HomeMy WebLinkAboutX2021-0200 - PermitsN Hi'rrkh City of Newport Beach - Building Division
e 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - SFP MECH ELEC PLUM
11111111111p11111p11111111111p11111111p111plJillCOMB Permit: X2021-020
X 2 0 2 1 0 2 0 0 Project No : 0212-2021
Issued Date : 09/16/2021
Inspection Area : 3
,RES 180 DAYS AFTER ISSUANCE OR LAST
VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0911612024 OR PERMIT WILL BE INVALID
PERMIT EXt
ConstrLCtion 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: 1521 KATHLEEN -N NB
Description: SFR ADD 716 SF
Legal Desc.: N TR 1806 LOT 4
Owner: WEICHMAN BARRY
Contractor:
HAVEN DEVELOPMENT GRP INC Architect: OLSON DAVID ROLF
Address: 1048 IRVINEAVE #148
Address:
14271 JEFFREY RD #502 Address: 470 WALD
NEWPORT BEACH CA 92660
IRVINE CA 92620 IRVINE, CA 92618
Phone:
Phone:
949.788-9227
Phone: 949-450-0093 State Lic:C019424
Applicant: OLSON DAVID ROLF
Con State Lic:
827901
Engineer: EOSAKUL DISSAKORN
Address: 470 WALD
Lic Expire:
01/31/2022
Address: 15 STUDEBAKER
IRVINE, CA 92618
Bus Lic:
Lic Exp Date:
BT30046360
02/28/2022
IRVINE CA 92618
Phone: 949-752-1612 State Lic:S-005226
Phone: 949-450-0093
Code Edit: 2019
Worker's Compensation Insurance
Designer:
Type of Construction: V-B
Carrier:
WC EXEMPT
Address:
Occupancy Group: R3
Policy No:
(NO EMPLOYEES)
Added /New sq.ft. Bldg: 716
Expire:
Phone:
Added /New sq. ft. Garage: 0
1
Building Setbacks
Rear: / fp1
Special Conditions: CMSD FEES PD
No of Stories:
1
Front: / �%
JD DEMO TO HAUL DEBRIS
�C °+
No of Units :
0
Left: I I
Bldg Height:
Bldg Sprinklers:
Right: / $- v
Flood Zone: X
Use Zone: Parkin Spaced
0 Fire Hazard Zone : N
$250 000.00
Construction Valuation:
Building Permit Fee: $2,045.00
Excise Tax:
$0.00
Planning Department - Fire Depa nq;l
lion: $0.00
Plan Check Fee: $1,497.00
Additional Fee :
$0.00
$0.00
Plan check Fee : $208.00 Fire Insp
Fair Share : $0.00 Fire Plan Rev $0.00
Overtime Plan Ck: $0.00
Investigation Fee: $0.00
Grading Bonds Fee:
Grading PC Consultant:
$0.00
SJH Trans : $0.00 Demolition Fee
Record Management: $48.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee : $0.00 Building Dept Adm $27.00
General Service $265.00
Energy Compliance: $175.00
Grading PC Fee:
$0.00
$152.00
Public Works Department -
Park Dedication : $0.00 Refund Deposit $564.00
CA Seismic Safety: $32.50
WO Insp. Fee:
PNV Plan Check : $203.00 Grading Bond: $0.00
Disabled Access : $0.00
Hazardous Mat $0.00
Electrical %:
$143.15
San Dist : $0.00
$0.00
Building Green Fee : $10.00
Mechanical %:
$81.80
NMUSD Fee: $1,317.44
$0.00
Plumbing %:
$184.05
TOTAL FEE : $6,952.94
Plan Check Fee
: $1,777.00 Fee Due at Permit Issuance : $5,175.94
PUBLIC WORKS APPROVAL:
PROCESSED BY:
PLAN CHECK BY: ✓�
ZONING APPROVAL:
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)
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
fessions 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 L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
liness 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).
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
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 improvements covered by this
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 applicable law, Section 7044 oft
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html.
'signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code and Dense is in full force
no effect. License Class License No DateCX y/ l� Contractor Signatur¢I L
WORKERS' COMPENSATION DECLARATION I 1
and
ARNING: 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 ($100,000), IN ADDITION TO THE
OST 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:
I I 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 th
erformance of the work for which this permit is issued. Policy No.
have 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'
rance carrier and policy number are:
Policy Number
Agent
Date
that, in the performance 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 workers' compensation laws of California, and
❑uld become subject to,the workers' corer peasation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
Datql,_.�
CLARATION REGARDING CONSTRUCTION LENDING AGENCY lX
;reby affirm under penalty 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).
lder'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 county to enter t above= ratified property for inspection purposes. //��
nature of Property Owner or Authorized Agent V Print ProDertv Owners or Authorized Aoent's Nnme/1i �lirr_elf z
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY y
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMITEXPIRED
' I SJBMITT9D ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
EPA
PERMITEXTENDED
4DAQMp
PERMITFINAL
ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
CERTIFICATE OF
OCCUPANCY ISSUED
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