HomeMy WebLinkAboutX2019-1922 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2019 -1922
'y 10633ivic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 1 9 2 2
Project No
a , n Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
r crshu�;' Combination Type - SFP ELEC MECH PLUM Issued Date : 06/18/2019
Inspection Area : 2
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Construction Hours: Monday - Friday 7.10 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00p.m. No work on Sundays or Holidays
Job Address: 120 KINGS PL NB
Description: SFR "STOP WORK* 2ND FLR GUEST BATHROOM REMODEL (85 SF) & WINDOW C/O "NO HEADER CHANGES*
Legal Desc.: N TR 1219 BLK E LOT 1
Owner
BROOKS BRIAN E
Address:
1835 NEWPORT BLVD #A109
Phone:
COSTA MESA CA 82627.
Phone:
'.
Applicant:
BROOKS BRIAN E
Address:
1835 NEWPORT BLVD #A109
$0.00
COSTA MESA CA 92627
Phone
Code Edit : 2016
Type of Construction: VB
Occupancy Group: R3/U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Flood Zone'
Construction Valuation: $10.i
Building Permit Fee:
$232.00
Plan Check Fee: $201.84
Phone:
Overtime Plan Ck:
$0.00
Investigation Fee:.
$232.00
Record Management:
$2.00
Energy Compliance:
$0.00
CA Seismic Safety :
$0.00
Disabled Access:
$0.00
Hazardous Mat
..$0.00
Building Green Fee :
$1.00
TOTAL FEE: $755.24
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor:
OWNERIBLDR
Address:
BROOKS BRIAN E
Phone:
949-490.9807.
Con State Lic:
cis
Lic Expire:
$40.00.
Bus Lic:
Address:
Lic Exp Date:
Fair Share:
Worker's Compensation Insurance
Carrier,.
State Lic:
Policy No:
0
oe••sm
e. m
Expire:
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WO Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %i
Rear: I
Front: I
Left: I
Right:. /
0
Fire
$0.00
Planning Department -
Architect:
Fire Department
$0.00.
Plan check Fee :
ddoeT
$40.00.
Fire Inspection:
Address:
$0.00
Fair Share:
Phone:
State Lic:
eomo.
. e
e•
0
oe••sm
e. m
Engineer:
•
• ` . • m
Address:
$0.00
m....
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ee o
e e
Phone:
State Lic:
e •m
....
o e e
e• m
Public Works Department -
• e
oeeao
Designer.
Park Dedication :
....
a
Address:
$0.00
0
emmmm
$0.00
m
oemmoo
Phone:
San Dist:
o.....
m
m
o 0
$9.28
mmmmmm
Special Conditions:
119-1588
o mm
e m m
o 0
moss
$20.88
O/B AUTH ATTACHED
m m o m
Fire
$0.00
Planning Department -
Fire Department
$0.00.
Plan check Fee :
$40.00.
Fire Inspection:
$0.00
$0.00
Fair Share:
$0.00
Fire Plan Rev
$0.00
$0.00
SJH Trans :
$0.00
Demolition Fee
$0.00
In -lieu Housing Fee:
$0.00
Building Dept Adm
$0.00
$0.00
Public Works Department -
General Service
$0.00 -
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
PAN Plan Check:
$0.00
Grading Bond:
$0.00
$16.24
San Dist:
$0.00
$9.28
NMUSD Fee:
$0.00
$0.00
$20.88
$0.00
Plan. Check Fee
: $755.24
Fee Due at Permit Issuance :
$0.00
PUBLIC WORKS APPROVAL: (/
PLAN CHECK BY:
APPROVAL TO ISSUE:Vr� - - -
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 applicabI6 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
of -ore than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
mess 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
imp vements 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 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 p@1801 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 legall)
sell a structure thab Mtwe built as an owner -builder i21: has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7944 of the Business and
PiNwipts Code,.is swilable upon request when t s has,
Is sub dor the following Web site:http://www.leginfo.ca.gov/calaw.htmi. / '
Sajnature of Pro*l.(I*er or Authorized Agent �_ nr Date
LiJ0gN8PD CONTRACTOR'S DECLARATION
I Icereby affirm under penalty of perjury that I amilicensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions C de, and my license is in full force
and effect License Glass License No _ Date Contractor Signature
I FIFERS' COMPENSATION DECLARATION
ARr11NCoFAILURE 10 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
OSI P� JdMPENSAThYN!CAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
nejepy alfirm under -penalty of perjury one of the following declarations:
II have: and w4weiAin 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
e{fpppynpe of the work for which this permit is issued. Policy No.
..
71 -haw, 'and wilhma'mtsln 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' compensatioi
isurance carrier andpolicy number are:
arrier Policy Number Expiration Date
ame of Agent Phone #
71 certify that, in the pe rmance of 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 agre
tat, if I should become ubject to the workers' com ensatiop provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant _ Vc//VJ Date I��lq
DECLARATION REG DING C NSTRUCTION LENDING AGENCY
hereby affirm under enalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, ivil Code).
ender's Name Lender's Address
y 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 co my, ordinances and state laws relating to building construction.
I authorize representatives of this city or count nter the abo b=ed property for inspection purposes.
ignature of Property Owner or Authorized A ent Print Property Owner's or Authorized Agent's Nam 6 5 ate Zfj
tCTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND ACIMD RULE
CERTIFICATEOF �/w J[5 SIGNATURE: MOKION
IFI J S NOT APPLICABLE TO
OCCUPANCY ISSUED N/ I CJYnh