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Home My WebLink AboutX2021-1659 - Permitsxt' v City of Newport Beach - Building Division COMB Permit: X2021-1659 100 Civic Center Drive, Newport Beach, CA 92660 Project No: 0362-2021 Permit Counter Phone (949)644-3288 'L C Inspection Requests Phone (949)644-3255 Combination Type - BLDG ELEC Issued Date : Inspection Arearea :2021 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0711612024 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: 1723 TERRAPIN WAY NB Description: SFR DELTA 2 -ADD OUTDOOR PATIO HEATERS Legal Desc.: N TR 3097 LOT 26 �F g/�• Owner: HAWKINS DANIELISARAH Contractor: OWNER/BLDR Architect: V T� Address: 1723 TERRAPIN WAY Address: Address: NEWPORT BEACH CA 92660 Phone: Phone: Phone: State Lic: Applicant: OLSON LINDSAY Con State Lic: O/B Engineer: WICKSTROM ERIC Address: 267 MAGNOLIA ST Lic Expire: Address: 28581 VIA PRIMAVERA COSTA MESA CA 92660 Bus Lic: SAN JUAN CAPISTRANO CA 92675 Phone: 949-370-7759 Lic Exp Date: Phone: 949-454-8045 State Lic:S-003989 Cade Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: Carrier: Address: Occupancy Group: U Policy No: Added /New sq.ft. Bldg: 0 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: / Special Conditions: SEE REV21-0916 FOR No of Units : 0 Front: / PLAN CHECK FEES Bldg Height: 0 Left: / Bldg Sprinklers: Right: / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone ' N Construction Valuation: $600.00 Building Permit Fee: $110.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $0.00 Additional Fee : $0.00 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 PNV Plan Check : $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $7.70 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $118.70 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $118.70 PROCESSED BY: PUBLIC 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 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). 111, 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 irpproved for the purpose of sale). brtul 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). ❑ I 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 legally 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 BusinesL! and Professions Codc, it available upon request when this applica,�gg�is�alybmitte�e following Web site:http://www.leginfo.ca.gov/calaw.htmi. Da j �l % Signature of Prbperty Gwner or Authorized Agent / �/ / '_'CEN9ED 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 sin full force alld effect. License Class License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION !NARNINC.: FAILURc TJ u_CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE SOS- r F COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. S�re')y affirm.unller penalty of perjury one of the following declarations: ,lave 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 .,, ,,ante of the work for which this permit is issued. Policy No. have and will Iaotain 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' compense raoce carrier and policy number are: Policy Number of Agent Date certify that, in the performance of the 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 if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions, nature of Applicant Date CLARATION REGARDING CONSTRUCTION LENDING AGENCY :reby 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). Idler'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 county t nt/0r/y}��e�abo^ve-identifie roperty for inspection purposes. / nature of Propertv Owner or Authorized Agent r 72 I/ V Print Property Owner's or Authorized Aqent's Namk' ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMITEXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED DEPA PERMIT EXTENDED LJAQMD PERM17FINAL CERTIFICATE OF OCCUPANCY ISSUED / _ Y ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO PROPOSED DEMOLITION SIGNATURE: