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Home My WebLink AboutX2021-1635 - PermitsCity of Newport Beach - Building Division III�II��II�II�I��III�IIIIIIIIIIIII��IIIIIII�I�lllllll COMB Permit: X2021-1635 I Il 9N, `100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 1 6 3 5 Project No Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Issued Date : 06/23/2021 Combination Type - MFP Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0612312024 OR PERMIT WILL BE INVALID Construction Hours: Monday - Friday 7.00 a.m. to 5:30 p.m. and Saturday from 8:00 a.m. to 8:00 p.m. No work on Sundays or Holidays Job Address: 513 1.12 BEGONIA AVE NB Description: MFR - WINDOW (5) CIO, ALL WINDOWS MEET EGRESS i lIB Legal Desc.: Owner. ARNOLDUS POLLY & MATT Contractor: RENEWAL BY ANDERSEN OF OC Architect: Address: 513 112 BEGONIA - Address: 22982 ALCALDE DR #100 Address: NEWPORT BEACH CA 92625 LAGUNA HILLS CA 92653 State Lic: Phone: 949-246-5669 Phone: 714-259-5120 Phone: Applicant: RENEWAL BY ANDERSEN OF OC Con State Lic: 990416 Engineer: 0000 a ° Address: 22982 ALCALDE DR #100 Lic Expire: 02/28/2022 Address: LAGUNA HILLS CA 92653 Bus Lic: BT30046925 Phone: State Lic: Phone: 714-259-5120 Lic Exp Date: 04/30/2022 o a Code Edit: 2019 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: OLD REPUBLIC INS CO Address: Policy No: Occupancy Group: R3/U Y MWC31415820 Phone: ° a v Added /New sq.ft. Bldg: 0 Expire: 10/01/2021 ° ° a a a a Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear. / Special Conditions: ° oaooao No of Units : 2 Front: / Bldg Height: 0 Left: oaa°ao Right: / Bldg Sprinklers: Flood Zone: X Use Zone: Parkin Spaces: 0 Fire Hazard Zone: N Construction Valuation: $4,000.00 Building Permit Fee: $144.00 Excise Tax: $0.00 Planning Department - $0.00 Plan check Fee: $0.00 Fire Department Fire Inspection: $0.00 Plan Check Fee: $0.00 Additional Fee : 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 $0.00 In -lieu Housing Fee: $0.00 Demolition Fee Building Dept Adm $0.00 Record Management: $0.00 Grading Permit Fee: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 Energy Compliance: CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Grading Bond: $0.00 Disabled Access: $0.00 P/W Plan Check: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 $000 $0.00 Building Green Tee: $1.00 Mechanical %: $0.00 NMUSD Fee: . $0.00 Plumbing %: $0.00 TOTAL F(EE:$145.00 Plan Check Fee: $145.00 Fee Due it Issuance : $10.00 PUBLIC WORKS AP OVA L: PROCESSED BY: PLAN CHECK BY: ZONING APPROVAL: APPROVAL TO ISSUE: GRADING APPROVAL: OWNER -BUILDER DECLARATION 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 (Section 7031.5, Business an;d 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 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 hundired dollars ($500). ❑ I, as owner of the pEoperty,'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, 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 improved for the purpose of gale). ❑ I, 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 propertywho 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 Ircensu're 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 overed this permit, I cannot legal) 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, S tion 70 4 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.govIGalaw.html. Signature of Property Ownerlor Authorized Agent to LICENSED CO? cl:;ACTOR'S DECLARATION I hereby affirm urli -renaltyof perjury that I am licensed under provisions of Chapter 9 (commencing with Section 00 o i isi n 3 of the Business and Profess' a and m icense is in full force Frd-e� ,t. Licep.5p Class. License No Date Z Z Contractor Signature WORKERS' C0117 RtNSATION DECLARATION e %VARVING'FAILURE TQ, 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 COSTrJ°r COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I rieret;y affirm Lmdec penalty of perjury one of the following declarations: have and;will maintain la 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 er ,ance of�h. wore for which this permit is issued. Policy No. I h 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' compensatio <« ase nFQ carrier�and pplicy n ber ar -arner - 6t,o 1 ' Policy Number ��L�J OW Expiration Date ?dame a. Agent - c' Phone # ' ❑1 certify that, in the p`erforrn n '' of the k 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 agre that, if I should become subje' the wor r ' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 7 Signature of Applicant Date DECLARATION REGA ING CONSTRU TION LENDING AGENCY I hereby affirm under pe altydof;pedury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name ' 1 Lender's Address By my signature below, I'd ertify to each of the following: am the property owner or authorized to act on the prop y owne s behalf. I have read this application and the information I have pr Led is orrect. agree to comply with all applicable city and county ordin Cps an tate laws relating to building construction. I authorize res ofthis city or county presentative'to r t e o e-i d property for inspection purposes. Signature of Property Owo nerr Authorized Agent Print Property Owner's or Authorized Agent's Name__� ' - Da ACTION DATE BY DECLA ION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED Ll I SUBMITTED ASBESTOS NOTIFICATION TO EPA 1, i-01 I PROPOSED DE J\FIFON I� OT�ICABLE TO