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Home My WebLink AboutX2019-2155 - PermitsCity of Newport Beach - Building Division Plan Check Fee: $0.00 Permits X2019-2155 $0.00 Overtime Plan Ck IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Plan check Fee Investigation Fee: $0.00 $0.00 Record Management: $0.00 Grading PC Consultant: Energy Compliance: $0.00 IICOMB CA Seismic Safety: $0.00 In -lieu Housing Fee: Disabled Access :. 100 Civic Center Drive, Newport Beach, CA 92660 X 2 9 1 9 2 1 5 5 $0.00 PfOJBCt NO Building Green Fee ;. a Permit Counter Phone (949)644-3288 PAN Plan Check: $0.00 Electrical %: Inspection Requests Phone (949)644-3255 San Dist: Issued Date: 0711112019 Mechanical %: $0.00 Combination Type - SFP $0.00 - $0.00 Inspection Area : 4 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. 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: 42 MONTGOMERY N8 Description: SFR CHANGE OUT (5) DOORS Legal Desc.: N TR 15517 LOT 64n UV I ,.a Owner: UDKOFF COREY Contractor: RENEWAL BY ANDERSEN OF OC Architect`". Address: 42 MONTGOMERY Address: 22982 ALCALDE DR #100 Address: NEWPORT BEACH, CA 92660 LAGUNA HILLS CA 92653 Phone: Phone:. 714-259.5120 Phone: State Lie: r//t Applicant: RENEWAL BY ANDERSEN OF OC Con State Lie: 990416 Engineer: Address: 22982 ALCALDE DR #100 Lie Expire: 02/29/2020 Address:, Phone: LAGUNA HILLS CA 92653 Bus Lie: BT30046925 714-259.5120 - Date: Lie Exp 04/3012020 _ Phone: State Lie: Code Edit : 2016 Worker's Compensation Insurance Designer. Type of Construction: VB Occupancy Group: R31U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories:. 2 No of Units: 1 Bldg Height: 0 Bldg Sprinklers: Flood Zone: X Construction Valuation: $9,000.0 Building Permit Fee: $216.00 TOTAL FEE: $217.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Carrier: EVEREST NATIONAL Policy No: MWC31415800 Expire: 10/01/2019 Building Setbacks Rear: l Front: I Left: I Right: I Address: Phone: Special Conditions: Excise Tax: Plan Check Fee: $0.00 Planning Department - $0.00 Overtime Plan Ck $0.00 Plan check Fee Investigation Fee: $0.00 $0.00 Record Management: $0.00 Grading PC Consultant: Energy Compliance: $0.00 CA Seismic Safety: $0.00 In -lieu Housing Fee: Disabled Access :. $0.00 $0.00 Hazardous Mat $0.00 $0.00 Building Green Fee ;. $1.00 TOTAL FEE: $217.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Carrier: EVEREST NATIONAL Policy No: MWC31415800 Expire: 10/01/2019 Building Setbacks Rear: l Front: I Left: I Right: I Address: Phone: Special Conditions: Excise Tax: $0.00 Planning Department - $0.00 Additional Fee : $0.00 Plan check Fee Fire Plan Rev Grading Bonds Fee: $0.00 Fair Share Grading PC Consultant: $0.00 SJH Trans Grading Permit Fee: $0.00 In -lieu Housing Fee: Refund Deposit Grading PC Fee: $0.00 Public Works Department - WO 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 Plan Check Fee $0.00 Fee Due at Permit Issuance : $217.00 e o� 129131-1b WAbRft .,APPROVAL: < cfl4 o B 6 O PLAN CHECK BY: .��.v - y v W c AnkROa �%ALfd .SSUE: m Fire Department $0.00 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 Fee Due at Permit Issuance : $217.00 e o� 129131-1b WAbRft .,APPROVAL: < cfl4 o B 6 O PLAN CHECK BY: .��.v - y v W c AnkROa �%ALfd .SSUE: m 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 is 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 of more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or `) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 nprovements 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 nproved 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 pply 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). 7 1 am exempt from licensure under the Contractors' State License Law for the following reason: ly 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 legallt ell 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 (rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.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 0 ) of Divisi 3 of the Business and Pr es' ode,�nd my license is in full force nd effect. License Class License No Date Contractor Signatur VORKERS' COMPENSATION DECLARATION IARNING: 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 OST OF COMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 3705 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 th eyfbrmance of the work for which this permit is issued. Policy No. have and will TIN*orkers' comp ation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatiol trance carrier and tic umber are: Tier ic' um Expiration Date ne of Agent s Phone # certify that, in theAlt of the work f 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 agre t, if I should becomworkers' c mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 1'Ij//nlnature of Applicana a/ 1✓/CLARATION REGNSTRUCTION LENDING AGENCY :reby affirm underrjury 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 count ordinances and state laws relating to building construction. I authorize representatives of this city or county t en�r the -identified property for inspection purposes. �. n �l�1,.� n nature of Prouertv Owner or Authorized ADent "�f16 _ Print Property Owner's or Authorized Agent's e I w 1 V a 1 ACTION DATE BY I DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE 1403 •• e•s ••• ••s PERMITEXPIRED ISUBMITTEDASBES196NOT4FICATION.TO • • + • s PERMITCANCELLED 0EPA • • •• •• •• PERMITEXTENDED OMD PERMITFINAL ASBESTOS NOT( ATIO INAPPLICABLE TO CERTIFICATE OF p A q, \ ` 1'1 Ivl) PROPOSE DEMO( N•• • ••• •°• ••• -�/ �° OCCUPANCYISSUED ` J SIGNATUR •e ••• • • •• se e•e