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Home My WebLink AboutX2019-0103 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 ry Permit Counter Phone (949)644-3268 Inspection Requests Phone (949)644-3255 "gdzr�rrc+��p Combination Type - SFP COMB Permit: X2019-0103 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIu II Project No: Issued Date : 0110812019 Inspection Area : 2 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 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 1400 DOLPHIN TER NB g Description: SFR REPLACE (3) WINDOWS, (2) SLIDER DOORS & (1) FRENCH DOOR Legal Desc.: N TR 1700 LOT 26 r b Owner: BARLOW & JULIET Contractor: RENEWAL BY ANDERSEN OF OC Architect: Address: 1400 DOLPHIN TER Address: 22982 ALCALDE DR #100 Address: CORONA DEL MAR, CA 92625 LAGUNA HILLS CA 92653 Phone: Phone: 714-259-5120 Phone: State Lic: Applicant: RENEWAL BY ANDERSEN OF OC Con State Lic: 990416 Engineer: Address: 22982 ALCALDE DR #100 Lic Expire: 02129/2020 Address: e e e e e e LAGUNA HILLS CA 92653. Bus Lic: BT30046925 Phone: 714.259-5120 Lic Exp Date: 04/30/2019 Phone: State Lic: o e. a °o e ° o ° ° ° ° o Code Edit: 2016 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: EVEREST NATIONAL Address: a°ee Occupancy Group: R3/U Policy No: MWC31415800 0 0 0 0 Added /New,sq.ft. Bldg: 0 Expire: 10/0112018 Phone: Added/New sq. k. Garage: 0 No of Stories: 1 Building Setbacks Rear: I Special Conditions: No of Units : 1 Front: I ° Bldg Height: 0 Left: / ooaoc c. 11 Bldg Sprinklers:...Right: / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N c ° ° ... Construction Valuation: 914.000.00 Building Permit Fee: $296.00 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 PAW 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 : $297.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $297.00 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 (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business 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 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 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 pursuantto: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 legally 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 j l I hereby affirm uR�der penalty of perjury�t{�at I am licensed under provisions o((�(@(,9�ommencing with Seo 7000) o Divi pn 3 of the Busil%es9nd Protassions �pde,,end my license is in full force and effect. Licen%gtlass ' y License No V`i� i I Contr$ECIr nature) in � &61MRS' COUREEISATION DECLARATION WARNING: FAILURE TO SECITRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE CPS? Q OOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm underpenalty of perjury one of the following declarations: L ,a and will4aintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for thnce of tPbA%for which this permit is issued. Policy No. • .. re and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' compensa Iol is ianGe carrier all policy number are: '6 ) + � 9 &rr'ier : (�t�. a= Policy Number NSCLC, IS�(� Expiration Date / 1 • • @rlify that, m•1G$ erformance f 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 ogre khat, if I shout om s bject to th ' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ) Signature ofb I ant te— )ECLARATION REGARDING CONSTRUCTION LENDING AGENCY 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 (Sect) 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 o dinanc s and state laws relating to building construction. I authorize representatives of this or county to an the a -id ' ied property for inspection purposes. }� \� e 3i nature of Property Owner or Autho .Agent Print PropertOwner's or Auth Jzed a tsa-Name `i ACTION DATE BY DE RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED OEPA PERMIT EXTENDED qMD PERMITFINAL ASBES OS OTIFICATIO IS NOTAPPLICABLE TO CERTIFICATE OF �i DELITION OCCUPANCYISSUED I l / SIG FID v v 0''2 (n vv- �_0� W mm� Z m O N O �+ w y o �. O x. w N O' goy c 7 0. m � 3 ❑ ❑ p. C/) (—D fn Z, W, w 3aa °1 fDaw mad am (D a 4 N O. C (D O CCL D N O 0 CD w O� �.m (\ �(a CL mo m 3 m3fO m Z w(oa 'mm \ fD (D <- O U p N d a. O N CD N. 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