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HomeMy WebLinkAboutX2018-3531 - Permitsh City of Newport Beach - Building Division IIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2018-3531 o 100 Civic Center Drive Newport Beach, CA 92660 X 2 0 8 3 5 3 1 Project No H x Permit Counter Phone (949)644-3288 InspectionRequests Phone (949)644-3255 Combination Type -. MFP Issued Date: 11/20/2018 Inspection Area : 3 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 6:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address:. 22 IMA LOA CT NEI - Description: MFR REPLACE (7) WINDOWS & (2) DOORS"LIKE FOR LIKE" Legal Desc.i TR7817 LOT 3 UNIT 149 OF PROJECT LOCATED ON AP 424-041-01 TOGETHER - .Owner ANDERSON DONALD E Contractor: AMERICAN VISION WINDOWS Architect: Address: 22 IMA LOA CT Address: 2125 N MADERA ROAD#A Address:'° ' NEWPORT BEACH, CA 92663 - SIMI VALLEY CA 93065 Phone: Phone 888.563-0008 Phone: State Lie: o"m- , -Pa v}µ,_ Applicant: AMERICAN VISION WINDOWS Con State Lie: 778326 Engineer; `® 1'9'1 Address: N MADERA ROAD#A Lie Expire: Address: s $IMI VALLEY CA 93085 .Bus Lie: SIMI ALLEY BT31/2020 BT30020869 Phone: 888.563-0008 Lie Exp Date:. 10/31/2019 Phone: State Lie: Code Edit: 2016 Worker's Compensation Insurance. Designer Type of Construction: VB Carrier. STARR INDEMNITY Address:1 Occupancy Group: R21U Policy No: 1000002552 ■ Y Added /New sq.ft. Bldg: 0 Expire: 01/01/2020 Phone: Added /New sq. ft. Garage: 0 - No of Stories: 2 Building Setbacks Rear: 1 Special Conditions: No of Units: 7 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: Right: / Flood Zone:. 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 Feer $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 PM 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: $361.00 Fee Due at Permit Issuance : $0.00 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: ' GRADING APPROVAL: - APPROVAL TO ISSUE: 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 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 hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) 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 im roved for the purpose of sale). 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 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 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 covered by 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, Section 7044 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.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. - I hereby affirm under penalty of perjury one of the following declarations: I 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 performance of the work for which 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' compensatio insurance carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # rI 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 became subject to the workers' compensation laws of California, and agre that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant Date_ DECLARATION REGARDING CONSTRUCTION LENDING AGENCY I hereby 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). Lender's Name Lender's Address By 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_. 1 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 4o enter the above -identified property for inspection purposes. - Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Date ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE. 1403 PERMIT EXPIRED L1 I suamriTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMIT EXTENDED 0AQMD PERMITFINAL T ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF--��—(� �4Z PROPOSED DEMOLITION