HomeMy WebLinkAboutX2019-1201 - PermitsCity of Newport Beach - Building Division
*X20191201*
COMB Permit: X2019-1201
Parking Spaces:
0 Fire Hazard ZoneN
6$ " 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Project No: 0864-2019
)
i
4 .,»spection Requests Phone (949)644-3255
_
Combination Type - SFP ELEC PLUM
Building Permit Fek $232.00
Issued Date : 0411612019
$0.00
Planning Department -
Inspection Area : 2
Fire Department
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Plan Check Fee: $201.84
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: 534 SAN BERNARDINO AVE NB
C/O
WATER HEATER SF
$40.00
Description:: SFR -BATH REMODEL, (2) NEW WINDOWS, WINDOW & DOOR & INST TANKLESS
40
Legal Desc.: FIRST ADD TO NEWPORT HEIGHTS BILK 33 LOT 9 :.
$0.00
�4 r r
$0.00
Fair Share :
_ham
Owner: GELS AL &LISA Contractor: OWNER/BLDR
ArchitectY"°.;p.
Address: 534 SAN BERNARDINO AVE Address:
Address:
Grading PC Consultant :
NEWPORT BEACH CA 92663
SJH Trans : -
•moe
Phone: 949481-6982 Phone:
Phone:
State Lie: m • ° o °
Applicant: .GELS AL Con State Lia b/B
Engineer: ABE STEVEN
m
Address: 534 SAN BERNARDINO AVE Lie Expire:
Address: 5111 DOOLAN
RD •mom
NEWPORT BEACH CA 92663 Bus Lia
LIVERMORE CA 94551 ° ° •�°
Phone: 949-867-5982 Lie Exp Date:
Phone: 925-944.6363
State Lic:C-055277
Grading PC Fee:
$0.00
Public Works Department -
Code Edit: 2016. Worker's Compensation Insurance
Designer.
$0.00
Type of Construction:. VB Carrier:.
Address:
• m o omeom
Occupancy Group: R3IU Policy No:
$0.00
Park Dedication : $0.00
Added7New sq.ft Bldg:. 0 Expire:
Phone:
$0.00
- Added INew sq. ft. Garage: 0
Disabled Access :
$0.00
No of Stories: 1 Building Setbacks Rear; /
Special Conditions:
P/W Plan Check: $0.00
No of Units: 1 '. Front: /
Grading Bond:
.$0.00
Bldg Height: 0 Left: /
Hazardous Mat
....
Bldg Sprinklers: - Right: /
$16.24 -
Sao Dist: $0.00.
Flood Zone:
Use Zone:
Parking Spaces:
0 Fire Hazard ZoneN
Construction Valuation: $9.500.00
Building Permit Fek $232.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $201.84
Additional Fee:
$0.00
Plan check Fee:
$40.00
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:
$4.00
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/W Plan Check: $0.00
Grading Bond:
.$0.00
-
Hazardous Mat
Electrical %:
$16.24 -
Sao Dist: $0.00.
-
Building Green Fee :
Mechanical °/m:
$0.00
NMUSD Fee: $0.00
$0.00
n$515.96
Plumbing %:.
. $20.86'
$0.00
TOTAL
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$515.96
PROCESSED BY:
PUBLIC WORKS AP
OVAL:
1
ZONING APPROVAL: -
`�
PLAN CHECK BY..
GRADING APPROVAL:.
APPROVAL TO I
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)
ctioD 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
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 theBusiness and
fessions 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
more than five hundred dollars ($500).
1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Iiness and Professions Code: The Contractors' Slate License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
rooy ements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
0ved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
ly to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I am exempt from licensure under the Contractors' State License Law for the following reason:
my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year
a structure that I rave built as an owner -builder if ijjas not been constructedin its entirety by licensed contractors.A contractors.u
ifessions Code is available upon request whe th' a plication is submitted or at the following Web site:
nature of PropL?rf?(5wner or Authorized Agent
SENSND CONTI$ACTOR'S DECLARATI
to completion of the improvements covered by tm
that a copy of the applicable law, Section 7044 of
rcalaw.html. . 11_1�
6
rebY affirm unddllAflalty of perjury that I am licensed under provisions of Chapter 9 (commencing with action 7000) of Division 3 of the Business and Professions Code, and my license is in
leffsot. License Class License No Date Contractor Signature
force
l%QRKfRS' CQyLP,JSATION DECLARATION
'ARMNG: 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
CST d1 tOMPENSATJQty RAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I?&@ "effFm uddet pertalty of perjury one of the following declarations:
•eee
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 th
• •ee•
ar{osmaace of tha.workfor which this permit is issued. Policy No.
e ..eee.
�leta�vgpnd will maintdin 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' compensatiol
�sur'ance-carries and policy number are:
sryvgr Policy Number Expiration Date
Agent
in the performance of the work for which this permit is issued, I shall not employ any person in any
)ecorpe subject to the workers' compensation provisions of Section 3700 of the Labor Cod�Jkyhal
of
-reby affirm under penalty of perjury that there is a construction lending agency for the performance of
tder's 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.
Vnner S as to become subject to the workers' compensation laws of California, and agre
V,
mply with those provisions.
Date
for which this permit is issued (Section 309 Civil Code).
I agree to comply with all applicable city and county ordinanc s an t e I relating to building construction.
I authorize representatives of this city or county to enter t ov I ti roperty for inspection purposes.
signature of Property Owner or Authorized A ant Print Property Owner's or Authorized A
ACTION DATE BY DECLARAT N COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULA NS PART 610E TITLE 40 AND, RULE
I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT FINAL�.A//d ��Y/�> p SIGNSED ATURE:EMOLITIONIO NOLIC E TO
CERTIFICATE OF 7 ^/ Y //�XJ.I
OCCUPANCYISSUED
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