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Home My WebLink AboutX2020-0285 - Permitsh City of Newport Beach - Building Division I IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit :X2020-0285 - 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Project NO : 0226-2020 v - Inspection Requests Phone (949)644-3255 -Issued Date: 0210312020 x 'dsul _'- pection Area : 5 ;p�_! PERM7T5 EXPIR 180 DAYS AFTER Ic¢tr®n+� OR e n r rn rnrcaernnnr� onstruction Flours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 6:00 a.m. to 6:00 p.m. ik Sundays or Holidays Job Address: 42 /A ISSUS AVE NB Description: M �Y ERIOR REMODEL 250 SF. R/R WINDOWS, STU CO REPLACEMENT Legal Desc.: C `pN DEL MAR BLK440 LO�Gd1E!JS Nil Qil15 _ (palaels NJOM) Owner: KE ED CRAIG PJ �"� ALBO COM A �gry� @ gyp+ ct _ ,x,01 UCH AI ISTI 20 Address: 425 kR ISSUS �A "AI.iY CAMPUS D j 4�" CO OIV EL MAR, CA 9225 ORT BEACH CA 92680 NEWPORT BEA H CA 92660 Phone: �.� Phone: 949-794.9534 Phone: 949-651-8345 State Lic:CO22334 i:. Applicant: FA T IM Con State Lic: 811059 Address: 510 A US DR STE 200 Lic Expi 0 NE ,y�..O BEACH CA 92660 Bus Lic 2 Phone: .. Lic Exp- e: 0313 0 I d P State Lic:. 3, Code Edit : �'r 2019 Worker's Compensation Insurance Designer Type of Constructi V -B Carrier: CALIFORNIA INS CO !o)e1ssC Occupancy Group. R31tl--.�17��01�, Added /New sq.ft. 6g: 0 Expire: - 2 N T-7Added /New sq. ft. Para e: 0RAF No of Stories. 8r. 2punJaa %OO ❑ a0 %U9 [=-(backs ondi7;eIns a% !M' No of Units : 2 Front: / y Bldg Height: 0 Tight�r A�a� Bldg Sprinklers: P', :9peogdde 11 Right: Flood Zone: #: Use Zone: Parkin Spaces: 0 Fire Hazard Zone : N Construction Vall*io Building Permit Fee: $1,468.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $1,277.16 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 $24.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $197.00 CA Seismic Safety : $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $564.00 Disabled Access : $0.00 P/W Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $102.76 San Dist: $0.00 Building Green Fee: $6.00 Mechanical %: $58.72 NMUSD Fee: $0.00 $0.00 Plumbing W $132.12 $0.00 TOTAL FEE : $3,871.76 Plan Check Fee : $3,871.76 Fee Due at Permit Issuance : $0.00 PROCESSED BY:P`ilBL9C WORKS APPROVAL: ZONING APPROVAL: L ° ° ' ° ` " PLAN CHECK BY: 3 ' y �� ce�+-%-� GRADING APPROVAL: ge r S3r APPROVAL TO ISSUE: _ 6V c0 E O C L G O OU 0G0 � 4 O9 )O 41g0 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 7000) of Division 3 of the Business and f. Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of Professions Code) or that he ll she is exempt from -Insure ar�tl7he trasis fdrtlle alleged-exempheR�nyt,ue)18t1,4LL.4,.,,„_c ,,. uW not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employe gg with iyas;bstheir sole compensation, will do (_) all of or L) portions of the work, and the structure is not intended or offered fors IS (Section 7044, Business and Professions Code: The Contract s' State License Law doe"s 0r1TpptThJr anvwnePef-praperty_ }hr�_employees�pra"fil tie p5l��gullds or improves the pro rty, provided that the A -B A(ilf improvements are not intended or offered fors e. If, however, the building or improvement is sold within one year of completion, the Own r- ul er ave the burden of proving at it was not built or improved for the purpose of sale). FinqT�wlth ". fT—�TTe:❑ I, as owner of the property, am exclusively ntra �,' nse ontractor c ns t p ct c 4, sinessi �tLotl rnplQ9tCaCte icense Law does not apply to an owner of property who builds or im oyeson who �ntra„ts ro) t cen to ursuant to the Contractors' State License Law). _JIM U I am exempt from licensure under the Con By my signature below I acknowledge that, ex, sell a structure that I have built as an owner-bl Professions Code, is available upon request w Signature of Property Owner or Authorized Ag LICENSED CONTRACTOR'S DECLARE I hereby affirm under penalty of perjury that I e and effect. License Class for my personal residence in which I must have resided Tor at least one year pnor ww1„PLUr,U�r, .».rY•W+w. r iu"as,natbeen cQnStructed_ in its entirety by licensed contractors. I understand that a copy of the applicable law, License No 3 of the Business and o Contractor SlQna =license I cannot lege ess and s in full force YORKERS' COMPENSATION DECLA TION 'ARNING: FAILURE TO SECURE WORKERS' COMPENS ION E la �y�WFUL, AND SHALL SUBJ TAN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS OST OF COMPENSATION, DAMAGES AS PROVIDED FO IN SE TION S O�1pp°E NTE T, NEY'S FEES. • `' hereby affirm under penalty of perjury one of a to ec4[I {� I have and will maintain a certificate of nsent to self -ins wprWpsfp sation, issued by the" of n us I I $s idpla ct n 3700 e rmance of the work for which this permit i issued. Policy N of I t UUd (no Work St�CteC�� I ave and will maintain workers' compen ti��qq in urance, as required by Section 3700 of the Labor Code, for the -performance of the wor for w ch this permit is issued. rance carrier and policy number are: NGlue; )arrier Policy Number - _Expiration Date Phone # lame of Agent 71 certify that, in the performance of the w !Nona a7i R'RI� narmit i ued`I shall not employ any perso ecolReS§�jed$Ed$N�k➢9 a s' c Ner Tat. if I should become Subject tg tli orkers' compensatlon prowslons or ecs1R3TDO�P'lfl.�dCa�ee® th those provisions. nature of Applica t ' 7 CLARATION REGARDING CONSTRUCTION LENDING AGENCY ireby 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 Code). ider's Name - Lender's Address 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 have provided is correct. I agree to comply with all applicable city and county ordinancesnd-g ate laws relating to building construction. I authorize representatives of this city, or county_to-ent oovve-identified property for inspection purposes. Print Property Owners or Authorized Agent's Name IN ADDITION TO THE the Labor Code, for workers' of California, and Date L DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY ACTION REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED .-/1-1) I SUBMITTED ASBESTOS NOTIRCA►IONTO -• PERMIT CANCELLED EPA • • • PERMIT EXTENDED QMD---(ptL1Cc PERMITFINAL LJASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION •.• • • ••• +• OCCUPANCYISSUED SIGNATURE • ••• IN ADDITION TO THE the Labor Code, for workers' of California, and Date L