HomeMy WebLinkAboutX2021-0402 - PermitsI City of Newport Beach - Building Division
100 Civic Center Dri;a;.Nae iyport Beach, CA 92660
E, Permit Counter Phone (949)644-3288
u p Inspection Requests Phone (949)644-3255
° renu4`s Combination Type - SFP MECH ELEC PLUM
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COMB Permit: X2021-0402
Project No: 1370-2020
Issued Date: 02/2212021
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 02/23/2024 OR PERMIT WILL BE INV,
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: 219 NORTH STAR LN NB
Description: SFR DELTA 2 & 3, NEW STAIRS, NEW GUARD RAIL & NEW FIREPLACE (REV21-0069)
Legal Desc.: N TR 4224 LOT 104
Owner: CARR TIMOTHY
Contractor:
OWNERIBLDR
Architect:
Address: 136 ROCHESTER ST
Address:
AUTH AGENT:
Address:
COSTA MESA CA 92627
JENN LANZNER
Phone: 949-230-8454
Phone:
949-933-3306
Phone:
State Lic:
Applicant: WOOLBERT CRAIG
Con State Lic:
O/B
Engineer:
SILVA CHRISTINA
Address: 5622 LITTLER DR
Lic Expire:
Address:
24482 MUELA
HUNTINGTON BEACH CA 92649
Bus Lic:
MISSION VIEJO CA 92692
Phone: 714-856.2605 -
Lic Exp Date:
Phone:
949-795-6256 State Lic:C-037201
Code Edit: 2019
Workers Compensation Insurance
Designer:
WOOLBERT CRAIG
Type of Construction: V-B
Carrier:
Address:
5622 LITTLER DR
Occupancy Group: R3/U
Policy No:
HUNTINGTON BEACH CA 92649
Added /New sq.ft. Bldg: 0
Expire:
Phone:
714-856-2605
Added Mew sq. ft. Garage: 0
No of Stories: 2
Building Setbacks
Rear: 6
Special Conditions:
LIQUEFACTION AREA
No of Units : 1
Front: 10 (water)
Bldg Height: 0
Left: 6
Bldg Sprinklers: N
Right: 6
Flood Zone: X
Use Zone: Parkins Soaces: 0
Fire Hazard Zone : N
Building Permit Fee: $450.00
Plan Check Fee: $391.50
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$22.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.Q0
TOTAL FEE $1,000.75
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Excise Tax:
$0.00
Planning Department -
Fire Department
Additional Fee :
$0.00
Plan check Fee:
$46.25
Fire Inspection:
Grading Bonds Fee: -
$0.00
Fair Share :
$0.00
Fire Plan Rev
Grading PC Consultant :
$0.00
SJH Trans :
$0.00
Demolition Fee
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
$0.00
Building Dept Adm
Grading PC Fee:
$0.00
Public Works Department-
General Service
WQ Insp. Fee;'
$0.00
Park Dedication :
$0.00
Refund Deposit
PAN Plan Check:
$0.00
Grading Bond:
Electrical %:
$31.50
San Dist:
$0.00
Mechanical %:
$18.00
NMUSD Fee:
$0.00
Plumbing %:
$40.50
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0
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee: $437.75 Fee Due at Permit Issuance : $563.00
? J•3._IG'hNDK° hS APPROVAL:
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APPROVAL TO ISSUE:
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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 plabed 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 U 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 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
imyr&ed 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
app 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).
❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason:
By 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 legall;
sell a structure that I have built as an owner -builder "fit has no een constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7 of the Business and
Professions Code, is available upon request wh is appli ion is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized AgenA 15ate
LICENSED CONTRACTOR'S DECLARATION-
I hereby affirm under penalty of perjury that I am Iloensed under 4rovisions 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
VORKERS' COMPENSATION DECLARATION
'ARNING: 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 (5100,000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 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 th,
erformance 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' compensatior
Isurance carrier and policy number are:
:arrier Policy Number Expiration Date
lame of Agent Phone #
xcertify that, in the performance o h work for which this permI ued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree
Iat, if I should become subject to a orkers' bompensatio ro ' ' ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /
signature of Applicant Date - I
hereby affirm undd penalty oaf perjury th6t there is a Construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Ender's Name Lender's Address
iy my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property ow7snr/da
If.
I have read this application and the information 1 have proved co
I agree to comply with all applicable city and county ordina a ws re Ing to building construction.
I authorize representatives of this city or count)Ltoj6nter be party for inspection purposes. ,� I
Si nature of Property Owner or Authorized Agent
Print Property Owners or Authorized Agent's Na .✓1Zl/1P ( Me a, a
ACTION
DATE
BY
D LARATIO OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
R ULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMITEXPIRED
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PERMIT FINAL
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