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Home My WebLink AboutX2021-1643 - PermitsCity of Newport Beach - Building Division rki 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 v Inspection Requests Phone (949)644-3255 Combination Type - BLDG IIIIII�IIIIIIIIIIIIIIIIIIIII II COMB Permit: X2021-1643 x 2 0 2 1 1 6 4 3 Project No : 2160-2020 Issued Date: 06/24/2021 Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 06/24/2024 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: 1375 DOVE ST NB St: 1 3 Unit: 300 R Description: DELTA 1 STRUCTURAL ROOF TOP PLATFORM FOR A/C UNIT (REV21-0982) Legal Desc.: Owner: PALM SPRINGS VILLAGE & 309 LLC Address: 2922 DAIMLER ST SANTA ANA CA 92705 Phone: Applicant: BLANK JOEL Address: 10474 SANTA MONICA BLVD STE 302 LA CA 90025 Phone: 310-415-1824 Code Edit: 2019 Type of Construction: Occupancy Group: U Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 0 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Construction Valuation: $25 000.00 Building Permit Fee: $501.00 Plan Check Fee: $435.87 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $20.00 Energy Compliance: $0.00 CA Seismic Safety : $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $1,131.62 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: 1J Contractor: TURELK INC Architect: BLANK JOEL Address: P O BOX 93101 Address: 10474 SANTA MONICA BLVD #302 LONG BEACH CA 90810 LOS ANGELES, CA 90025 rn Phone: 310-835-3736 Phone: 310-415-1824 State Lic:CO25176 �y Con State Lic: 372562 Engineer: STOVNER ERIC Lic Expire: 04/30/2023 Address: 1350 CORONADO AVE ®�1 Bus Lic: BT30073234 LONG BEACH CA 90804 (ArA1 Lic Exp Date: 10/3112021 Phone: 310-530.3050 State Lic:S-004204 � Worker's Compensation Insurance Designer: Carrier: HARTFORD INS Address: Policy No: 72WEAQT9653 Expire: 08/14/2021 Phone: Building Setbacks Rear: / Special Conditions: Front: I Left: / Right: / Use Zone: Parkinq Spaces: 0 Fire Hazard Zone : N Excise Tax: $0.00 Planning Department - Additional Fee : $127.50 Plan check Fee Grading Bonds Fee: $0.00 Fair Share Grading PC Consultant : $0.00 SJH Trans Grading Permit Fee: $0.00 In -lieu Housing Fee Grading PC Fee: $0.00 Public Works Department - WQ Insp. Fee: $0.00 Park Dedication : $0.00 PAN Plan Check: $0.00 Electrical %: $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 Plai -Check Feel: - Fire Department $46.25 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 $639.62 Fee Due at Permit Issuance : $522.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: WE I 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 L) 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://vnwv.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 Section 70 ) pf Division 3 of the Business and Profes ons CodP�a�d my license is in full force and effect. License Class License No Date Contractor Sign (rf WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE 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 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: 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 m of the work for which this permit is issued. Policy No. have and will m In workers' compensation insurance, as required rance carrier an olic number are: /`i .. �� of Agent Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' Date certify that, in the performance of the work foir t 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 if I should become sub' ct to the w rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. iature of Applicant _ Date I,), —6 -1 ARATIn IJ rf ZAR rV1NC RI If:TI(1N I FNfIIN(: Ar F:NCV 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 Lender's 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. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and count ordinances and state laws relating to building construction. I authorize representatives of this city or cou t enter the above -identified property for inspection purposes. \, _ Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name _Ie- Date ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIREDLJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT EXTENDED LJAQM D PERMIT FINAL ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATE OF L / / / PROPOSED DEMOLITION OCCUPANCY ISSUED (�J(� SIGNATURE: