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HomeMy WebLinkAboutX2021-2763 - PermitsCity of Newport Beach Community Development Department - Building Division. 100 Civic Center Drive, Newport Beach, CA 92660 f✓, Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 newportbeachca.gov/inspections Combination Type - SFP ELEC MECH PLUM Work Class -Addition/Alteration Ii,In - "<r *.r-) Ii�.; b �� et i COMB Permit: X2021-2763 Plan Check No : 2407-2021 Issued Date ; 10/1112022 Inspection Area : 1 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 612 CLUBHOUSE AVE Legal Desc : A TR CANAL SECTION BLK 634 LOT 7 CANAL SECTION LOT 7 BLK 634 ALL -INC POR ALLEY Description: SFR -ADD 204 SF (1ST FL LAUNDRY & 2ND FL BEDROOM/DEN). 166 SF DECK W/ STAIRS W/DRAINAGE 'STOP WORK' Owner: AGARWALDIVYA Address : 612 CLUBHOUSE AVE NEWPORT BEACH, CA Phone: (949)419-7659 Applicant: MAGGIESALIB Address : 24310 MOULTON PKWY, 0-105 LAGUNA HILLS, CA 92637 Phone: (714)717-7788 Owner/Builder: AGARWAL DIVYA Address: 612 CLUBHOUSE AVE NEWPORT BEACH, CA Phone: (949)419-7659 Contractor Address : Phone: Con State Lic Lic Expire Bus Lic : Bus Lic Expire Workers' Compensation Insurance Carrier: Policy No W. C. Expire: Architect: Address : Phone: State Lic Engineer: BENJAMIN AMGAD SAMWEL Address: 24310 MOULTON PKWY #0-105 LAGUNA WOODS, CA 92637 Phone: (949) 446-1417 Designer: Address : Phone: Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $60,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 204 Occupancy Groups : U,R-3 No of Units : 1 Alteration sq. ft. Bldg : Bldg Height: No of Stories : 2 Added/New sq. ft. Garage: 0 TOTAL sq. ft. Bldg : 204 Building Setbacks : Front: 5, Side: 3, Side: 3, Rear: 5 Flood Zone: X Use Zone : R-2 - Two -Unit Residential NO CONSTRUCT19N NO SC PROCESSED BY SPECIAL CONDITIONS: HIGH DENSITY ZONE ON THE WEEKEND 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 items) (Section 7031.5. Business and Professions Code: Any city or county that requires a permit to construct, after. improve, demolish, or repair any SWcture, 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 licensors 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 ore than five hundred dollars (Iffi Or 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 EFuroved for the purpose of sale). 3 i, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044. Business and Professions Code: The Contractors Stale 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' Stale License Law). ❑ 1 am exempt from licensure under the Contractors' Stale License Law for he following reason: By my signature below I acknowledge that, except for my personal resident n whit must have resided for al least one year prior to completion of the Improvements covered by this permit I cannot legally sell a structure that I have built as an owner -builder If it rgNnot been constm tad m it ntirely by licensed contractors. I understand that a copy of the applicable law, Section 7044 of h Business and Professions Coda, is available upon request when this pp anon is sub, mi t d or at t following Web site:htip:!lwww.leg[nfo.ca.govlcaiaw.htmi. Signature of Property Owner or Authorized Agent i, __ Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty 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 Class License No Date Contractor Signature WORKERS" COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL Fall UP TO ONE HUNDRED THOUSAND DOLLARS flilrir i, IN ADDmON TO THE COST OF CC MPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEn EST, AND ATTORNETS SEES. I hereby affirm under penalty of perjury one of the following declarations: 111 have and will maintain a cerlificate of consent to self -insure for workerscompensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for in performance of the work for which this permit is issued. Policy No, ©1 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' compensahoi insurance carrier and policy number are: Carrier Policy Number Expiration Date Na of Agent Phone # I certify that m the perform f the work for whit thi ermit 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 that, if I should become suble� the workers comp sat n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant .--- _.------ .._ ....., . ..., __ __..___._.-..__._.,„_.._.__._.___-.____.,_......__............. Date__— / ____.._.._. DECLARATION REGARDINO RUCTION L ING AGENCY.___,_ ,......_.._..._,__�..w I 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). Lender's Name Lenders Address By 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, 1 have read this application and the information I have 'Poyidep is correct. I agree to comply with all applicable city and Sou rdinanc an tale laws relating to building construction. p 1 [ ` ' to I I authorize representatives of this city or county o n r he ove am fied property for inspection purposes. 1 vl l Signature of Property Owner or Authorized A aril Print Property Owner's or Authorized ears N Date ACTION DATE By XCLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY L RFGUI ATI ONS PART 61 OF TITLE 40 AND AOMD RULE. 1403 PERMITEXP'PEC Olskwrttli FDASBF.STOS NOTIFICATION TO F RNiIi CANCELlEP CPA PERMIT EX'FNOEC AID MD_ _ r r. F RM1MT FINAL i EST05 NO71F1 ON IS JOTPLICABLE TCERTf ICAL. OF PROPOSED BEMOLI ^pCCUPANCrdJUtO SIGNATURE: /�