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X2016-3498 - Permits
Wray City of Newport Beach - Building Division IIIIIIIIIIIIII�IIIIIII�II�I�IIIII�I�Ill�llli �I� ` o 100 Civic Center Drive, Newport Beach, CA 92660 1 X 2 8 1 6 3 4 9 8 1 Permit Counter Phone (949)644-3288 a. Inspection Requests Phone (949)644-3255 �'rcaroF�'� Combination Type - MFP , PERMITS EXPIRE 180 DAYS AFTER IS CE OR LA$I ID IN SF INSTALL OR VERIFY SMOKE/CARBON MONOX ETECTORS dk INrUl61g Job Address: 221 DIAMOND AVE NB Description: MFR RPLC (3) WINDOWS "LIKE FOR LIKE" ENLARGE (2) Legal Desc.: BALBOA ISLAND SEC 3 BILK 10 LOT 27 Owner: NEEL BEALA Address: 221 DIAMOND AVE NEWPORT BEACH, CA 92662 Phone: Fire Plan Rev $0.00 Applicant: AMERICAN VISION. DWS Address: 2125 N MADERA ROAD#A _ SIMI VALLEY CA 93965r,.�jw ^ i Phone: 888-563-0008 113 x. Code Edit: 2013 Type of Construction: VB ". Occupancy Group: R3, Added /New sq.ft. Bldg: 0 Added/New sq. ft. Garage: 0 No of Stories: 2 No of Units : 2 _ Bldg Height: 0 Bldg Sprinklers: �y M. r?Y�" I-- STRUC) TO MEET EG ©FA8 U STD" ISG_ Address: \\�� Address: Phone: Building Permit Fee: $127.00 °V° additi �m� 5+� �IIdl Plan Check Fee: $110.49 e :'�tQ(�(. $0.00 Overtime Plan Ck: $0.00 ends `1 `. $0.00 Investigation Fee: $0.00 Grading PC Consultant : $0 Record Management : $2.00 Grading Permit Fee: 0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 CA Seismic Safety: $0.00 WQ Inrystg®�dye : Disabled Access : $0.00 `. \ o/ _ Hazardous Mat $0.00 Electrical %: 0.00 Building Green Fee : $1.00 Melhan� m: $0.00 Plurdlbinp ° . $0.00 Fair COMB Permit: X2016-3498 ,Proiect No : Engineer: Address: Phone: j Designer: Addr 333,,,/' 0) se �r,061A%onditions e� I�ieTHousing Fee : Public Works Department - Park Dedication : $0.00 P/W Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Date : 10/26/2016 :tion Area : 2 II TOTAL FEE : $277.99 Plan Check Fee : $0.00 Fee Due at Permit Issuance PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: GRADING APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: 00000� m m ° o ° � o ° 00 00000 000ac� o � ; comm.+- C", Doom° °.c` $0.00 o e ° o $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $277.99 Fire Department $37.50 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: II TOTAL FEE : $277.99 Plan Check Fee : $0.00 Fee Due at Permit Issuance PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: GRADING APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: 00000� m m ° o ° � o ° 00 00000 000ac� o � ; comm.+- C", Doom° °.c` $0.00 o e ° o $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $277.99 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 appli t permit subjects the applicant to a civil penalty of of more than five hundred dollars ($500). T 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of and the structure or offered for sale (Section 7044, Usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property w employees' or personal effo s or improves the property, provided that the nprovements are not intended or offered for sale. If, however, the building or improvement is sold w year of completion, the Owner -Builder wi h the burden of proving that it was not built or nproved for the purpose of sale). 11 r b`e. „ ` 1, as owner of the property, am exclusively contracting with licensed Co o construct the profigpt OifA44, Busines f� GJAAPA C e'+ a Contractors' State License Law does not pply to an owner of property who builds or improves thereon, a ntracts for the projects with a Ii ns Contractor f3sA49Aee contractors' a 'cense Law). I am exempt from licensure under the Contra a �Icense Law for the follo!�! on: 0 0x V A ly my signature below I acknowledge 4 P for qe }nal residence IchiTi must have resided least one year prior to comp) a r-A ants covered by this permit, I cannot legal ell a structure that have owner- r iAlh 9 dbb���d�i444444 be s rutted in its atb tensed contractors. I ugderstan copy of the apple aw, Section 7044 of the Business and 'rofessions Code, i I able upon request wh this Ion is submitted he lowing eb site:http:/(�14f . gov/calaw.html. signature of Pr)pert Owner or �l�o�ozed "' Q Date .ICENSED CONT CTQE ARATI N fix /; hereby affirm under naltyof perjury that I an) d u ro I ( 0 mencing with Sectio 7000 of��Diyyision 3 f the Busin s a_ Pr e s de, and m (cense is i roll force nd effect. LicensgC ss ... - l� e b _ �e _ —a [9 Contractor g ure 4:.� iu KERS' COBE SA ON DERAING FAI}dR6RO SECU E WO ERS' 00 NSATIO OF COMPFyION, DA AGES S P OR IN eby affirWinder pen ty of one of the have aTtdwill mainta ace con:{t i r 'sisnoe tic ance'carrte+and policy mbe i1 MVERAGE IS L SECTION 1706 OF as required by Section 3700 of PENALTIES AND CIVIL FINES UP TO issued by the Director of PERMIT EXPIRED PERMIT FINAL CERTIFIC4TEOF OCCUPANCYISSUED I SUBMITTED ASBESTOS NOTIFICATION TO work for permit is issued DOLLARS ($'100,000), IN ADDITION TO THE 3700 of the Labor Code, for issued. My workers' , Civil Code). laws of California, and G1/1�2 All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shall be in place priorto approval to fill pool/spa & shall remain in place & be maintained for the IS NOT AP9dNBLE TO life of the pool. t:rrier ' Policy Number v" Mame of 4f" MI certif ,trot, in the Performa of_ f is i sued, I shall not employ any person in any manner so that, if I hauld ecome su ' ct the orke ' c i pro 'si action 3700 of the Labor Code, I shall con Signature uo pplicant i� DIECLARAON REGARDING C STRUCTION LEMING AGENCY � I hereby affirm under penalty of pe ury that there is a construction lendin g or the performance ork f welfi is Lender's Name I Lenderess By my signature below, I certify to etc hf'��f�.t�H��vfdllo_yung 'd To act on the property o e ehalf. I am the property owner or auth\te I have read this application and information I ovided'I agree to comply with all appliccou ces and state laws relating to building construction. I authorize representative of tht o enter the above -identified property for inspection purposes. Signature of Property Ow or Authorized Agent Print Property Owners or Authoria ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE - I 1_� I REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE I PERMIT EXPIRED PERMIT FINAL CERTIFIC4TEOF OCCUPANCYISSUED I SUBMITTED ASBESTOS NOTIFICATION TO work for permit is issued DOLLARS ($'100,000), IN ADDITION TO THE 3700 of the Labor Code, for issued. My workers' , Civil Code). laws of California, and G1/1�2 All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shall be in place priorto approval to fill pool/spa & shall remain in place & be maintained for the IS NOT AP9dNBLE TO life of the pool.