HomeMy WebLinkAboutX2020-1071 - Permitsr�wro� City of Newport Beach - Building Division IIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2020-1071
o� 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 0 1 0 7 1 Project No
tom. Permit Counter Phone (949)644-3288
u@ Inspection Requests Phone (949)644-3255
Issued Date : 0510112020
°+tr.��ur•' Combination Type - BLDG
Inspection Area : B
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: 20451 UPPER BAY DR NB
Description: SFR R/R SIDING & FASCIA @ FRONT ELEVATION (LIKE -FOR -LIKE)
Legal Desc.: N TR 6407 LOT 4
Owner: ANDERSEN JASON
Contractor:
OWNER/BLDR
Architect:
Address: 20451 UPPER BAY DR
Address:
ANDERSEN JASON Address:
NEWPORT BEACH, CA 92660
Phone: 714-785-4646
Phone:
714-785-4646
Phone:
State Lie:
Applicant: ANDERSEN JASON
Con State Lie: O/B
Engineer:
Address: 20451 UPPER BAY DR
Lie Expire:
Address:
NEWPORT BEACH, CA 92660
Bus Lie:
Phone: 714.785-4646
Lie Exp Date:
Phone:
State Lie:
Code Edit: 2019
Worker's Compensation Insurance
Designer:
Type of Construction: V-B
Carrier.
Address:
Occupancy Group: R31U
Policy No:
Added ]New sq.ft. Bldg: 0
Expire:
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 1
Building Setbacks
Rear: /
Special Conditions:
No of Units : 1
Bldg Height: 0
Front: I
Left: I
7n
a�
Bldg Sprinklers:
Right: I
���
Flood Zone:
Use Zone:
Parkin Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $1,000.00
Building Permit Fee: $104.00
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 Sham: $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
P/N/ 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 : $105.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$105.00
PROCESSED BY: 'U 1
_ __
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
_
APPROVAL TO ISSUE:
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 chackmark(s) I have placed next to the applicable 4sm(s)
Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, after, improve, demolish, or repair any structure, prior to Its issuance, also requires the applicant for
he permit to file a signed statement that lie 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
'rofesslons Code) or that he or she is exempt from ]!censure 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).
31, 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,
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
mpnevements are n tended or offered for sale. If, however, the building or improvement is said within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
mproved f�rNlnAr-NEAEt a Of sale).
I, as otie.,ertiie property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Cade: The Contractors' State License Law does not
to an owner of property who builds Or Improves thereon, and who contracts far the pro{ects with a licensed Contractor pursuant to the Contractors' State License Law).
am exempt from ficensure under the Contractors' State License Law for the following reason:
y signature below I acknowledge that, except for my personal residence in which I must have resided far at least one year prior to completion of the improvements covered by this permit, 1 cannot legally
all a structure .hat I have built as an owner-buRder 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
'rofessions Code, is available upon request when this cy-efion is�r at the following Web sitedrttplfwww.leginfe.ca.gavicalaw.htmi.
Kgnatme at Property Owner or Authorized Agent
_ICENSED CONTRACTOR'S DECLARATI 1�9'
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter g (eommenrarg with Section 7000) of Division 3 cf the Business and Professions Code, and my license is in kill force
and effect. License Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGEIS UNLAWFUL, AND SHALL SllBJEU AN EMPLOYER TO CRIMINAL PENALTIIES AND GNIL FNES UPTO ONE HU"RED THOUSAND DOLLARS (s1ca.4oa), N ADDRION TO THE
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION VaOFTHE LABOR CODE, INTEREST,ANDATTORNEY"S FEE&
hereby affirm underpenalty Of perjury one ofthe following declarations:
7 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 1114
�arformance of the work for which this permit is Issued. Policy Nc..
have and will masrtaiin workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is. issued. Nly workers'
mace carrier and policy num bar are:
Number
Of
Dale
j fy 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 Cafifornia, and afire
I should become subject to a workerss C/r/�r�Saat�dfi�rovislons of Section 3700 of the Labor Code, 'I shall for hwlth comply with those provislons.
nature of Appfee" :Z/� (i / r i/ 1 Z Date /I
CLARATION REGA G CO Tf'ON LENDING AGENCY
)retry affirm under ape ally of perjury that there is a construction lending agency for the performance of thewerk far which this permit is issued (Section 3007, Civil Code).
takers 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 appfrable citypan d county or ances and state laws relating to building construction
I authorize representatives of this city or county to er thee above -id I led property for inspection purposes.
nature of Prooerty Owner or Authorized Aeard / Point Property Owners fir Authorized Anent's Na a Q•
ACTION DATE I BY DECLARATION OFCOMPUANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART Bl OF TITLE 40 AND AryMD RULE
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