HomeMy WebLinkAboutX2019-1706 - Permitsr City of Newport Beach - Building Division
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COMB Permit: X2019-1706
100 Civic Center Drive, Newport
Beach,
¢ CA 92660
X 2 0 1 9 1 7 0. 6
Project No:
r+ : Permit Counter Phone (949)644-3280.
Inspection Requests Phone (949)644-3255
Combination Type - SFP
-.
Issued Date: 05/2912019:
-
Inspection Area : 4
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: 1436 KEY VIEW NB
Description: SFR WINDOW CIO (14) LIKE FOR
LIKE
Legal Desc.: N TR 6152 LOT 58
� re m
� r ,i
r
Owner: YOUNG KENDALL
Contractor.
RENEWAL BY
ANDERSEN OF OC - Architect:
Address: 1436 KEY VIEW
Address.
22962 ALCALDE DR #100 Address:
. _ • I'
CORONA DEL MAR, CA 92525
LAGUNA HILLS CA 92653
<.'
"Phone:. -
Phone:
714.259-5120
Phone:
State Lic:
Applicant: RENEWAL BY ANDERSEN OF OC
Con State Lie:.
990416
Engineer..
a e°°
oeei°o
Address: - 22982 ALCALDE DR #100
Lie Expire:.
02/2912020
Address:
LAGUNA HILLS CA 92653
Bus Lia: ,
BT30046925
me. s
Phone: 714-259-5120.
Lie Exp Date:
04/3012020 -
Phone:
State Lic:.
°
Code Edit: 2016
Worker's Compensation Insurance
Designer.
o. ° o'
.0 .0.
.Type of Construction: V -B
Carrier:
EVEREST NATIONAL Address:
.Occupancy Group: R3/U
Policy No:
MWC31415800:
Added /New sq.ft. Bldg:. 0
Expire:
10/0112019
Phone:
Added /New sq. ft: Garage:. 0
No of Stories: 2
Building Setbacks
Rear: I
Special Conditions:
No of Units: 1
Front: I
Bldg Height: 0.
Left: I
Bldg Sprinklers:-
Right: I°
oc°o
Flood Zone:
Use Zone: Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $13.000.00
Building Permit Fee: $280.00
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
PAN Plan Check: $0.00
' Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical W
$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 : $281.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance ;
$281.00
PROCESSED BY:
PUBLIC WORKS APPROVAL:
ZONING APPROVAL: -
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO ISSUE:
ry
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the resson(s) indicated below by the checkmark(s) I have placed next to the applicabK. itenitmp
(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 acivil 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 (_) 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).
1, 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 toanowner 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, ig,pvailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signature of ProQerty,Owner or Authorized Agent ate
CEN6ED CONTRACTOR'S DECLARATION i
erenry affirm under ponalty of perjy that I am licensed under provisions Q��@ to` 9 (commencing with Section 7 Q)r f Di i ' n 3 of the Business and P/EDTHOUSAND
ons d a y�nse is in full force
apd etfect. Lidensd Class IS License No iU l�y.. Date J Contractor Signatu
SRARS' COOMPENSATION DECLARATION
WARNING: FAILURE T08EOURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ND CIVIL FINES UP TO ONE HUNG DOLLARS ($100,000(, IN ADDITION TO THE
'DST -PCOMPENSATION,l1AMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I h:r:.by affirm :vii *nd r pt natty of perjury one of the following declarations:
4av
.6e and ` aintain a certificate of consent to self-insure for workers' compensation, issued by the Director of Industrial Relations as providedfor by Section 3700 of the Labor Code, for th
prjarpglnce of th@ work for which this permit is issued. Policy No.
haus and wial Kiiiaintain 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
hpvouppe carrier and Ifolicy number are:
airwc� t�r�i : P113�,\ (� Policy Number MWG 3�w I yW Expiration Date 91-1 1d ,) ' /9
Name of Agent Phone #
I certify that, in the perfo nce he work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' co, pensation Is s of California, and agre
that, if I should become subj c to the rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant. Date
DECLARATION REG DING CONST UCTION LENDING AGENCY
I hereby, affirm under nalty 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 rovided is correct. I
I agree to comply with all applicable city andcou ty o anc and state laws relating to building construction.
I authorize representatives of this city or county o an r e atified property for inspection purposes. n l Al (L,ti
Signature of Property Owner or Authorized Agenf 1�'' YYY/�" YYYPrint PropertyOwner's or Authorized A ent's Name a 9 - t`'"'�D e
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
7R ULATIONS PART 61 OF TITLE 40 AND AQMD RULE
403
PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO
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PERMITFINAL LJASBESTO FICATIO S�T APPLICABLE TO
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