HomeMy WebLinkAboutX2022-1782 - Permitsrigru City of Newport Beach - Building Division
) pry 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
S ., Inspection Requests Phone (949)644-3255
Combination Type - BLDG PLUM
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2022-1782
x 2 0 2 2 1 7 8 2 Project No : 2762-2021
Issued Date : 06/28/2022
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
Jab Address: 2762 BAY SHORE DR NB
Description: SFR DEMO HOUSE/GARAGE 3800 SF. 3 BEDROOMS. SEWER CAP INCLUDED
Legal Desc.: N TR 1014 LOT 3
Owner:
DEYOUNG ROGER A
Address:
2762 BAY SHORE DR
NEWPORT BEACH, CA 92663
Phone:
Applicant:
DE YOUNG ROGER
Address:
2521 BAYSHORE OR
NEWPORT BEACH CA 92663
Phone:
949-296-2810
Code Edit : 2019
Type of Construction: V-B
Occupancy Group: R3/11
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 2
No of Units : 1
Bldg Height: 0
Bidg Sprinklers:
Construction
Building Permit Fee: $122.00
Plan Check Fee: $0.00
Overtime Plan Cl
$0.00
Investigation Fee:
$0.00
Record Management :
$0.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE : $2,117.98
PROCESSED BY:
ZONING APPROVAL:
Contractor
Address:
Phone
Con State Lic:
Lic Expire:
Bus Lic:
Lic Exp Date:
OWNERIBLOR
DE YOUNG ROGER
949-296-2810
O/8
Workers Compensation Insurance
Carrier:
Policy No:
Expire:
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: /
Front: /
Left: /
Right: /
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$10.98
Architect: tA0VD
Address'.
\ `G1`O` _
NO �Slv� V State Lic:
Engineer:
Address:
Phew \ jHe� G State Lic:
Designer:
Address:
Phone:
Special Conditions: TIGHT QUARTERS TO
HAUL DEBRIS
Planning Department -
Plan check Fee
Fair Share:
SJH Trans :
In -lieu Housing Fee
Public Works Department -
Park Dedication :
$0.00
PNV Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Zone :N
Fire Department
$0.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$27.00
General Service
$265.00
Refund Deposit
$1,692.00
Grading Bond:
$0.00
$0.00
$0.00
Plan Check Fee : $0.00 Fee Due at Permit Issuance : $2,117.98
PUBL IC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: _ APPROVAL TO ISSUE:
N
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
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 licehsure 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
not 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 L) portions of the work, and the structure 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, through employees' or personal effort, builds or improves the property, provided that tale
improvements 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 c,
Improved for the purpose of sale).
LJ 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
o 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).
m exempt from licensure under the Contractors' State License Law for the following reason:
By nnsignature 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 legal)
ell a tructure 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
ssions Code, is available upon request when is ppl" n is sy T}�� or at the following Web site:http:!/www.leginfo.ca.gov/calaw.html. f
Signature of Property Owner or Authorized Agent li f/t L/.�^-� Dat is z Z2-
LICENSED CONTRACTOR'S DECLARATI
I 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 my license is in full force
and effect. License Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: 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 1$100,0001, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
El 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
performance of the work for which this permit is issued. Policy No.
❑1 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' compensatio
insur nce carrier and policy number are:
C ier Policy Number Expiration Date
a of Agent Phone#
I ce ify 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 agre
that, if I should become subject t e workeerr�/'por/r}p/a sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ` ��/�9
Signature of Applicant 71 ;�![l//Gnl Da�Ly �0 ��2-
DECLARATION REGAR I CONSTRUCTION ENDIN GENCY Z
I hereby affirm under pe alty 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).
Lender'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 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 t ant a abov -I a if' d property for inspection purposes. ®)
Si nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam f✓ L Date
ACTION DATE BY DECLARATION OF C MPLIANC- WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403 _
PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATIOC Tr f
PERMITCANCELLED upq —
PERMIT EXTENDED QMD
PERMITFINAC {� ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
CERTIFICATE OF 'tg Z A�� PROPOSED DEM ON� OCCUPANCYISSUEDSIGNATUREF
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