HomeMy WebLinkAboutX2021-1449 - Permits`MrTr,T City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2021-1449
100 Civic Center Drive, Newport Beach, CA 92660 x 2 0 2 1 1 4 4 s Project No : 2106-2019
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - SFP Issued Date :
" Inspection Arearea :2021
5
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0610812024 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: 620 CARNATION AVE NB
Description: SFR INCR SCOPE OF WORK (REV21-0736)DELTA 3, 4, 5, 6 (ARCH). DELTA 4, 5, 6 (STRUCT) -ADDED SCOPES: TO RECONSTRUCT (E) ROOF OVER BEDRMS/BATHRMS 2 8 3,
Legal Desc.: CORONA DEL MAR BILK 531 LOT 22 FOR ABAND ST
Owner:
SHULL KEITH 8: JEANETTE
Address:
520 CARNATION AVE
CORONA DEL MAR, CA 92625
Phone:
Applicant:
OLSON DAVID ROLF
Address:
470 WALD
IRVINE, CA 92618
Phone:
949-450-0093
Code Edit : 2016
Type of Construction: V-B
Occupancy Group: R3IU
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 2
No of Units : 1
Bldg Height: 24
Bldg Sprinklers: N
Construction
Building Permit Fee: $679.00
Plan Check Fee: $0.00
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 :
$2.00
TOTAL FEE: $792.75
PROCESSED BY:
ZONING APPROVAL: r�Y'
GRADING APPROVAL:
Contractor:
HILTON BUILDERS
Address:
425 31ST ST
NEWPORT BEACH CA 92663
Phone:
949-673-4128
Con State Lic:
316788
Lic Expire:
05/31/2021
Bus Lic:
BT00014142
Lic Exp Date:
02/28/2021
Worker's Compensation Insurance
Carrier: FALLS LAKE FIRE AND CASUALTY
Policy No: FLA00537103
Expire: 05/07/2021
Architect: OLSON DAVID ROLF
Address: 470 WALD
IRVINE, CA 92618
Phone:
949-450.0093 State Lic:C019424
Engineer:
EOSAKUL DISSAKORN
Address:
15 STUDEBAKER
IRVINE CA 92618
Phone:
949-752-1612 State Lic:S-005226
Designer:
Address:
Phone:
Building Setbacks Rear: 2.5' Special Conditions: HIGH DENSITY AREA
Front: 4' !!l... %-rO R
Left: 4' ISP � t1.JR
Right: 4'
Use Zone: PC-29 Parkino Spaces: 2 Fire Hazard Zone : IN _.
Excise Tax:
$0.00
Planning Department-
Fire Department
Additional Fee :
($315.25)
Plan check Fee :
$0.00
Fire Inspection:
$0.00
Grading Bonds Fee:
$0.00
Fair Share :
$0.00
Fire Plan Rev
$0.00
Grading PC Consultant :
$0.00
SJH Trans :
$0.00
Demolition Fee
Grading Permit Fee:
$232.00
In -lieu Housing Fee :
$0.00
Building Dept Adm
$0.00
Grading PC Fee:
$195.00
Public Works Department -
General Service
$0.00
WQ Insp. Fee:
$0.00
Park Dedication : $0.00
Refund Deposit
$0.00
PAN Plan Check : $0.00
Grading Bond:
$0.00
Electrical %:
$0.00
San Dist: $0.00
Mechanical %:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00
$0.00
Plan Check Fee
: $0.00 Fee Due at Permit Issuance :
$792.75
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(:)an
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 applict for
he 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
lot more than five hundred dollars ($500).
J 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,
3usiness 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
mprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-Builderwill have the burden of proving that it was not built or
mproved 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).
1 am exempt from licensure under the Contractors' State License Law for the following reason:
3y 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
Zell 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
Drofessions Code, is available upon request when this application is submitted or at the following Web site:hftp://w .leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent Date
_ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 ) ofl9ivi ' 3 of the Business and Profe s od n li a is ful orce
and effect. License Class License No Day L�j^ Contractor Signatur
NORKERS' COMPENSATION DECLARATION �/11
VARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNORE THOUSAND DOLLARS ($100,[100), 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 thr
i o ce of the work for which this permit is issued. Policy No.
I Eve 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' compensatior
ns rance carrier and policy number are:
)arrier Policy Number Expiration Date
Jame of Agent Phone #
:1I Certify that, in the performInca of the h" e h not employ any person in any manner so as to became subject to the workers' compensation laws of California, and agree
hat, if I should become/subje to ylR�j rl r�IS' co a a' visi Sect]
n 00 of the Labor Code, I shall forthwith comply with those provisions. / +�•1� 6
Signature of Applicant A� �%�y/e�77/
)ECLARATION REGARDING C STRUCTION LENDING AGENCY
hereby 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).
-ender's Name Lender's Address
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 Aconor Iatin to building construction.I authorize representatives of this city or coun r t a o -i i rty f r inspection purposes. S -" -
signature of PropertyOwner or Authorized Agent Print Property Owner's or Authorized Agent's Name Date
ACTION DATE BY DECIARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 51 OF TITLE 40 AND AQMD RULE
1403
PERMITEXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO _
PERMITCANCELLED UEPA
PERMITEXTENDED QMD
PERMITFINAL OASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
CERTIFICATE OF / _ZWR=ED DEMOUTION
OCCUPANCYISSUED ( SIGNATURE: -