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Home My WebLink AboutX2021-2985 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - SFP X 2 0 2 1 2 9 6 5�� II 1 COMB Per it:=X2021-2985 Project No : 04 - Issued Date : 11/03/2021 Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1110312024 OR PERMIT WILL BE INVALID 916'nstr ction 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: 436 NDOZA R NB Description: SF (DELTA 5-A H, 2-STRUC) NEW HIP ROOF @ (E) GARAGE (REV21-1721) Legal Desc.: TR 1237 LOT 5 flm Owner: 436 DOZA INVESTMENT LLC Contractor: KEYSTONE D C S INC Architect: Address: 436 MENDOZA TER Address: 9140 TRASK AVE Address: g, CORONA DEL MAR CA 92625 GARDEN GROVE CA 92844 5� Phone: 949-274-3761 Phone: 714-791-3771 Phone: State Lie: Applicant: HILL MALLORY P Address: 436 MENDOZA TER CORONA DEL MAR CA 92625 Phone: 949-371-3573 Code Edit : 2019 Type of Construction: V-B Occupancy Group: R3/U Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 2 No of Units: 1 Bldg Height: 0 Bldg Sprinklers: Y Flood Zone: Construction Valuation: $10,000.00 Building Permit Fee: $246.00 Plan Check Fee: $214.02 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $24.00 Energy Compliance: $0.00 CA Seismic Safety : $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $537.02 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Con State Lie: 1013293 Lie Expire: 04/30/2022 Bus Lie: BT30076080 Lie Exp Date: 07/31/2022 Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9157538 Expire: 04/21/2022 Building Setbacks 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: / $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Engineer: CHRISTIAN DALE Address: 1744 W KATELLA AVE #107 ORANGE CA 92667 Phone: 714-997-1145 State Lic:S-002705 Designer: NGUYEN TIMOTHY Address: 2961 W MAC ARTHUR BLVD SANTA ANA CA 92704 Phone: 714-883-6001 Special Conditions Fire Hazard Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication: $0.00 PAN Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department $52.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: LU CL (J) Z $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee : $266.02 Fee Due at Permit Issuance : $271.00 PU3LIC 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 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 L) all of or (_) 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 improved 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: 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 the Business and Professions 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 Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7 00 of Divisi n 3 of the Business and Profn�s Code,and my license is in full force and effect. License Class License No Dat Contractor Signaturr q�I4 ` �tA O7 WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN L PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑,,1Ihave 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 pe4rmance of the work for which this permit is issued. Policy No. have and wiVinitdntain workerompensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' rance carrier nd licv numb€tar¢ is of Agent`_ certify that, in the performance of , if I should became su ject to the Date work for which 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 'kers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicanr ^ A I a --p - C 9.4-15- D if ( /o :t. /2-r CLARATION REGAtli CONSTOUCTIOlt LENDING AGENCY Ireby affirm under p nalty 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 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 ordinances and state laws relating to building construction. I authorize representatives of this city or c unt ttoolenntter..the above-identifie property for inspection purposes. nature of Prooertv Owner or Authorized Alaen,rT --crn L,t<�1 Print Property Owner's or Authorized Agent's Nal'T, M a1LFv( rl,�-f�Y (��03�,�.a ACTION PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED DATE BY( XATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY 7REGU 'TIONS PART 610E TITLE 40 AND AQMD RULE 1403 I SUB ITTED ASBESTOS NOT: F;CATION TO EPA Q D HZ Illk NOTIFICATION IS NOTAPPLICABLE TO