HomeMy WebLinkAboutX2021-1531 - Permitst�"nb�r City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
L ham,e Inspection Requests Phone (949)644-3255
t:,r,y a7 Combination Type - BLDG MECH PLUM ELEC
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2O21-1531
Project No : 1347-2021
Issued Date : 12121/2021
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 12/21/2024 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: 20282 RIVERSIDE DR NB
Description: COMM NEW DOG KENNEL BUILDING 443 SF
Legal Desc.:
Owner:
FRIENDS OF NB ANIMAL SHELTER
Address:
20282 RIVERSIDE DR
NEWPORT BEACH CA 92660
Phone:
714-6514221
Applicant:
DWYER MARK
Address:
1300 QUAIL ST #208
NEWPORT BEACH CA 92660
Phone:
949/8872292
Code Edit: 2019
Type of Construction:
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units : 0
Bldg Height: 0
Bldg Sprinklers:
Construction
Building Permit Fee: $1,660.00
Plan Check Fee: $1,444.20
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management :
$0.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.50
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$7.00
TOTAL FEE: $3,732.54
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor: SLATER BUILDERS INC
Address: 3100 - B PULLMAN STREET
COSTA MESA CA 92626
Phone: 714-615-6108
Con State Lic:
675832
Lic Expire:
08/31/2023
Bus Lic:
- BT30025319
Lic Exp Date:
02/2812022
Worker's Compensation Insurance
Carrier: CYPRESS INS COMPANY
Policy No: SLWC245302
Expire: 02/16/2022
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: /
larking Spa
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$217.29
$124.17
$279.38
0
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
°tr`'
DWYER MARK
3244 BROAD ST UNIT A
`^L '
NEWPORT BEACH CA 92660
949/887-2292 State Lio:CO23233
YAGHI SHUCRII
112 E. CHAPMAN #D
t,r
ORANGE CA 92866
714-997.9120 State Li¢C-043205
Special Conditions:
Planning Department -
Plan check Fee
Fair Share
SJH Trans
In -lieu Housing Fee
Public Works Department -
Park Dedication :
$0.00
P/W Plan Check :
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
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:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee : $1,233.74 Fee Due at Permit Issuance : $2,498.80
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION
I hereby affKm 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 U 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-Builderwill 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
apply 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 Iipensure under the Contractors' State License Law for the following reason:
By my signature :,el.,v/ ! 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
sell a st, ucture 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
Pfofessions Code, i= available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Cwner or Authorized Agent Date
,_K:ENSED CONTRACTOR'S DECLARATION
I hereby affirm u:Ider penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 o Di is' 3 of the Business and Pro i s C e s`e is in full force
an.: effect. Licei,e Gass License No Date Contractor Signatur
WORKERS' COMPENSATION DECLARATION
WARNINU: FAILURE TO SE'URE 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
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I n9reov affirm under penalty of perjury one of the following declarations:
❑ I have and V:11 mTintain 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
p�erf"o�rmance of fhe work for which this permit is issued. Policy No.
Dave 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
nsu nee carrier and policy number are:
rner Policy Number Expiration Date
Name of Agent Phone #
❑I 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 agree
that, if I should become s to th w ' co sat' revisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applica Date Z 2
DECLARATION RE A CONSTRUCTION LE D G AGENCY
I hereby affirm unde pe ty 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 c my ordinances and state laws relating to building construction.
I authorize representatives of this city or c my er ve- 'tied property for inspection purposes.
Signature Of Property Owner or Authorized Print Property Owner's or Authorized Agent's Na a Date 2
ACTION DATE e DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED MEPA
PERMIT EXTENDED QM D
PERMITFINAL ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
CERTIFICATE OF •�Ir3 PROPOSED DEMOLITION
OCCUPANCYISSUED SIGNATURE: