permit is issued (Section 3097, Civil Code). ONLY Name