HomeMy WebLinkAboutX2022-1482 - Permitst° City of Newport Beach - Building Division
G. 100 Civic Center Drive, Newport Beach, CA 92660
E:, •. �; Permit Counter Phone (949)644-3288
• ID Inspection Requests Phone (949)644-3255
Combination Type - SFP ELEC
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2022-1482
x 2 0 2 2 1 4 8 2 Project No : 0402-2022
Issued Date : 05/25/2022
Inspection Area : 5
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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
Jab Address: 332 EVENING CANYON RD NB
Description: DELTA 1- SFR *ADDITIONAL SCOPE* POWDER RM REMODEL 8: ELEC WORK
Legal Desc.: N TR 1116 LOT 69
m
Owner: LILJESTROM JASONICHRISTINA Contractor: VOGEL CHARLES M Architect: CHILDS CYNTHIA
Address: 332 EVENING CANYON RD Address: 1601 MANZANITA LANE Address: 2732 E COAST HWY #B 3
CORONA DEL MAR, CA 92625 MANHATTAN BEACH CA 90266 CORONA DEL MAR CA 92625 +J
Phone: Phone: 310-613-3602 Phone: 949-718-3528 State Lic:CO22985
Applicant:
ALSTON PAT
Address:
2732 E COAST HWY#B
NEWPORT BEACH CA 92625
Phone:
949-718-3528
Code Edit :
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 1
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Flood Zone:
11 Construction Valuation:
Con State Lic:
388241
Lic Expire:
03/31/2024
Bus Lic:
BT30054953
Lic Exp Date:
06/30/2022
2019 Worker's Compensation Insurance
V-B Carrier:
NO EMPLOYEES
R3IU Policy No:
0 Expire:
0
Building Setbacks
Rear: /
Front: /
Left: /
Right: /
Use Zone:
Parkinq Spaces: 0
Building Permit Fee: $127.00
Plan Check Fee: $110.49
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$10.00
Energy Compliance:
$0.00
CA Seismic Safety :
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $309.38
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
Fire
State Lic:
$0.00
Planning Department-
Fire Department
$0.00
Plan check Fee : $52.00
Fire Inspection:
$0.00
$0.00
Fair Share: $0.00
Fire Plan Rev
$0.00
$0.00
SJH Trans : $0.00
Demolition Fee
$0.00
In -lieu Housing Fee: $0.00
Building Dept Adm
$0.00
$0.00
Public Works Department-
General Service
$0.00
$0.00
Park Dedication : $0.00
Refund Deposit
$0.00
PAN Plan Check : $0.00
Grading Bond:
$0.00
$8.89
San Dist : $0.00
$0.00
NMUSD Fee: $0.00
$0.00
$0.00
$0.00
Plan Check Fee
: $0.00 Fee Due at Permit Issuance :
$309.38
PUBLIC WORKS APPROVAL:
_
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 U all of or U 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 ofY.e 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 o' property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
Lcrexempt frc:n ':censure under the Contractors' State License Law for the following reason:
(y my signature below Iacknowledge 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,
@5 a sfructure 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
� ofess:ons Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govicalaw.html.
;igoatu•e of Property Uvmer or Authorized Agent Date
:�CEMSED CONTRACTOR'S DECLARATION
,h?reh� affirm unuer penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section of Division 3 o the Business and Prof io Coe license is in full force
nd effec,. License :ass License No Date ntractor Signature
unRKERS' COMPENSATION DECLARATION
IV
'ARNING: FAILURE TJ SFUIIRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRE THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
OST OF COMPENSA-InN, D^.MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEV'S FEES.
hereby ^ffirm unr'er p=,,alty of perjury one of the following declarations:
I have and wi.; ,Tail,tain 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
formance of the 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' compensa
urance carrier and policy number are:
Policy Number
of Agent
Date
that, in the performance of the wor o hich 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
Iould become s )ect hew 'sR-previsierls-Df5ection-VU0 of the Labor Code, I shall forthwith comply with those provisions.
of Applican Date
1TION RF(:}�2f11�NCTIfIRTI[]N I FNr11NC: GrFNCV TTTiii���
Ireby 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, CiL(iI Code).
Ider's Name Lender's Address I
3y 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 county nces and a Ing to building construction.
I authorize representatives of this city or cou toe er e v d ified property for inspection purposes.
ii nature of Property Owner or Authorized Agen Print Property Owner's or Authorized Ag
ACTION DATE BYY JQECLAR4TION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED
I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
EPA
PERMIT EXTENDED
AQM D
PERMITFINAL
CERTIFICATE OF
OCCUPANCYISSUED
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ASBESTO IFICATIO IS NOTA AE
P OPOSED DE OLITION/� ,'�
SIGNATURE:
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