HomeMy WebLinkAboutX2020-1160 - Permitsrx.��ry City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
is iq Inspection Requests Phone (949)644-3255
Combination Type - SFP
COMB Permit: X2020-1160
66 X 2 0 2 e 1 1 5 011111 Project No:
Issued Date : 05114/2020
Inspection Area: 5
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY OR PERMIT WILL BE INVALID
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: 1611 ARCH BAY DR NB -
Description: SFR CHANGE OUT (18) WINDOWS 8 (3) FRENCH DOORS
Legal Desc.: N TR 15222 LOT 23
Owner: MCCARY M
Contractor:
RENEWAL BY ANDERSEN OF OC
Architect:
Address: 1611 ARCH BAY DR
Address:
22982 ALCALDE DR #100
Address:
NEWPORT BEACH, CA
LAGUNA HILLS CA 92653
Phone: 0
Phone:
714-259-5120
Phone:
State Lie:
Applicant: JANOSIK STEVE
Con State Lie:
990416
Engineer:
Address: 22982 ALCALDE DR #100
Lie Expire:
02/28/2022
Address:
LAGUNA HILLS CA 92653
Bus Lie:
BT30046925
Phone: 714-259-5120
Lie Exp Date:
04130/2021
Phone:
State Lie:
Code Edit: 2019
Worker's Compensation Insurance
Designer:
Type of Construction: VB
Carrier:
OLD REPUBLIC INS CO
Address:
Occupancy Group: R3/U
Policy No:
MWC31415819
Added /New sq.ft. Bldg: 0
Expire:
1010112020
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 2
Building Setbacks
Rear: /
Special Conditions:
No of Units: 1
Front: /
Bldg Height: 0
Left: /
Bldg Sprinklers: N
Right: I
Flood Zone: X
Use Zone: Parking Spaces:
0
Fire Hazard Zone : N
Construction Valuation: $18,000.00
Building Permit Fee: $360.00
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 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
$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 : $1.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $361.00
Plan Check Fee :
$0.00
Fee Due at Permit Issuance :
$361.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
PUBLIC WORKS APPROVA,: -
PLAN CHECK BY: -
APPP.OVA!. TO ISSUE:
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vvr¢rt•ourLucR UCI. l IVIV
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 Rem(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
he 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
2rofessions 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
iot more than five hundred dollars ($500).
1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
3usiness and Professions Cade: 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
mprovements 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
51roved 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
ipply 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 followng reason:.
3y 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 Dwnervbuilder if it has not been constructed in its entirety by licensed contractors. I understand that a ropy of the applicable law, Section 7044 of the Business and
'mfessicns Code, is available upon request when this application is submitted or at the following Web site:http:l/w .leginfa.m.govicalaw.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 Division 3 of the Business and Profess' ode, aryd�gy license is y� full force
and effect. License Class License No - Date Contractor Signature V i7�w�O l_.U1JtBdl.�i
VORKERS' COMPENSATION DECLARATION -
1ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND OCLLA1 S (FteD,DaDJ, IN ADOmON TO THE
;OST OF CONPENSATLDN, DAMAGES AS PROVIDED FOR IN SECnON 37DG OF THE LADOR CODE, W ERM, AND ATfORNEVS PEES.
hereby affirm under penalty of perjury one of the following declarations:
11. 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 IN
rs , rinance of the work forwhich this permit is issued. Policy No.
1 have 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' Compensator
isurance carrier and p llsy-number are:
•�•^_ — —A.19
- rancymtmp r Expiration Date
lame of Agent }} Phone #
31 certify that, in 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 workers' Compensation laws of California, and agree
iat, if I should become supject to the worke Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
signatureofAppllcant , 5/14/2020
IECLARATION REGARDING CONSTRUCT)ON LENDING AGENCY - -
hereby affirm under penalty of perjury that here is a ConsWction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
enders Name - Lender's Address
ly 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 ordinances and state laws relating to building Construction.
I authorize representatives of this city or co t 'o a ter the ab •identified pro erty for Inspection purposes. Steve J8f1OSli( li nature of Property Owner or Authorized Agent Print Propa Owners or Authorized Agent's Nam D /14/202(
SCTION DATE BYZ DECIARATIO F COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMITCANCEILED
CERTIFICATEOF
OCCUPANCYLSSUED
ISN7i APPLICAS:E TO