HomeMy WebLinkAboutX2019-1922 - Permits (2)5f1r Citi of Newport Beach - Building Division
.1 u'']; ivic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
eK , tPa� Combination Type - SFP ELEC MECH PLUM
IIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2019-1922
x 2 6 1 9 1 9 2 2 Project No
Issued bate : 0 611 812 01 9
Inspection Area : 2
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: 120 KINGS PL NB
Description: SFR *STOP WORK* 2ND FLR GUEST BATHROOM REMODEL (85 SF)
Legal Desc.: N TR 1219 BLK E L071 {� ,+ fill
Owner: BROOKS BRIAN E Contractor: OWNERIBLDR Architect:' "'y N 6
Address: 1835 NEWPORT BLVD #A109 Address: BROOKS BRIAN E Address:
COSTA MESA CA 92627.
Phone:
Applicant: BROOKS BRIAN E
Address: 1835 NEWPORT BLVD #A109
COSTA MESA CA 92627
Phone
Code Edit : 2016
Type of Construction: VB
Occupancy Group: R31U
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:
Building Permit Fee: $232.00
Plan Check Fee: $201.84
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:
Phone:
949-490-9807
Con State Lie:
0113
Lie Expire:
$0.00
Bus Lic:
EXPOSE ALL STRUCTURAL,
Lie Exp Date:
ELECTRICAC VWMBING,
Worker's Compensation Insurance
Carrier:
Address:
Policy No:
Phone:
Expire:
SJH Trans :
Building Setbacks
Rear: I
119-1588
Front: /
018 AUTH ATTACHED
Left: I
o ° o
e.00eoo ° o 0
Right: /
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %°:
Phone:
State Lie:
AS BUILT PERMIT
Engineer:
$0.00
Address:
EXPOSE ALL STRUCTURAL,
Phone:
ELECTRICAC VWMBING,
Designer:
AND
Address:
MECHANICAL COMPQNENTS
Phone:
°.00 ° °o
mmmo
SJH Trans :
omoo° o 0
Special Conditions:
119-1588
$0.00
018 AUTH ATTACHED
o ° o
e.00eoo ° o 0
Building Dept Adm
mm °
$0.00
Planning Department-
Fire Department
$0.00
Plan check Fee:
$40.00
Fire Inspection:
$0.00
Fair Share :
$0.00
Fire Plan Rev
$0.00
SJH Trans :
$0.00
Demolition Fee
$0.00
In -lieu Housing Fee :
$0.00
Building Dept Adm
$0.00
Public Works Department -
General Service
$0.00
Park Dedication :
$0.00
Refund Deposit
PAN Plan Check:
$0.00
Grading Bond:
$16.24
San Dist:
$0.00
$9.28
NMUSD Fee:
$0.00
$20.88
Plan Check Fee
-mo ° -000c
°
$0.00 0000
°
$br00m o
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $755.24
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
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 thee"W-pplicabPa, if?m(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 far
is 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
rEygkf@ssions 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
�tl�ore than five hundred dollars ($500).
F as er-ofthe 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,
IUOS se d 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
nprovements 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
nproved 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 net
pply 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).
7 I am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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 cov ed by this permit, I cannot legall,
ell a structure that I have built as an owner -builder if it has not been constructed ' its entirety by licensed contractors. I understand that a copy of the applicable law, Secti n 7044 of the Business and
Professions Code, is available upon request h hIs appli on Is sub d or t the following Web site:http://www.leginfo.ca.gov/calaw.html. //
'Pignature of Property Owner or Authorized A t > a - _ _ 6 ! (t ` l F
.ICENSED CONTRACTOR'S DECLARATI N
hereby affirm under penalty of perjury that I am licensed 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
nd effect. License Class License No Date Contractor Signature
YORKERS' COMPENSATION DECLARATION
ARNING: 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
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm undarp,enaltyof perjury one of the following declarations:
have and WAIF msintain 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 ormince ofJI%wark forwhich this permit is issued. Policy No.
3L have and will ntElntain 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 and policy number are:
Perrier : _ _ _ Policy Number Expiration Date
rrAof Agent vnonev rtthepertormance 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 agree
I should bec mB subject to the workers' cq\' ens ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. a
Tgnarure f' iS. 1^L�Md— i e 6_�8�ou1
4LA a ---
�C�I,ARATION4ARDING CONSTRUCTION LENDING AGENCY
hereby affirm•tjnder penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sectio g7, Civil Code).
renter's Name Lender's Address
3y my signet, re• 6Slow, 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 relating to building construction.
I authorize representatives of this city or county t ter the ab -ide 1fied property for inspection purposes. f'
ii nature of PropertyOwner or Au[ o gent C Print Property Owner's or Authorized ame 1 I�,wks a G t Z/i//C
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE OlqrY 717
REGULATIONS PART 61 OF TITLE 40 AND A( RULE
PERMITEXPIRED iX j UI SUBMITTED
PERMITCANCELLED I UEPA
NOTIFICATION IS NOT AWLICABLE TO
CERTIFICA TE F , PROPOSED
OCCUPANCYISSUED i�vO RI
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