HomeMy WebLinkAboutX2021-1650 - Permitsrc4 City of Newport Beach - Building Division 111111111lill1111111111111111111111111111111111111111
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 1 6 5 0
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - SFP
,i
PERMIT EXPIRES 160 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST OMPLETED BY IlYZ
Construction Hours: Monday -Friday 7:00 a.m, to 6:30 p.m. and Saturday fro . 0 a.m. to 6:00 p.m.a H
Job Address: 1833 LEEWARD LN NB
Description: ADDITIONAL SCOPE -ADDITION OF FIREPLACE TO GREAT ROOM (DELTA 1) - er(L��
Legal Desc.: N TR 4463 LOT 18 " P\ �OIp t
Owner: D'ANNA IGNACIO
Address: 1833 LEEWARD LN
NEWPORT BEACH, CA 92660
Phone:
Applicant: SIMONS RICHARD
Address: 123 N LOOP DR
CAMARILLO, CA 93010
Phone: 805.910-9826
Code Edit :
19
Type of Construction:
;Vogl
Group: .:U
Added /New sq.ft. Bldg:
�Q.Ak Es'
Added /New sq.ft. Garage:
No of Stories:
`2
No of Units :
1
Bldg Height:
0
Bldg Sprinklers:
Flood Zone:
X,,..,,r
Construction Valuation:
$7.0(
Building Permit Fee:
$195.00
Plan Check Fee: $169.65
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$2.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
PROCESSED BY:
COMB Permit: X2021-1
Project No : 0081-2021
Issued Date : 06123/2021
Inspection Area : 3
Sundays or Holidays
Contractor: B W SOCl/{TcES �\\G OA1cchhitect:
Address: 01 VENTURA�gL`�tjjD ST�140mC Address:
ENCINO CA 91436 Q iUU
Phan 818-30 297 O� P e: ..µ
on State Lic: 9248 Engineer:
Lic Expire: 13 '3 ?f 2 < �O Address: :
Bus ST3007 9 aq.
xp Date �0212812 2 Phone.
[)� ork a 1C,gmpensation InsurartE Designer:
Carr
Cier BCIJCHMARK - Address:
! a
' Policy: No: CST50199r,.1-> e ry
Expire: 0812812021'4Ept.:, Phone:
'King Setbacks Rear I a� ditionc��
Front I - S�!�p
€� Left
3 Right: / + re Ha //'/�'
eOee Zones^ arkina Spaces: 0 _el �F}re Hazard Zone _W ,r (_ '
i.00 sar
' itional Fee
-Fading Bonds Fee:
Grading PC Con 4 AKN' 'ViOj0
Gradin r � I,DDb
0tri
��`$0.00
cal %: 0nical %:
Plumbing %: $0
5 J.
TOTAL FEE: $413.90 Check
ZONING APPROVAL:
GRADING APPROVAL:
Planning Department -
Plan check Fee :
Fair Share:
SJH Tr
In-' Housing F
I Ic Works pa
nt-
Park Icat
P--WVI PI eck:
a
$0.00
$0.00
$0.00
#1�fUSD Fee:
$0.00
Fee : $0.00
Lic:
V Department�5 ee
Inspection:
$
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
Fee Due at Permit Issuance : $413.90
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
HE
1" ,
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 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 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 .S by -luny 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 sale compensation, will do (_) all of or U portion the work, a theructure 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, t ugh employees' o ere aI 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 y of completion, the Qw -8u l4er 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 pro (Section 7044, Bu�is and Prof io1i`£ode: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who contracts for the projects wit icens\dContractoObj�yr cant to the on cfd -State License Law).
❑ I am exempt from licensure under the Contractors' State License Law for the following reas �� _
By my signature below I acknowledge that, except for my personal residence in which I must a rest clq� at lea'�t a year prior completion o ei� ' ovements covered by this permit, I cannot legally
sell a structure that I have built as an owner -builder if it has not been constructed in its a ty by lic ;��`�dd contr d4pfs. I underst that a copy; of the pli _ e law, Section 7044 of the Business and
Professions Code, is available upon request when this application is submitted or at t ollowink %ite: tt twyw.leginfo .gov/calaw.htmL
Signature of Property Owner or Authorized Agent a Date
LICENSED CONTRACTOR'S DECLARATION //��
I hereby affirm I•rdor penalty of perjury that I am licensed under provisions hapter 9 (commenc1ii;; ith Sec ig000 Ivisio 3 of the Business and Pro li> Gyre-aw a anse is in full force
and effect. LJIRPS Class License No - to Contractor Signature -
WORKERS' CCf9PENSATION DECLARATION 1�0
NARNING: FAIL IRE TC SECURE WORKERS' COMPENSATION COVERAGES WFUL, AND ALL SUBJECT A MPL. R TO CRIMINAL PENALTIES AND CIVIL FINES UP TO r�I RED THOU ND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370 THE LABOR CODE, IN,
AND A 'S FEES.
Innreby affirm under penalty of perjury one of the followi declaration
41
❑ I have and will maintain a certificate of conse o self-insu for workers' compensation Issu r• Director of Industrial IOn�as provided for by S ion 7001bdf the Labor Code, for th
mance of the work for which this permit is died. P D. ss r
and Brill maintain workers' comp - ationI+fr ce, as required by Section 3700 of the Labor`Cor' e, for the perfor thgep for which s i issued. My workers' compensatiol
In`? la ce carrier, and policy number are'
,aine. �� Policy Number %XDiration Dat
Name of Agent rm.,. S Phone #
LJI certify that,'m th? oerf . Ge' rk for w h thls�permit Is issued I shall not employ any perso a a e,r;i�s t'410 become ject•,,((S�i�le wgtk'ers' compensation laws of California, and ogre
that, If I should become -object od4ets' cocoin ` sat,'C?* ovis ions of Section 3700. of the Labor Cod I sha rthw omply with se p�ay'Ans�'
Signature of Appllcaxft / \ . °s=�'YY s"§ Date��/ �
DECLARATION REGARDI CON CTIO - NDING AG„FjCY ;a ' ,�y`% /
I hereby affirm under penalty erju hat them. gagency construdtidn Iendinfor the perf nce of the work for which s permit' iss6+eG (Section 3097, Civil Code).
Lender's Name a' Lendess
By my signature below, I certify to ch o ollowi
I am the property owner or auth ' ad to act h erty oMiner's behalf.
I have read this application and th 'nfor Ion I vided is correct. e'
I agree to comply with all applicable an d sta %latiggx4ouilding con diction.
I authorize representatives of this city coun er the I._ o . or inspectio urposeIc d,✓�� �/j�P /(�7�
Signature of Property Owner or Authorized A nt "c,,. wY nn operty n s or Authorized Agen�'s Name Date
ACTION DATE BY DEC NIIW`tOMPL;,17f i WITH CO OF L OR OFFICE USE ONLY
REfZ I .- S PARTII$bF TITLE 40 A AQMD 3N E
PERMITEXPIRED 'L� a,� d Kam- " I SUBMITTED ASBESTOS
PERMIT CANCELLED EPA
PERMITEXTENDED QMD „�'
PERMITFINAL ASB IFVaFIICP.T�IP
CERTIFICATE OF P POSE. tfT.Lj�N�
OCCUPANCYISSUED SIG TUR