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HomeMy WebLinkAboutX2019-2995 - Permitsxlo City of Newport Beach - Building Division construction vaivation: COMB Permit: X2019-2995 - IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII - Building Permit fee: $424.00 Excise Tax: $0.00 Planning Department- II Fire Department 100 Civic Center Drive, Newport Beach CA 92660 X 2 0 1 9 2 9 9 54 Additional Fee : Project NO ; �, Permit Counter Phone (949)644-3288 0 $0.00 Fire Inspection: c. Inspection Requests Phone(949)644-3255 Overtime Plan Ck: n'1ttr11,iv�� '` Combination Type - SFP. Grading Bonds Fee: Issued Date ::0 911 912 01 9 Fair Share.: $0.00 Inspection Area: 8 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: 2734 WINDOVER DR NB Grading PC Consultant: $0.00 Description: SFR -R/R 10 WINDOWS, 4 FRENCH DOORS. ALL SAME OPENINGS $0.00 Demolition Fee Legal Desc.: N TR 6113 LOT 65 Record Management: Owner:. ADAMSON MICHAEL & MINDY Contractor: RENEWAL BY ANDERSEN OF OC Architect: $0.00 Address: 2734 WINDOVER DR Address: 22982 ALCALDE DR #100 Address: Building Dept Adm CORONA DEL MAR, CA 92626 LAGUNA HILLS CA 92663 Energy Compliance: Phone: Phone: 714.259-5120 - Phone: State Lic: Applicant: RENEWAL BY ANDERSEN OF OC Con State Lie: : 990416 Engineer. - General Service Address: 22982 ALCALDE DR #100 Lie Expire: 02/2912020 Address: CA Seismic Safety: LAGUNA HILLS CA 92653 Bus Lie: BT30046925 WQ Insp. Fee: $0.00. Phone: 714-259-5120 Lie Exp Date: 04130/2020 Phone:.:.. State Lie: Code Edit: - -2016 Worker's Compensation Insurance Designer: Disabled Access : Type of Construction: V -B Carrier: EVEREST NATIONAL Address: Occupancy Group: R31U Policy No: MWC31416800 Grading Bond: Added/New sq.ft. Bldg:. 0 Expire: 10/01/2019 Phone: - Added /New sq. ft. Garage: 0 Electrical %i .. ' No of Stories: 2 Building Setbacks Rear: I Special Conditions: No of Units : 1 Front: / Building Green Fee : Bldg Height: 0 Left: / Mechanical %: $0.00'. - Bldg Sprinklers: Right:. J - �."Q _ Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N �.' construction vaivation: szz.uuu.uu - - Building Permit fee: $424.00 Excise Tax: $0.00 Planning Department- Fire Department Plan Check Fee: $0.00 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 Feer $0.00 Grading PC Consultant: $0.00 SJH Trans: $0.00 Demolition Fee Record Management: $0.00 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. WQ Insp. Fee: $0.00. Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 PNV Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %i $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 : $425.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $426.00 PROCESSED BY: ti PUBLIC WRKS.PP�201,-/`Aj ° o o 9 ° o © co c ZONING APPROVAL: PLAN CHEdk BYi' GRADING APPROVAL: APPROVAL TO°ISv9LJ5: • q. a °' r v 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 (_) all of or L) 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). 1, 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). I 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 legally 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 70 of D'vision 3 of the Business and ProfeP4I0114ode, my license is in full force nd effect. License Class License No Date I A Contractor Signatur VORKERS' COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAe E ALTIE AND IVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEE& 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, erkmance of the work for which this permit is issued. Policy No. �I In ve 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' compensatiol I ra ce carrier and poic number are: L `3 IS l G.I me 1''U� Policy Number ri1 �`1 Expiration Date Ime of Agent Phone # ertify that, in the perf NC� he work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation lawsIf California, and agre that, if I should become s 1 orkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant Date C DECLARATION REGA N 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, mode). 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 hEve provided is correct. I agree to comply with all applicable city and coun rdlmancces and state laws relating to building construction. I authorize representatives of this city or county to n aJagvp-identified property for inspection purposes. t�� ,,p q C( Signature of PropertyOwner or Authorized Agent d V Print PropertyOwners or Authorized Agent's Name a� P*1y JEJf Date ACTION DATE B 16ECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OFTITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED •f • ISLM3MIMp ASBESIOSPMFICATIONTO PERMITC4NCELLED • • • LWA i • : ••• PERMIT EMENDED • • QM e • • PERMITFINAL ASBESTO OTIFIC TON IS NOT APPLICABLE TO CERTIFICATE OF 1 •Z 1' (w • • • P§OPOSJD LIT �O• • f. OCCUPANCYISSUED • SIC#VAiU E: w •.