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Home My WebLink AboutX2021-1053 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit :X2021-1053 x 2 0 2 1 1 0 100 Civic Center Drive, Newport Beach, CA 92660 5 3 Permit Counter Phone (949)644-3288 Project No L,. Inspection Requests Phone (949)644-3255 Combination Type - BLDG Issued Date: 05/03/2021 Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, PROJECTS MUST BE COMPLETED BY 05/03/2024 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: 1627 CORNWALL LN NB Description: SFR -REPLACE STUCCO/INSULATION/LATH AROUND NEW ELECTRICAL PANEL Legal Desc.: N TR 3607 LOT 23 Owner: HASTINGS STU Address: 1627 CORNWALL LN Record Management: NEWPORT BEACH, CA 92660 Phone: $0.00 Applicant: HASTINGS STU Address: 1627 CORNWALL LN Hazardous Mat NEWPORT BEACH, CA 92660 Phone: $1.00 Code Edit: 2019 Type of Construction: V -B Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units: 1 Bldg Height: 0 Bldg Sprinklers: Construction Building Permit Fee: $110.00 Plan Check Fee: $0.00 Overtime Plan Ck: $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: $111.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: OWNER/BLDR Architect: Address: HASTINGS STU Address: Phone: 949-922.4646 Phone: State Lic: Con State Lic: OIB Engineer: Lic Expire: Address: Bus Lic: Park Dedication : Lic Exp Date: Phone: State Lic: Worker's Compensation Insurance Designer: Carrier: Address: Policy No: Refund Deposit Expire: Phone: , Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant: Grading Permit Fee: Grading PC Fee: WO Insp. Fee: Electrical W Mechanical %: Plumbing %: Rear: / Front: / Left: / Right: / Parkinq Spaces $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee Special Conditions: SEE ELEC21-0077 FOR 0/8 AUTH Planning Department - Fire Department Plan check Fee $0.00 Fair Share $0.00 SJH Trans Fire Plan Rev In -lieu Housing Fee: $0.00 Public Works Department - Park Dedication : $0.00 P/W Plan Check : $0.00 San Dist : $0.00 NMUSD Fee: $0.00 N $0.00 Fee Due at Permit Issuance : $111.00 cam asr ® s G PUBLIC!A O�KR APP.F?0VAL:® a G Goo c uow w PLAN CHECK BY: APPROVA`CT(MeSl4Ev:o c u- 0 %0 va¢ ucc a ooc uc uca G Fire Department $0.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $111.00 cam asr ® s G PUBLIC!A O�KR APP.F?0VAL:® a G Goo c uow w PLAN CHECK BY: APPROVA`CT(MeSl4Ev:o c u- 0 %0 va¢ ucc a ooc uc uca G 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 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 not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section d that 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 the 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 or improved 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 t property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). am exempt from licensure under the Contractors' State License Law for the following reason: By y signature below I acknowledge that, except for my personal reside ce in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal as a structure that I have built lean owner -builder if it has not been structed in i ntirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of t e Bu iness and ofessions Code, is available upon request when 's apple atitin Dr" th following Web site:http://v✓ww.leginfo.ca.gov/calaw.html. Dat I Z Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATIO I hereby affirm under penalty R perjury that I am licensed under provisions C pter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, an my license is in full force and effect. License Class License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION VARNICOMPENSATION,&LURETOSECURE OMPENSATON IOED ON GE ISF T E LABOR AND SHALL SUBJECT ST, AND ATTORNEY'S F ESCRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO TH COSTOFAMAGES AS PROVFOR IN SECT I 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 t performance 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 performance of the work for which this permit is issued. My workers' compensate insurance carrier and policy number are: .Rrrier Policy Number Expiration Date me of Agent I certify that, in the performance of the work for hich this perm' 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 t, if I should become subject to the wor rs` pensatI n ovis ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 3 Da ignature of Applicant DECLARATION REGARD& CONSTRUCTION LEN ENCY hereby affirm under penalty of perjury that there is const r ction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil ode . Ender's Name / Lender's Address y 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 tae laws �- IIlding construction. I authorize representatives of this city or county to enter the e ti d Popertyh P Inspection purposes. �,.� Date signature of Property Owner or Authorized Agent Print PropertOwner's or Authorized Agent's Name KTION DATE BY X DECLARATI N OF COMPLIWITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 QF Y LE 40 AND AOMD RULE 'I a mciinhlli-rfpnAMFcTnqtinTIFrATIONTO PERMITJEMENDED LZIvlu PERMIT FINAL -��—Zd/ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF -PROPOSED.DRAOLITIONi•• i OCCUPANCYISSUED SIGNATURE• • • • • • s