HomeMy WebLinkAboutX2021-1658 - Permitsrry
City of Newport Beach - Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
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Combination Type - BLDG PLUM
*X2021-1658*
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COMB Permit: X2021-1658
Project No : 0482-2021
Issued Date : 0711212021
Inspection Area :3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 07/12/2024 OR PERMIT WILL BE INVd
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: 1720 KINGS RD NB
Description: SFR (2) EXTERIOR 6' FIREPLACES
Legal Desc.: N TR 1221 LOT 15
Owner:
WERNER ERIC LAWRENCE
Contractor:
Address:
1720 KINGS RD
Address:
NEWPORT BEACH, CA 92663
Phone:
Phone:
Applicant:
OLSEN ERIC
Con State Lic:
Address:
2728 E COAST HWY, STE A
Lic Expire:
CORONA DEL MAR CA 92625
Bus Lic:
Phone:
949-837-8856
Lic Exp Date:
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:
Flood Zone: X
Construction Valuation: $5,000.00
Building Permit Fee: $161.00
Plan Check Fee: $140.07
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: $368.56
PROCESSED BY:
ZONING APPROVAL:
Let.1.1 N I P "A J 9 1.141T/_1 IF
LONGMAN CONSTRUCTION CO INC
Architect:
OLSEN ERIC
2782 CIRCLE DR
Address:
2728 E COAST HWY, STE A
NEWPORT BEACH CA 92663
CORONA DEL MAR CA 92625
949.722.7711
Phone:
949.887.8856 State Lic:C034489
393881
Engineer:
FORBES DALE L
08/31/2021
Address:
1800 E 16TH ST #B
BT00001921
SANTA ANA CA 92701
03/31/2022
Phone:
714-835-2800 State Lic:C-030407
Worker's Compensation Insurance
Carrier: STATE COMP INS FUND
Policy No: 9062475
Expire: 07/01/2022
Building Setbacks
Use Zone:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: 10
Front: 20
Left: 4
Right: 4
rking Spacf
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$14.49
0
Designer:
Address:
Phone:
Special Conditions:
Fire Hazard Zone : N
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
Plan Check Fee : $0.00
Fire Department
$52.00
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
Fee Due at Permit Issuance : $368.56
PUBLIC WORKS APPROVAL: t /
PLAN CHECK BY: �S
APPROVAL TO ISSUE: S�o J -
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, prier 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 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 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
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 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 legal
sell 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
Professions 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
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio s" of the Business and Prof ion "ayens is in full force
aaJ a,-fuut. License C:&ss License No Date Contractor Signature
CJMPENSATION DECLARATION
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
OMPENSATION. D4MAGES 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:
have and w;1l ri 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
mance of tho work for which this permit is issued. Policy No.
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'
carder, nd pclicy number are:
rdL r. _ Polic Number Expiratic
me of Agent _ _ _ _ - ,� / Phone #
Date
I certify that, in the prforman work fo5!�L
sued, I shall not employ any person in any manner so as to become subject to the workers' compensatio aws of alifornia, and agre
d, if I should beco a ub workers's of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /t /
(nature of Applicant Date
:CLARATION REGAkDKG MNSTROCTION 6WbING AGENCY
areby affirm under penalty of perjury that thereqs a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Co e).
nder's Name Lender's Address
my signature below, I certify to each of the following:
I am the property owner or authorized to act on tZprovid
s behal
I have read this application and the information I orreI agree to comply with all applicable city and couaws relating to building construction.
I authorize representatives of this city or countI tilled property for inspection purposes.
mature of Praoertv Owner or Authorized Ape Print Property Owner's or Authorized Agent's Name Da
ACTION DATE BY I DECLARATION DKOMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQM D RULE
1403
PERMITEXPIRED MITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
PERMIT EXTENDED el MD
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