HomeMy WebLinkAboutX2019-4039 - PermitswhoQ City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2019-4039
,100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 4 0 3 9 Project No: 1105-2016
Permit Counter Phone(949)644-3288
4t Inspection Requests Phone (949)644-3255
"urrrus' Combination Type - SFP ELEC PLUM Issued Date : 12/17/2019
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: 20192 BAY VIEW AVE NB
Description: SFR *REPLACE EXPIRED X2018-1746' CONVERT OFFICE INTO BATHROOM
Legal Desc.: N TR 1607 LOT 30
INSPECTOR
Owner: BLAYLOCK CINDY
Contractor:
OWNER/BLDR
Architect:
Address: 20192 BAY VIEW AVE
Address:
BLAYLOCK CINDY Address:
NEWPORT BEACH, CA 92660
Phone:
Phone:
Phone:
-State Lie:
Applicant: BLAYLOCK CINDY
Con State Lie: O/B
Engineer:
Address: 20192 BAY VIEW AVE
Lie Expire:
Address:
NEWPORT BEACH, CA 92660
Bus Lie:
Phone:
Lie Exp Date:
Phone:
State Lie:
Code Edit: 2016
Worker's Compensation
Insurance
Designer:
Type of Construction: VB
Carrier:
Address:
Occupancy Group: R3/U
Policy No:
Added /New sq.ft. Bldg: 0
Expire:
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 1
Building Setbacks
Rear: I
Special Conditions:
o
No of Units : 1
Front: I
O/B AUTH ATTACHED
°
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: I
Flood Zone:
Use Zone:
Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $0.00
c00000 0 0
Building Permit Fee: $0.00
Excise Tax:
$0.00
Planning Department -
Fire Department
0 0 0
Plan Check Fee: $0.00
Additional Fee :
$116.00
Plan check Fee : $0.00
Fire Inspection:
$11.00
Overtime Plan Ck: $0.00
Grading Bonds Fee:
$0.00
Fair Share : $0.00
Fire Plan Rev
$o.bb�-
Investigation Fee: $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
o ° 94T o °
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
P/W Plan Check: $0.00
Grading Bond:
Hazardous Mat $0.00
Electrical %:
$0.00
San Dist: $0.00
,
Building Green Fee : $0.00
Mechanical %:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $116.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$116.00
PROCESSED BY:
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO ISSUE:
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 applicpble item(s)
lection 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
ie 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 U all of or `) 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
CNNnot intended or offered far i1ON
however, the building or improvemenone year of completion, the Owner -Builder will have the burden of proving that it was not built or
u d for the purpose of sale).as dwnerofthe property, am exclusivelting with licensed Contractors to conct (Section 7044, Business and Professions Code: The Contractors' State License Law does not
y to an owner pf property who builds or imhereon, and who contracts for the proensed Contractor pursuant to the Contractors' State License Law).
I am exempt from licensure under the Co' State License Law for the following rly my signature below I acknowledge that, exmy personal residence in which I mufor at least one year prior to completion of the improvements c vend by this permit, I cannot legalyell a structure that I have built as an owner -bit his. not been constructed in its entircontractors. I understand that a copy of the applicable law, S tion 7044 of the Business and
'rofessions Code, is available upon requestupplication is sub 'tted or th follttp://v w .leginfo.ca.gov/calaw.htmi. /signature of Property Owner or Authorized Agate� � `ICENSED CONTRACTOR'S DECLA
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (immencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
nd effect. License Class License No Date Contractor Signature
COMPENSATION DECLARATION
DARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL 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 FEES.
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
ormance of the work for which this permit is issued. Policy No.
have and will tMrRlin workers' compensation insurance, as required by Section 3700 of the Labor Code,
irancvcarrier and policy number are:
rier
er . ..
Policy Number
of agent
Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
for the performance of the work for which this permit is issued. My workers'
Date
�it1fy that, the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the
yn ,gf I•spou bdddMd Subject to the workers' m nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
.....
hereby affirm under penalty of perjury that there is a eonstruction lending agency for the performance of the work for which this permit is issued (Section
jr146}'g Name Lender's Address
y my signature OeloM certify to each of the following:
•
I'M :he propWV owner or authorized to act on the property owner's behalf.
•PW&e read thi%Tplfcation and the information I have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of this ci r c ty to enter�the above -)7 of%'ed pr erty/f�c,r inspection purposes.
ionature of Prooertv Owner or Authorize Dent /ii ,ice L e, / < //.(.fir / Let' Print Property Owner's or Authorized
ACTION
PERMITEXPIRED
PERMITC4NCELLED
PERMITEXTENDED
PERMITFINAL
CERTIFICATE OF
OCCUPANCYISSUED
DATE I BY
1403
OF COMPLIANCE WITH CODE OF FEDERAL
PART 61 OF TITLE 40 AND AQMD RULE
NOTIFICATION TO
NOTIFICATION IS NOT APPLICABLE TO
FOR OFFICE USE ONLY
compensation laws of California, and
/> /7-/ 9/
Civil Code).
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