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Home My WebLink AboutX2021-2560 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 u z • Inspection Requests Phone (949)644-3255 ux Combination Type - BLDG PLUM "X2021-2560* COMB Permit: X2021-2560 Project No: 2219-2021 Issued Date : 09/23/2021 Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 09/23/2024 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: DEMO SFR 1391 SF (3 BEDROOMS) Legal Desc.: Owner: LANGFORD JONATHON Contractor: SLATER BUILDERS INC Architect: DWYER MARK Address: 20282 RIVERSIDE Address: 3100 - B PULLMAN STREET Address: 3244 BROAD ST UNIT A .. NEWPORT BEACH, CA 92660 COSTA MESA CA 92626 NEWPORT BEACH CA 92660 Phone: 949-322-5333 Phone: 714-615-6108 Phone: 9491887-2292 State Lic:CO23283 Applicant: BUTTS JENNIFER Con State Lic: 675832 Engineer: KIRK MATT Address: 3100-B PULLMAN ST Lic Expire: 0813112023 Address: 17520 NEWHOPE ST. STE 140 ' COSTA MESA, CA 92626 Bus Lic: BT30025319 FOUNTAIN VALLEY CA 92708 - Phone: 949-306-6662 Lic Exp Date: 0212812022 Phone: 714-460-7259 State Lic:C-051619 - Code Edit: 2019 Type of Construction: Occupancy Group: R3 Added /New sq.ft. Bldg: 0 Added INew sq. ft. Garage: 0 No of Stories: 0 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Flood Zone: Construction Valuation: $10 000.00 Building Permit Fee: $122.00 Plan Check Fee: $223.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management : $6.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $2,450.98 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Worker's Compensation Insurance Carrier: CYPRESS INS COMPANY Policy No: SLWC245302 Expire: 02/16/2022 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: / Front: / Left: / Right: / rking Spa $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.98 01 Designer: Address: Phone: Special Conditions: CERT MAIL RECEIPTS ATTACHED Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PNV Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department $104.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: Plan Check Fee : $0.00 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: $0.00 $0.00 $27.00 $265.00 $1,692.00 $0.00 $0.00 $0.00 $2,450.98 PLAN CHECK BY: 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 ie 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 'rofessions 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 of more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 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 Iicensure 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site: http:I1w. wu. leginfo.ca.gov/calaw. html. �igncture of Rcpert/ Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm Inder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with SectionPoo/f D io 3 of the Business and Pro n Ice a is in full force no effect. License Class License No Date� Contractor Signatur VOPKERS' CUMOENSATION DECLARATION IARNING: FAIL'IRE 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 CS7 OF COMF-NCATICV, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. h3-eby affirm under penalty of perjury one of the following declarations: I nave 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, erfo.mance of tha 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' r nce calner ano policy number are: Policy Number of Agent Date I certify that, in the perfor ance of the work forwhich 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 agre t, if I should become f 0 a \pensation provisions of Section 3700 of the Labor Cade, I shall forthwith comply with those provisions. . ��gq((//((JJ/J�� 71 nature of Applicann/ \ Da,-/ CLARATION RE ONSTRUCTION L ING AGENCY / (/ 3reby 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, Ci I Code). ider'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 the property owners behalf. I have read this application and the information I hav rovided is correct. I agree to comply with all applicable city and co ina ce d st ws relating to building construction. I authorize representatives of this city or coup o e h b n roperty for inspection purposes. mature of PmDertv Owner or Authorized Aaent. Print Property Owner's or Authorized Agent's Name)( /^" Dat G ACTION PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED DATE BY I REGULATIONS PPA TO 1 O TITTLE 40 A DCE WITH ODE OF AQMD RULE RAL FOR OFFICE USE ONLY I SUBMITTED ASBESTOS NOTIFICATION TO EPA PROPOSED 111i Complete item9c�{2, and 3. ■ Print your rame*and address on the reverse $o that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits.- 1. Article Addressed to: GurrenA- Properly owneT1gLQ 2U21\ K\�" Orli New�orl- �atchiCpr 9264D II I Illill ilil III I II IIIII II I I III II III I I I I III ill 9590 9402 4730 8344 7392 11 2. Article Number frmns(er /rom service labep 7018 0680 0001 7007 5141 PS Form.001 ].July 2015 PSN 7530-02-000-9053 ■ Complete items-It-2, and 3. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: Current+ Proper owner��eslc Lo2bl 141 1n 2 Drwl NewpDrA- C3Pach,CI+ 117-woa IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIN IIIII 9590 9402 4730 8344 7391 05 2. Article Number (rransferfrom service label) 7018 0680 0001 7007 5127 PS Form 3811, July 2015 PSN 7530-02-000-9053 X jp 1 1 l[ I V 1 ❑ Agent UW� ❑ Addressee B. Received by (Printed Name) C- Date of Delivery D. Is delivery addrp�s,-diT item 17 El Yes If YESr{%deliGbrS, fd'��syelow: ❑ No f ". " r ❑ Atlul I9g9natut re - ature ❑ Priority Mail Express® ❑ Registered MallTM esiri`tl Dell' V Cedliiii ❑ Registered Mail Restricted rl l@LI ❑ Certified Mail Restricted Delive Delivery Receipt for E, Collect on Deliveryry Merch e ise ❑ Collect on DeliveRestricted Delivery ❑ Slgnalureffi ConmatibnT" ❑ Insured Mail -1 Insured Mali Restricted Delivery tnver Sari ❑ Signature Confirmation Rsstrcted Dellvary Domestic Return Receipt n, oignas re X V 1"t l.l' \ l/"' ❑ Agent ❑ Addressee B. Received by (Printed Na e L+l AO, `qf Delivery IR D. Is delivery addre 4]�fere from item 17 IN If YES, enter d ,iefy a dress below: : ❑ - 0 Go_ CP " 2021 Service Type El \(jiprPr)ority Mail Express® ❑ Adult Signature _ ❑ Registered Mail. ❑ Adult Signature Restricted Delivery ❑ Registered Mal Restricted V Certified Mall® Delivery ❑ Certified Mail Restricted Osilvery >iReturn Receiptfor 11 Collect on Delivery Merchandise ❑ Collect on Delivery Restricted Delivery ❑ Signature ConflrrnationTa 11 Insured Mail ❑ Signature Confirmation ❑ Insured Mall Restricted Delivery Restricted! Delivery Domestic Return Receipt a ■<Complete items 1, 2, and 3 ■>Print your name and address on the reverae� so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: TI-7ie Db� Park I hr) Zb20I2 F-iverslde. Drive, NCw�rk gcach,cr� gzelo '""'""""I 1119IIII III II IIIII IIIII III 9590t9402114730 8344 7391 98 2. Article Number (rrans(er from service label) 7018 0680 0001 7007 57f65 PS Form 3811, July 2015 PSN 7530-02-000-9053 CAI B. Received b (Pyinied ams) C. Pj E'': D. I qg 10eryry�dTm— e B nt on kern 1, 'U21 3. SerNEe Typed-- A pdodr ❑ Adult SiOqq��tur ❑ Adult Signahre Ei`siricted De�ery ❑ Reegist dGail reci Mail® gist Deliver �j Certified Mail Restricted Delivery IL Return ❑ Collect on Delivery March. ❑ Collect on Delivery Restricted Delivery ❑ Signal ❑ Insured Mall ❑ Signal ❑ Insured Mail Restricted Delivery Restric m a �KV `s a° alpC -I m m c e ml'r 1iZ t � v2 E E c _ to m m y v c m Me ti5,im r\ v «s�El❑❑ElOa .n I° ,n rnV lye WST5 ZOO? TOOO 0990 91CO? Domestic