HomeMy WebLinkAboutX2021-2006 - PermitsCity of Newport Beach - Building Division
`X2021-2006"
COMB Permit: X2021-2006
100 Civic Center Drive, Newport Beach, CA 92660
ft I ® t'i
Project No: 1755-2021
Permit Counter Phone (949)644-3288�,f
.,.
Inspection Requests Phone (949)644-3255
Issued Date: 11/09/2021
Combination Type - SFP GRAD PLUM ELEC MECH
Inspection Area : 2
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST SE COMPLETED BY 1110912024 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: 2001 SEADRIFT DR NB
Description: SFR ADD 884 SF, REMODEL 2596 SF
Legal Desc.: N TR 2813 LOT 17
Owner: MAYA SALOMON/SAMANTHA
Contractor:
OWNER/BLDR
Architect:
Address: 2001 SEADRIFT DR
Address:
MAYA SAMANATHA Address:
CORONA DEL MAR, CA 92625
Phone:
Phone:
310-738-5629
Phone: State Lic:
Applicant: SAMANTHA/FLORE RAUL
Con State Lic:
O/B
Engineer: CARRILLO JESUS EDUARDO
Address: 1325 SHEPPARD DR
Lic Expire:
Address: 1412 ESPANOL AVE
FULLERTON CA 92831
Bus Lic:
MONTEBELLO CA 90640
" n
Phone: 323-637-5154
Lic Exp Date:
Phone: 562-708-3586 State Lic:C-077737
Code Edit: 2019
Worker's Compensation Insurance
Designer: FLORE RAUL
_ ..
Type of Construction: V-B
Carrier:
Address: 1325 SHEPPARD DR
-
Occupancy Group: R3/U
Policy No:
FULLERTON, CA 92831
Added /New sq.ft. Bldg: 884
Expire:
Phone: 323-637-5154
Added /New sq. ft. Garage: 0
"
No of Stories: 1
Building Setbacks
Rear: 1 U
Special Conditions: O/B FORM ATTACHED
No of Units : 1
Front:
Bldg Height: 0
c1 /O
Left: 1
Bldg Sprinklers:
Right: L/
_
Flood Zone:
Use Zone: Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $420,000.00
Building Permit Fee: $4,194.00
Excise Tax:
$0.00
Planning Department - Fire Department
Plan Check Fee: $3,298.63
Additional Fee :
$0.00
Plan check Fee : $208.00 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 :
$0.00
SJH Trans : $0.00 Demolition Fee
Record Management: $46.00
Grading Permit Fee:
$237.00
In -lieu Housing Fee: $0.00 Building Dept Adm
$27.00
Energy Compliance: $294.00
Grading PC Fee:
$199.00
Public Works Department - General Service
$265.00
CA Seismic Safety : $54.60
WQ Insp. Fee:
$0.00
Park Dedication : $0.00 Refund Deposit
$564.00
Disabled Access : $0.00
PAW Plan Check : $101.50 Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical W
$293.58
San Dist: $1,016.00
Building Green Fee : $17.00
Mechanical %:
$167.76
NMUSD Fee: $1,626.56
$0.00
Plumbing %:
$377.46
$0.00
IITOTAL FEE: $12,987.09 Plan Check Fee : $3,922.37 Fee Due at Permit Issuance : $9,064.72 --
��
PROCESSED BY: 7
%� PUBLIC WORKS APPROVAL: _
ZONING APPROVAL: l ' 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 checurnwk(s) i h5Ve 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 -Builder will have the burden of proving that it was not built or
AImp o!"an
d for the purpose of sale).
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
p 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 legall•,
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 h Bu ness and
Professions Code, is available upon request when s ��II'''',,,�...���111FI I bmitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. 11 4 Z
Signature of Propartv Cwner or Authorized Agent K Date l I
LICENSED CONTRF.CTOR'S DECLARATION
I ha. cty affirm urder pcnaty 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
and effect. License Glass License No Date Contractor Signature
CONIPENSATION DECLARATION
rARNING: FAILURE "C FF-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
'GST Or COMPENSATION, LAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
herr by affirm under penalty of perjury one of the following declarations:
I ha,,e and will miintain 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
enormance of the work for which this permit is issued. Policy No.
I hay.; and wit' ma r.`.ain workers' compensation insurance, as required by Section 370G of the Labor Code, for the performance of the work for which this permit is issued. My workers'
urance carrier and policy number are:
of Agent
Policy Number Expiration Date
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' compensatio laws of California, and agre
it, if I should become subject to the wo ers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 1� 1
(nature of Applicant Date .0 1
ICLARATION REGA D ONST UCTION LENDING AGENCY �7-'�
=_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:
I am the property owner or authorized to act on the property owners 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 cour4ylo NtcK thplaggyA identified property for inspection purposes. y ] /1 , n _ 1 L I
of Property Owner or AL
DATE
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFIC4TEOF
OCCUPANCY ISSUED
OF COMPLIANCE WITH CODE OF FEDERAL
PART 61 OF TITLE 40 AND AQMD RULE
I SUBMITTED ASBESTOS NOTIFICATION TO
EPA
NOTIFICATION 15 NOTAPPLICABLE TO
FOR OFFICE USE ONLY
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