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HomeMy WebLinkAboutX2021-3237 - PermitsCity of Newport Beach - Building Division 'p 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 . Inspection Requests Phone (949)644-3255 �, �,rrufie Combination Type - BLDG II� I III IIillllllll l llllll 111 111 ll� 11 COMB Permit: X2021-3237 Project No : 2798-2021 Issued Date : 11/30/2021 Inspection Area : 2 PERMIT EXPIRES 180 DA YS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1113012024 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: 1015 DOLPHIN TER NB Description: DEMO DETACHED GARAGE Legal Desc.: N TR 5130 LOT 4 Owner: POLOS PETER Contractor: LEGACY CUSTOM HOMES INC Address: 2 HERMITAGE LN Address: 1000 QUAIL ST, STE 220 NEWPORT BEACH CA 92660 NEWPORT BEACH CA 92660 Phone: Phone: 949-887-4750 Applicant: RIELLY BRUCE Con State Lic: 986194 Address: 1000 QUAIL ST #220 Lic Expire: 08/3112023 NEWPORT BEACH CA 92660 Bus Lic: BT30045036 Phone: 949-887-6233 Lic Exp Date: 1013112022 Code Edit : 2019 Worker's Compensation Insurance Type of Construction: Carrier: OAK RIVER INSURANCE Occupancy Group: Policy No: LEWC117490 Added /New sq.ft. Bldg: 0 Expire: 1210212021 Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: / No of Units : 0 Front: I Bldg Height: 0 Left: / Bldg Sprinklers: Right / Architect: TOBLESKY KENNETH Address: 1450 W 6TH ST CORONA CA 92882 Phone: 909-217-1866 State Lic:CO23571 Engineer: Address: Phone: State Lic: Designer: Address: Phone: Special Conditions: Fire Construction Valuation: $1,000.00 Building Permit Fee: $110.00 Excise Tax: $0.00 Planning Department - Plan Check Fee: $0.00 Additional Fee : $0.00 Plan check Fee Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share Investigation Fee: $0.00 Grading PC Consultant : $0.00 SJH Trans Record Management: $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - CA Seismic Safety: $0.00 WQ Insp. Fee : $0.00 Park Dedication : $0.00 Disabled Access : $0.00 P/W Plan Check: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 TOTAL FEE : $111.00 PROCESSED BY: �1t ZONING APPROVAL: �V GRADING APPROVAL: Fire Department $0.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: Plan Check Fee : $0.00 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL. PLAN CHECK 6Y: APPROVAL TO ISSUE: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $111.00 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) 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 ie 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 Irofessions Code) or that he or she is exempt from Iicensure 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 of more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 nprovements 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 nproved for the purpose of sale). 7 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 pply 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). I am exempt from Iicensure 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 permit, I cannot legally 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 of the Business and 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.htmi. Iignature 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 7 00) of Division 3 of the Business and Professi �iS C Grand my i, effse is (force nd effect. License Class License No Date (f 'Z 1 Contractor Signature UORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUWECT AN EMPLOYER TO 'MINA] PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($ ,0001, IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby 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 Industrial Relations as provided for by Section 3700 of the Labor Code, for the a,dormance 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' carrier and policy number are: Policy Number le of Agent certify that, in the performance of the work for which this permit is issued if I should become subject to the workers' co arsation pr visions o Date one # not employ any person in any manner so as to become subject to the workers' compensation laws of California, and /Jrpp 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant /1. �f'� Date %( '�O �Z/ CLARATION REGARDING CONS ENO G AGk CY :reby affirm under penalty of perjury4tf a ere is a constru?111 (ending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ider's Name Lender's Address By 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 havie provided is correct. I agree to comply with all applicable city and county Ordinances and state laws relating to ilding construction. I authorize representatives of this city or county enter the ab " entifi operty nspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's I Date 11 Z ACTION DATE BY DFIF&IVATION OF COMPLIA 6E WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 610 ITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED U I SUBMITTED ASBES-1OS NOTIFICATION TO PERMITCANCELLED LIEVA PERMITEXTENDED UAQMD ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION SIGNATURE: PERMITFINAL CERTIFICATE OF OCCUPANCYISSUED 'L ZL k''' Pub Q