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Home My WebLink AboutX2021-0337 - Permitswt City of Newport Beach - Building Division t 100 Civic Center Drive, Newport Beach, CA 92660 H Permit Counter Phone (949)644-3288 fiq Inspection Requests Phone (949)644-3255 Combination Type - BLDG PLUM IIIIIIIIIIII IIIIIIIIIIIIIIIII II COMB Permit: X2021-0337 Project No : 0881-2020 Issued Date : 0211612021 Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 02/17/2024 OR PERWT 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 Srtwt or Holidays Job Address: 434 GOLDENROD AVE NB Gt$D ription:: Description: DEMREAR UNIT OF DUPLEX MAR BLK 434 LOT SF) 1 BR WI GARAGE. SEWER CAP INCLUDED CORONA I�OG�w\� Owner: Address: INJEV VAL 16 SILVRFERN Contractor: GRAYSTONE CUSTOM BLDRSS``INC r Address: ress: VIA IBEACH IRVINE, CA 92 03 NEWPORT3419 CA 92663 Ili Phone: Phone: 94 A& State Lic: e- Engineve Applicant: INJEV VAL Con State Lie: 971 856-0900 jN Address: 16 SILVERFERN Lic Expire: 03131/2022 Address. IRVINE CA 92603 Bus Lic: BT30040057 Phone: Lic Exp Date: 03/3112021 Phone: State Lic: Code Edit : Type of Construction: Occupancy Group: Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 2 No of Units: 1 Bldg Height: 0 Bldg Sprinklers: 2019 Worker's Compensation Insurance V-B Carrier: STATE FUND R3IU Policy No: 9216106 0 Expire: 08/15/2021 0 Building Setbacks Rear: I Front: I Left: I Right: I Designer: Address: I '®�13.SPLCT R Phone: Special Conditions: TIGHT QUARTERS TO HAUL DEBRIS Flood Zone: Use Zone: Parking Spaces, 0 Fire Hazard cone : N Construction Valuation: $1,000.00 Building Permit Fee: $120.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $0.00 Additional Fee : Koo Plan check Fee: $0.00 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: $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 PAN Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $10.80 $0.00 TOTAL FEE : $131.80 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $131.80 --------- ..... . , PI IRI IC WORKS APPROVAL - ZONING APPROVAL: 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 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 (_) 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 n roved 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). 7 I am exempt from licensure 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, 1 cannot legall) 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://www.leginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Agent VUSAND .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 o Div' ion 3 of the Business and Pre, an my license is in full force nd effect. License Class License No Date Contractor Signal VORKERS' COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDROLLARS ($100,000), 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: I 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, F,? grmance of the work for which this permit is issued. Policy No. .at h v and will maintain workers' compe sation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatio ns ce carrier and poll numb are: A err' Policy Number Expiration Date ame of Agent Phone # :11 certify that, in the p ormanc a wo f ch this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compen Ation ews of California, and agre hat, if I should become j o th or ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. q , signature of Applicant •v ltf' 2 )ECLARATION REG I ONSTRUCTION LENDING AGENCY hereby affirm under ty f perjury that 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 3y my signature below, I certif to each of the followin . I am the property owner or thorized to act on t e prop rty ow er's behalf. I have read this application a d the informal! I ave pr vided s correc I agree to comply with all app able city and c u ty o anc ate laws relating to building construction. I authorize representatives of this city or count t r the e-identified property for inspection purposes. �G�/ 21,1( signature of Property Owner or Authorized Agent Print PropertyOwner's or Authorized Agent's Name lG Date 6 ACTION DATE BV ECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY R GULATIONS PART 61 OF TITLE 40 AND AQMD RULE 14 3 PERMITEXPIRED SUBMITTED ASBESTOS NOTIFICATION TO _ PERMIT CANCELLED PA PERMITEXTENDED ( QMD PERMIT FINAL U111 ASBEST S NXI'61CATION'14NOT APPLICABLE TO CERTIFICATE OF /f �� LITIO OCCUPANCY ISSUED _` SIGNA