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Home My WebLink AboutX2019-2226 - Permitsfr City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIillllllllllllllllllllllll� COMB Permit: X2019-2226 c1 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1: 9 2 2 2 6 Project No: 1604-2019 Permit Cnter Phone (94644-3288 9 ' ar nspect on Requests Phone (949)644-3255 �ar74uy�s Combination Type - CIP Issued Date : 0711712019 Inspection Area : 7 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: 3112 NEWPORT BLVD NB - Description: COMM RE-STRIPING OF PARKING LOT Legal Desc.:.°U kgASTERS ADD BLK 431 LOT 2 "(30ner AXR L.4RR Contractor: OWNERIBLDR Architect: aAtlbI'Asa: e11.605 ENSIGN CIR Address: JEHEBER ROD FOR OWNER Address: o o HUNTI"NGTON BEACH, CA 92649 eq�hrrnay ° Phone: Phone: Slate Lica. oe `A`pppIQc t: JErCkEtt!'R ROD. Con State Lica. O/B Engineer. r dress. A 32Np ST STE 202 Lic Expire: Address: NFRVR&PT BEACH CA 92663 Bus Lic - Phone° 949-723-4393 Lic Exp Date: Phone:.. .. State Lic: 5006 Edit : ° 2016 Worker's Compensation Insurance Designer: JEHEBER ROD Type of QonstruC ioir.. ° Carrier: Address: 410 32ND ST #202 Oeeuau0�y Group:, U Policy No: Added /New sq.fts4ldg:°° 0 Expire: NEWPORT BEACH CA 92663 Phone: Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: I Special Conditions: LL No of Units: 0 'Front: I Bldg Height: 0 _ Left: Bldg Sprinklers: Right: /ECT( - Flood Zone: Use Zone: Parkin S aces: 0 Fire Hazard Zone : N - Construction Valuation: $1.000.00.r II TA Building Permit fee: $104.00 Excise Tax: $0.00 Planning Department-- Fire Department Plan Check Fee: $90.48 - Additional Fee: $0.00 Plan check Feel .$40.00 Fire Inspection: - $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 fair Share- $0.00 Fire Plan Rev $67.00 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: $41.25 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 : $333.73 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $333.73 PROCESSED BY: WU;LIC WORKS APPROVAL: Nfa ° a ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: _ ° m "� XPPROVAL TO ISSUE: ° OWNER -BUILDER DECLARATION 1 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) 1 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 (_) 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 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 a 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 prior to completion of the improvements covered by this parmit, I cannot If'o sell a structure that I have built as an owner -builder if it has not an constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of thei°BuseleaS and ° Professions Code, is available upon request when this p' io is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agen Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am license der pr visions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my Iicelig i full fo°nc ° and effect. License Class No Date Contractor Signature • o.. WORKERS' COMPENSATION DECLARATION •• NARNING: 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 ADDITIOI TUITHE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 0. hereby affirm under penalty of perjury one of the following declarations: • • • 0 : ° :11 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 11L.Cebor Cofooriuj 3erformance of the work for which this permit is issued. Policy No. ' •• 131 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: Policy Number of Agent Date artify that, in the performance of the ork 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 agre F, if I should become subject o e o ers' compensati n provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions.. nature of Applicant f _+ I 261 CLARATION REGARNkIJ4,011STIZUtTION LENDING AGENCY :reby affirm under penalty of pe ' tha there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). lder'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 I agree to comply with all applicable city and county ordina c s and state laws relating to building construction. f I authorize representatives of this city or county to eptrt a ove-identified property for inspection purposes. •�• �r�� •--�' Z� nature of Procertv Owner or Authorized Aqent , Print Property Owner's or Authorized Agent's Name ACTION DATE BY — ACLARAT[OV OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGNOTIOPf PART 610E TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED LJ 1 SUBMITTED ASBESTOS NOTIFICATItj(N to PERMITCANCELLED EPA . • •.• , ° •• PERMITEXTENDED qMD `•• ` •.• °: •° PERMITFINAL G 'jZ \•1� ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFIC4TEOF PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: • • • • ••• `°` `• u.• . ••• •••