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Home My WebLink AboutX2020-1096 - Permits (2)�w City of Newport Beach - Building Division *X2020-1096* COMB Permit: X2020-1096 100 Civic Center Drive, Newport Beach, CA 92660 Project No: 2571-2019 Permit Counter Phone (949)644-3288 u.. : Inspection Requests Phone (949)644-3255 Combination Type - SFP Issued Date : 12020 Area : �#Fe$ Inspection Area 1 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0510712023 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: 1025 W BALBOA BLVD NB Description: NEW SFR & GAR 3700 & 557 SF, COVERED PATIO 133 SF, COVERED ROOF DECK 716 SF & OPEN ROOF DECK 205 SF *change of engineer & designer"• Legal Desc.: TR 234 LOTS 17&18 BLK 10 Owner: KEILCH ROBERT Contractor: AMPLE CONSTRUCTION Architect: Address: 227 20TH ST, STE 100 Address: 3857 BURCH ST #333 Address: NEWPORT BEACH CA 92663 NEWPORT BEACH, CA 92660 Phone: Phone: 714-454-4305 Phone: State Lie: Applicant: KEILCH ROBERT Con State Lie: 957060 Engineer: MCCANN MAXWELL Address: 227 20TH ST STE 100 Lie Expire: 01/31/2021 Address: 1541 W AMERIGE AVE NEWPORT BEACH CA 92663 Bus Lie: BT30067810 FULLERTON AVE CA 92833 Phone: Lie Exp Date: 06/3012021 Phone: 714-803-6954 State Lic:C-077614 Code Edit : 2016 Workers Compensation Insurance Designer: Type of Construction: V-B-SPR Carrier: NATIONAL LIABILITY & FIRE Address: Occupancy Group: R31U Policy No: A9WC124628 Added /New sq.ft. Bldg: 3700 Expire: 07112/2021 Phone: Added /New sq. ft. Garage: 557 No of Stories: 3 Building Setbacks Rear: 0' Special Conditions: HIGH DENSITY AREA No of Units: 1 Front: 10' LIQUEFACTION AREA Bldg Height: 24 Left: 3' "change of engineer* Bldg Sprinklers: Y Right: 3' Flood Zone: X Use Zone: R-2 Parking Spaces: 2 Fire Hazard Zone : N Construction Valuation: $740,000.00 Building Permit Fee: $0.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $0.00 Additional Fee: $6.00 Plan check Fee : $0.00 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Investigation Fee: $0.00 Grading PC Consultant: $387.04 SJH Trans : $0.00 Demolition Fee Record Management : $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $84.96 Public Works Department - General Service $0.00 CA Seismic Safety : $0.00 WQ Insp. Fee: $0.00 Park Dedication: $0.00 Refund Deposit $0.00 Disabled Access : $0.00 P/W Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical W $0.00 San Dist: $0.00 Building Green Fee : $30.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $35.00 Plan Check Fee: $35.00 Fee Due at Permit Issuance: $0.00 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: _ PLAN CHECK BY: 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) 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 is 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). 1, 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, lusiness and Professions Cade: 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). 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 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 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 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 Irofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.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 my license is in full force nd effect. License Class License No Date Contractor Signature VORKERS' COMPENSATION DECLARATION IARNING: 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 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: 1 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 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 Date TIE of Agent Phone # certify 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 I, if 1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant Date_ CLARATION REGARDING CONSTRUCTION LENDING AGENCY :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). Ider's Name Lender's Address my signature below, I certify to each of the following: 1 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 the above -identified property for inspection purposes. nature of Prooertv Owner or Authorized Aaent Print Prooertv Owner's or Authorized AGent's Name _ Dale ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED I I I V I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT EXTENDED LJAQMD PERMITFINAL / ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO CERTIFICATE OF 13f� �� PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: