HomeMy WebLinkAboutX2018-2085 - Permits1r°�r
City of Newport Beach - Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
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Combination Type - MFP PLUM
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIq II COMB Permit: X2018-2085
x 2 0 1 8 2 9 8 5 Project No :
Issued Date : 07111/2018
Inspection Area: 1
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: 811 W 15TH ST NB
Description: MFR *WORK IN PRGRS* MSTR BATHROOM SHOWER ONLY, RPLC TILE, LATH, HOTMOP ONLY (NO PENETRATIONS TO THE COMMON WALL)
Legal Desc.: TR 10272 LOT 1 UNIT 7 OF PROJECT LOCATED ON AP 424-011-32 TOGETHER "CTOR
Owner: JOSEPH SVEN OLSON Contractor: OWNER/BLDR Architect:
Address: 811 W 15TH ST #2A Address: THOMSON BONNIE Address: INSPE
NEWPORT BEACH CA 92663
Phone: Phone: 949.922-0809 Phone: - State Lie',
Applicant: THOMSON BONNIE Con State Lic: O/B Engineer: AS BUILT PERMIT
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Address: 811 15TH ST Lie Expire: Address: EXPOSE ALL UCTMAeI,�
NEWPORT BEACHCH CA 92663 Bus Lie: S I[
Phone: 949-922-0809 Lie Exp Date: Phone*+" S to LL'c: /•+ /�t�t
Code Edit: 2016 Worker's Compensation Insurance 9S er: - CTR/ AL PLUN#I 1IN6, AND-
Type of Construction: VB Carrier: ,�„-s�� Addreaa: - ME /CAL COMQ'ONEh1T�°
Occupancy Group: R2/U Policy No: __tea.•'''' t, ,1b�e',
Added /New sq.ft. Bldg: 0 �Ipire°'0� '� �{p�7Pl�dttB:
Added /New sq. ft. Garage: 0 ^ �o�%Yefund°OO°° °° °°°
No of Stories: 3. ?uildjo�S®tbacks Rea ---'�— ao6�Ql rdealdi ons: O/B AUTH ATTAC ED
lI °0 0
No of Units: 1 io runt: I Q NO PLANS REQ RDJK o°°°o°
Bldg Height: ' 0
'Fri
Left: - �f ° ......
Bldg Sprinklers: 'g ......
Flood Zone: �.('. Zo r aces: �O W�ve Hazard Zone: N ° °
Construction Valuation:r'I-' 1 2 * ° ° ° ° • °
Building Permit Fee: $97'
0 Exc $0.00 it rtment - FirAa
tme °. °
Plan Check Fee: $0 Oq', La
Additions Fee : $0.00 eck e : $0.00 Fectio $0.00
Overtime Plan Ck "$0. 0 Grading Bonds Fee' 0 re : $0.00 Firev $0.00
Investigation Fee $�97 Gradi t . fl. - $0.00 DeFeeRecord Management „$0 radi P it 0. ousing Fee : $0.00 B.Dept m $0.00
Energy Compliance ,$0 0 t�' radi ee $0. Public Works Department - ,Servic $0.00
CA Seismic Safety $0 0 Q I $0.00 Park Dedication : $0.00 eposit $0.00
Disabled Access $0.00.h PNV n e ° (/ e ond: $0.00
Hazardous Mat $0.00 Electrical %: $0.00Sa DistBuilding Green Fee : $1.00 Mechanical %.,QO�. NM SD a $0. 0$0:00
PI�tH ¢i mg °/n.„.Ts { �$e?17�t;"' o Vl1 �.fr1C � $0.00
TOTALFEE: $203.73 Plan Check Fee : $0.00 FeeDue at cmit'ts$203.73
PROCESSED BY: ""- PUBLIC WORKS AP,RPbOAL.
ZONING APPROVAL: 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)
ction 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 fo[_
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
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
than five hundred dollars ($500).
Zowner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
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
rovements 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
roved for the purpose of sale).
an owner: of property who
LJ I am exempt from licensure under
By my;§ignature below I acknowledge
sell a structure that I have built as an
Professions Code, is available up
o
Signature of Pro erty Owner o
LICENSED C3f TRAC,7QK,9 bE
I hereby affirm under penalty of pedur,
and effett'r, Lice>vier'9lasa r ;
contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
troves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
:ractors' State License Law for the following reason:
apt for my personal residence in which I must have resided for at least one year prior to completion of the improvements cov red by this permit, I cannot legal
ilder' it'hss not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Secti f the B siness and
;elTthis ion i ub ilLed or at the following Web site:hftp://www.leginfo.ca.gov/calaw.htmi. 11
Int Da eIn 2b
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
License No Date Contractor Sicnature
iNINGGFQR,i TO JEFCiME 1^ ORkEJ Sj,OOMPENSATION•CDVERAGE 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
iFCR OMPEN�`P.TION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Ireby affirm, i?dder'penaltyb perjury one of the followingdeclarations:
I *leve 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 the
formance of thewvorle for which this permit is issued. Policy No.
h90e and wil4maintain 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' compensatior
mance carrie►alTd'pc;licy number are:
'14WO � _ Policy Number Exoiration Date
......
Ili 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 become subject to
m® subject to the workers' compe ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisic
re of Apo' alig'��—� /iCl /� _
Ireby as lender penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued
Ider's Name Lender's Address
compensation laws of California, and egret
, Civil Code).
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,.
I agree to comply with all applicable city and county ordinances and state laws r ting to building construction. ..
I authorize representatives of this city or county to enleLlb a above-identi p arty for'nspection purposes.
Signature of Property Owner or orized Agent 'n Owners or Authorized A ent's Name
ACTION DA BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
EGCLATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED I S-11: IG I P� I LJ I SUBMITTED ASBESTOS NOTIFICATION TO
UBION IS NOTAPPLICABLE TO
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