HomeMy WebLinkAboutX2018-3288 - PermitsCity of Newpt:}rt B aE.-aSpilding°Division
100 Civic Center Drfv4 Ng%y;ok Bba�h, C A.0660 t
Permit Counter Phone(949)644-3288
Inspection RegVests Phone (949)644-3255
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Combination*Typh BSF•p
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I x 2 0 1 8 3 2 8 P Project No: 0481-2018
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PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION,
Issued Date : 10/3012018
Inspection Area : 1
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: 405 40TH ST NB
Description: SFR ENTRY DOOR RELOACTION AND FOLDING DOOR INSTALLATION
Legal Desc.: CANAL SECTION BLK 440 LOT 2
'Ow ner: ROBINSON LAWRENCE
Contractor:
OWNER/BLDR
Address: 405 40TH ST
Address:
ROBINSON ANNA
NEWPORT BEACH, CA 92663
714/587-3018 State Lic:S-002607
Designer:
Phone: 961-288.1778
Phone:
Applicant: SANTA MARIA ANDREW
Con State Lic:
CIS
Address: 2333 PORT CARLISLE PL
Lic Expire:
$0.00
NEWPORT BEACH, CA 92660
Bus Lic:
Fire Department
Phone: 949-533-8138
Lic Exp Date:
Code Edit: 2016
Worker's Compensation Insurance
Type of Construction: V -B
Carrier:
Fire Inspection:
Occupancy Group: R31U
Policy No:
$0.00
Added /New sq.ft. Bldg: 0
Expire:
Fair Share :
Added /New sq. ft. Garage:
0
$0.00
No of Stories: 2
Building Setbacks
Rear: I
No of Units : 1
SJH Trans:
Front: I
Bldg Height: 0
Left: I
Bldg Sprinklers:
Grading Permit Fee:
Right: I
Architect:
Address:
Phone: State Lic
Engineer:
ALLEN T WILLIAM
Address:
6 MORGAN STE 100
0 Fire Hazard Zone : N
IRVINE CA 92718
Phone:
714/587-3018 State Lic:S-002607
Designer:
Address:
Phone: � � M1y CTOR Special Conditions: -
Flood Zone:
Use Zone:
Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $10.000.00
Building Permit Fee:
$232.00
Excise Tax:
$0.00
Planning Department-
Fire Department
Plan Check Fee: $61.00
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:
$22.00
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
WO Insp. Fee:
$0.00
Park Dedication : $0.00
Refund Deposit
$0.00
Disabled Access :
$0.00
PM Plan Check: $0.00
Grading Bond:
$0.00
Hazardous Mat
$0.00
Electrical %:
$0.00
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: $316.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$316.00
PROCESSED BY: in PUBLIC WORKS APPROVAL:
Y:s Rov
OWNER -BUILDER DECLARATION : I hereby affirr
der penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmartdrj I Have pldced next to the applicable item(s) (Section 7031 .5,
siness 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 requireslhe applicant for the permit to
a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing w ith Sectipn 711IO(1) of Division $of the Business and
Aessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5•tyanyiapplipatt for aperrAit subiects,the applicant to a civil toe nalty
,..
not more than five hundred dollars ($500). • , - • �• `.'
I, as ow ner of the property, or my employees w ith w ages as their sole compensation, w ill do (_) all of or (_) portions of the w ark, •zgri thAftructure is not intended or offered for sale (Section 4044,
siness and Professions Code: The Contractors' State License Law does not apply to an ow ner of properly w ho, through employees' or personal effort, builds or improves the property, provided that
I improvements are not intended or offered for sale. F, how ever, the building or improvement is sold w ithin one year of completion, the Ow ner-Builder w ill have the burden of proving that R w as not
!it or improved for the purpose of sale).
❑ I, as ow, ner of the property, am exclusively contracting w ith licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law
as not apply to an ow ner of property w ho builds or improves thereon, and w ho contracts for the projects w ith a licensed Contractor pursuant to the Contractors' State License Law).
❑ I am exempt from licensure under the Contractors' State License Law for the follow Ing reason:
By my signature below I acknow ledge that, except for Try personal residence in w hich I must
ve 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 ow ner-builder if it has not been constructed in its
tirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request w hen this application is submitted or at the
low ing Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Ow ner or Authorized Agent
Date LICENSED CONTRACTOR'S DECLARATIO
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing w ith Sectic
00) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No
to Contractor Signature
COMPENSATION DECLARATION
I ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP
,F COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37N OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the follow Ing declarations:
DOLLARS ($1N,N0), IN ADDITION TO
I have and w ill maintain a certificate of consent to self -insure for w orkers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the
formance of the w ark for w hich this permit is issued. Policy No.
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' compensation
trance carrier and policy number are:
Policy Number
of Agent
Date
that, in the performance of the work for w 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,
if I should become sNbject to t roars' compens tion provisions of Section 3700 of the Labor Code, I shall forlhw ith comply w ith those provisions.
of
Lender's Name
Da?�JOJ
_
DEUARAT16N REGARDING CONSTRUCTION LENDING AGENCY
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
Lender's Address
By Try signature below, I certify to each of the follow Ing:
I am the property ow ner or authorized to act on the property ow ner's behalf.
I have read this application and the information I have provided is correct.
I agree to comply w ith all applicable city and county ordinance and state law s relating to building construction.
I authorize representatives of this city or county to a ter th ao ident'Ified property for inspection purposes. hnVLA=_ I —
store of Property Owner or Authorized Ag Print Property Ow ner's or Authorized Agent's Narr( Date
I,
f,✓w( S' (,-t,4 BY REGULATIONS PART061 OF TITLE 40 AND AQMD RULE AL FOR OFFICE USE ONLY
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