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Home My WebLink AboutX2021-2507 - Permitswl>nt, City of Newport Beach -Building Division 'X2021-2507` COMB Permit: X2021-2507 pp 3 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 2128-2020 H `. Permit Counter Phone (949)644-3288 �p g Inspection Requests Phone (949)644-3255 ` ' '�` `� L CT V 1 a..i it Issued Date : 0912112021 ., t:atry�u,,,>. Combination Type - SFP Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0912112024 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: 422 ALSO AVE NB > . Description: DEMO DETACHED GARAGE Legal Desc.: FIRST ADD TO NEWPORT HEIGHTS BLK 28 LOT 6 Owner: DUNCAN CHARLES W Contractor: OWNER/BLDR Architect: > » Address: 422 ALSO AVE Address: Address: , NEWPORT BEACH, CA 92663 Phone: Phone: 714-747-8773 Phone: State Lic: ' Applicant: DUNCAN CHARLES W Con State Lic: O/B Engineer: GABRIEL MICHAEL R Address: 422 ALSO AVE Lic Expire: Address: 483 E 20TH STREET NEWPORT BEACH, CA 92663 Bus Lic: COSTA MESA CA 92627 Phone: 714-747-8773 Lic Exp Date: Phone: 949-646-6596 State Lic:S-002939 ' Code Edit : 2019 Worker's Compensation Insurance Designer: VAN DYKE BRUCE ' ' • ' Type of Construction: Carrier: Address: Occupancy Group: U Policy No: Added /New sq.ft. Bldg: 0 Expire: Phone: 714-747-8773 Added /New sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: 5' Special Conditions: No of Units : 0 Front: 20' Bldg Height: 0 Left: 4' Bldg Sprinklers: Y Right: 4' Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $5,000.00 Building Permit Fee: $161.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $140.07 Additional Fee : $0.00 Plan check Fee : $0.00 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 : $0.00 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 PAN Plan Check : $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical W $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 : $302.07 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $302.07 PROCESSED BY: Z PUBLIC WORKS APPROVAL: ZONING APPROVAL: � (/' PLAN CHECK BY: t 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) indic (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, dem the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License L Professions Code) or that he or she is exempt from Iicensure and the basis for the alleged exemption. Any violation of Secti not mo fi dred dollars ($500). rer or my employees with wages as their sole compensation, will do (_) all of or o ions t Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through [ improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of comp improved for the ^t rpose of sale). I, as owne- Y t:le property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, apply to an cwn�.r of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor I am exempt f-cm Iicensure under the Contractors' State License Law for the following reason: By r.IV signature, below I acknowledge that, except for my personal residence in which I must have resided for at least one y sell 3 structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I un Prof-ssions Code, is available upon request whentkfs �Icemen G�uitied or at the following Web site:http://www.legin Signature of Property Owner or Authorized Agent' ?' LICENSED E OW P.ACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) o and effect. License Class License No Date :ERS' COMPENSATION DECLARATION KING: FAILURE 10 SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL , Or COMPENSATION; DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. haieoy affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of formance 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 pe urance carrier and policy number are: Policy Number of Agent d below by the checkmark(s) I have placed next to the applicable items) ;h, or repair any structure, prior to its issuance, also requires the applicant for (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of <; and the structure is not intended or offered for sale (Section 7044, ees' or personal effort, builds or improves the property, provided that the the Owner -Builder will have the burden of proving that it was not built or and Professions Code: The Contractors' State License Law does not to the Contractors' State License Law). to completion of the improvements covered by this permit, I cannot legall, . that a copy of the applicable law, Section 700444 of the 9usilness and rcalaw.html. Dail 3 of the Business and Professions Code, and my license is in full force Contractor Signature AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,010), IN ADDITION TO THE ustrial Relations as provided for by Section 3700 of the Labor Code, for of the work for which this permit is issued. My workers' Date I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manners D as to become subject to the workers' compensation laws of California, and agre t, if I should become DEC o e r rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith Comply with those provisions. �O mature of Applicant Dato( "7 '.CLARATION REG I DING CONSTRUCTI N LENDING AGENCY areby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which his 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 county ordinances and state laws relating to building construction. I authorize representatives of this city or co y t n It ve-identified property for inspection purposes. Signature of Property Owner or Authorized Agen Print Property Owner's or Autl prized Agent's Name ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE JSE ONLY REGULATIONS PART 61 OF TITLE 40 AND, RULE PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED I SUBMITTED ASBESTOS NOTIFICATION TO EPA AQMD ASBESTOS NOTIFICATION IS NOT APPLICABLE TO