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HomeMy WebLinkAboutX2019-1271 - PermitsCity of Newport Beach - Building Division *X2019-1271* COMB Permit: X2019-1271 100 Civic Center Drive, Newport Beach, CA 92660 Project No: a Permit Counter Phone (949)644-3288 Inspection ReOu,-sts Phone (949)644-3255 Combination Type - MFP Issued Date : 04123/2019 Inspection Area : 5 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: 5041/2 ORCHID AVE NB Description: MFR- REPAIR WATER DAMAGED WOOD @ WINDOWS AS NECESSARY, STUCCO & DRYWALL RPR r Legal Desc.: 1 `js' §CT , . Owner: TENEYCK SHARI Contractor: FILSINGER JOHN CONST Architect: "' Address: PO BOX 452 Address: 1825 PARK ST Address: CORONA DEL MAR CA 92625 HUNTINGTON BEACH CA 92648 Phone: 949-867.0512 Phone: 714-612-0138 Phone: State Lia Applicant: FILSINGER JOHN Con State Lia 629974 Engineer: VAHDAT SIAMAK Address: 1825 PARK ST Lie Expire: 10/3112019 Address: 4000 BARRANCA PKWY #250 • • • HUNTINGTON BEACH CA 92648 Bus Lia BT30067019 IRVINE CA 92504 ...... • • ° Phone: 714-612-0138 Lie Exp Date: 04130/2020 Phone: 949.654-0858 State Lie C-065255 • •.. Code Edit: 2016 Worker's Compensation Insurance Designee • • • • ° a Type of Construction: Va Carrier: EXEMPT. Address: ° Occupancy Group: R3IU Policy Na m ° ® ° ® • ° Added /New sq.ft. Bldg:. 0 Expire: Phone: ° • • ° ° ° Added /New sq. ft. Garage: 0 om ° No of Stories: 2 Building Setbacks Rear: / Special Conditions: ° ° • ° ° m • ° ° ° ° ° No of Units: 2 Front: I • - O°°°° Bldg Height: 0 Left: I O°°o`er Bldg Sprinklers: Right: I Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N ° ...... Construction Valuation: . $1.000.00 Building Permit Fee: $104.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $90.46 Additional Fee: $0.00 Plan check Fee: $40.00 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: $2.00. 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 PAN Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee: $1_Q(-_� Mechanical W $0.00 NMUSD Fee:. $0.00 $0.00 Plumbing %: TOT¢L FEE: $237 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: $0.00 Plan Check Fee: $0.00 Fee PUBLIC WORKS APPR PLAN CHECK BY: APPROVAL TO ISSUE: $0.00 ssuance : $237.48 I 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 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 70(70)•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 L) all of or `) 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 Dim roved 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 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 legalh 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 Web site:http://www.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm undar penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 If TMoff of the Business and Profes 'm1s n ylicense is in full force and effect. Lictrlispadss License No Date 2- 9 Contractor Signature kORKIRS' COM��PLLE�NSATION DECLARATION NARNINGNAILURE T45kYYRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THO AND DOLLARS ($100,000), IN ADDITION TO THE OST OP COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. [hereby affirm under penally of perjury one of the following declarations: .❑ L haue and 1:96Ihattain 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 derfoMlance of the work for which this permit is issued. Policy No. QI have and wll0winfain 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 ri?Mce carrier agd policy number are: Policy Number Expiration Date eo ent: Phone# •.../ g PEG y that, tr M,, p,rforman the work for w ictf 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 should beware subject o th workers' pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Gj Iignature of Applicant 2 IECLARATION REG DING C N RUCTION LENDING AGENCY hereby affirm under nalty p rj ry 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 certifyYo 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 ordinances and state Is I authorize representatives of this city or county to erker t�rq" ler DATE I BY EXPIRED PERMIT EMENDED PERMIT FINAL CERTIFICATEOFi,� OCCUPANCYISSUED us relating to building construction. property for inspection purposes. 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