HomeMy WebLinkAboutX2017-0862 - Permits� " 4 City of Newport Beach - Building C:vision "X2017--0862*
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
e"+rtaF's Combination Type - MFP
COMB Permit: X2017-086
Project No :
Issued Date : 03/16/2017
Inspection Area : 4 a
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSlrtc nun.
INSTALL OR VERIFY SMOKEICARBON MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED
Job Address: 615 POPPY AVE NB
Description: MFR -REPLACE CEDAR SIDING WIHARDIE PLANK SIDING (BACK UNIT)
Legal Desc.: CORONA DEL MAR BLK 643 LOT 15
Owner: STRONGIN MIKE Contractor: ZORNOSA OCTAVIO GEN CONTRACTOR INC Architect:
Address:
615 POPPY AVE
NEWPORT BEACH, CA 92625
Phone:
Applicant
ZORNOSA OCTAVIO
Address:
14 DEMBERLY
MISSION VIEJO CA 92692
Phone:
949-697-3420
Code Edit : 2016
Type of Construction: V-B
Occupancy Group: R3/U
Added /New/TI sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units: 2
Bldg Height: 0
Bldg Sprinklers:
Flood Zone: X
Address:
P O BOX 8791
NEWPORT BEACH CA 92658
Phone:
949-697-3420
Con State Lic:
695388
Lic Expire:
12/31/2017
Bus Lic:
BT00021275
Lic Exp Date:
02128/2018
Worker's Compensation Insurance
Carrier: STATE COMP INS.
Policy No: 9142462
Expire: 0911812017
Building Setbacks Rear: /
Front: I
Left: /
Right: /
Zone:
0
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
State Lic:
State Lic:
Special Conditions: NO ENGINEERING REQ
PER KH
Fire Hazard
Construction Valuation:
$16,000.00
Building Permit Fee:
$307.00
Excise Tax:
$0.00
Planning Department -
Plan Check Fee:
$0.00
Additional Fee :
$0.00
Plan check Fee
Overtime Plan Ck:
$0.00
Grading Bonds Fee:
$0.00
Fair Share:
Investigation Fee:
$0.00
Grading PC Consultant :
$0.00
SJH Trans :
Record Management:
$0.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee
Energy Compliance:
$0.00
Grading PC Fee:
$0.00
Public Works Department -
CA Seismic Safety:
$0.00
WQ Insp. Fee:
$0.00
Park Dedication :
PNV Plan Check:
$0.00
$0.00
Disabled Access :
Hazardous Mat
$0.00
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Building Green Fee :
$1.00
Mechanical W
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$0.00
TOTAL FEE: $345.50
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Fire Department
$37.50
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
Plan Check Fee : $0.00 Fee Due at Permit Issuance : $345.60
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE: n
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 apeli,
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 dnd
Professions Dude) 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 mnre than, five hundred dollars ($500).
0 I, as owner of fhd 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,
D isincss and Frofessions 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
�,r,pruvements am 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
i:T.p. Lved for the pi-r ose of sale).
C i, as owner it do property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
app:y 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).
d 1'am exempt from Jcensure under the Contractors' State License Law for the following reason:
By n;} 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 legall)
BPI( 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:hftp://www.leginfo.ca.gov/calaw.htmi,
3:3.idW.e of Property Owner or Authorized Agent Date
LICENSED CONII RACTOR'S DECLARATION
I hereby affirm urioer penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0 ) of Division 3 of the Business and Prof d my license is in full force
and effect. License Class License No Date ° — b_ Contractor Signature
WORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND'G LARS (E100,000J, IN ADDITION TO THE
COST 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:
1 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 thl
nce of the work for which this permit is issued. Policy No.
�"Vl, 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' compensatior
nsgoKca carrier and policy number are:
Policy Number
of Agent
Date
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 agre
if I should become
`subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
lature of Applicant X Date
'I ADATInrd Donn
hereby affirm under penalty of perjury that s 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
3y 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 county to enter the above -identified property for inspection purposes. O �/ 3 —1
3ignature of Property Owner or Authorized Agent u �� �+%-/ K oSt Print Property Owner's or Authorized Agent's Name r vw
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 51 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED OEPA All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shall
PERMIT EXTENDED QMD be in place prior to approval to fill pool/spa & shall remain in place & be maintained for the
PERMIT FINAL („�,-1 ur STOS NOTIFICATION IS NOTAPPLICABLE TO life of the pool.
CERTIFICATE OF ` { l SEDD MOLITION
OCCUPANCYISSUED " .TllaF