HomeMy WebLinkAboutX2016-1508 - Permitscwt City of Newport Beach - Building Division
ab$ = 100 Civic Center Drive, Newport Beach, CA 92660
F ,permit Counter Phone (949)644-3288
` n Inspection Requests Phone (949)644-3255
�^rcrsrru's Combination Type - SFP ELEC PLUM
*X20161508*
COMB Permit: X2016-1508
Project No : 1105-2016
Issued Date : 02116/2017
Inspection Area : 8
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
INSTALL OR VERIFY SMOKE/CARBON MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED
Job Address: 20192 BAY VIEW AVE NB
Description: SFR -CONVERT OFFICE INTO BATHROOM
Legal Desc.: N TR 1507 LOT 30 /�
Owner: BLAYLOCK CINDY Gontracto . jd' ILS jO BING Architp�t'
Address: 20192 BAY VIEW AVE Cha Address � V l20352�e� IFS,,..At[€IJWre Addre�§:��piicai3l�:
NEWPORT BEACH, CA 9266 NEWPORT BEACH 92660
Phone:
Applicant:
WILT CHRIS
Address:
3797 CARLOS CT
Occupancy Group:
CHINO CA 91710
Phone:
909.240-9539
Code Edit:
2013
Type of Construction:
VB
Occupancy Group:
R3/U
Added /New[TI sq.ft. Bldg:
0
Added /New sq. ft. Garage: 0
No of Stories:
1
No of Units :
1
Bldg Height:
0
Bldg Sprinklers:
Flood Zone:
ee:
Construction Valuation:
$8.000.00
Building Permit Fee:
$180.00
Plan Check Fee:
$212.60
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management :
$2.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $537.90
PROCESSED BY:
ZONING APPROVAL:
Phone 49-NO7 Phon� 8�J�/D or C7 100D.�tarnhind
Co tate ic: 12 Engineer:
Lic pire 1 reto whom:
Bus B
Lic Exp Date: 01/31/2018 Phone: State Lic:
rmw,ftker's 'o s I R Q'Ig
ner:
Car X ens:
e:
Building Setbacks Rear: / Special Conditions:
�j^-�� Front: / y��yg j'`� ;v�r�
R Left
n L3
(workstarted)
Excise Tax: $0.00
� Qdit�ional Fee : $0.00
Planning Department -
Plan check Fee :
ti lU VVV1IN Z)lfAl LUU
Fire Department '. .
$37.50 Fire In a ti
g Bondc Fr
e4^_
Fire Plan Re
Grading PC Consultant :
$0.00
SJH Trans :
$0
�n�"f�'uildi
Grading Permit Fee:
$0.00
In -r___ Hay_ Fee=
:O+86S�' �tTr•�'
ee:
$0.00
Public Wo
i
.dPtQol----Park
edication :
$0.00
Refund Deposit
P/W Plan Check:
$76.00
Grading Bond:
Electrical %:
$12.60
San Dist:
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$16.20
C
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O
V!p„
p'
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:00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee: $0.00 Fee Due at Permit Issuance : $537.90
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
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momcou
OWNER -BUILDER DECLARATION T-
I hereby affirm under penalty of perjurythat 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 app,(cable ite-n(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 (_) 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
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 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 Business and
Professions Code, is available upon request when this application is submitted or at the following Webbsite:http:// Wiw.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION /
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9,(commencing with Section 700 f Division of the Business and Professions Cc S, my license is in full force—/G •"( Contractor Signature
and effect. License Class License No Date
WORKERS' COrMPtNSATION DECLARATION
N{ pRNING:FAILURE Tt)%tCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNILFINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE
00e1 OPOOMPENSAiION,CAMAGES 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: -
PhBJe and will maintain a certificate of consent to self -insure for workers' compensation,
ornlance of IpppplMfor which this permit is issued. Policy No.
hove and will mainfain 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'
1; ;e carriep Ar?e0glicy number are: - -
riar.' Policy Number
issued by the Director of Industrial Relations, as.provided for by Section 3700 of the Labor Code, for
till/ that, if ltWAVormance of
hffhould become subject to the
ire of Applicant ,/�
Date
forwhich 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 agree
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Date/ L � i 6 '- � 7
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).
Ender's Name Lender's Address
ly 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 ordinanc s an state laws relating to building construction.
I authorize representatives of this city or cou/(tty to enter tylf#v -identified property for inspection purposes.
of ProDertv Owner or Authorized
ACTION I DATE I
EXPIRED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATEOF
OCCUPANCYISSUED
Print Prooertv Owner's or
WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
Date
SUBMITTED ASBESTOS NOTIFICATION TO
All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shall
be in place prior to approval to fill pool/spa & shall remain in place & be maintained for the
life of the pool.
EPA
QMD
SRFSTOS NOTIFICATIONYIS N TAPPLICABLE TO
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