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HomeMy WebLinkAboutX2019-1410 - Permitsa City of Newport Beach - Building Division IIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2019-1410 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 1 4 1 6 Project No : 0983-2019 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - SFP PLUM ELEC MECH Issued Date : 0511412019 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: 520 VIA LIDO SOUD NIB,� Description: SFR'S'@WER REPAIWVSTAIR HANDRAILS, CONV BATH TO OFFICE,12ND FL NON-STRUCTURAL WALL & DOOR CHANGES *STOP WORK* 118-2902 Legal Desc.: TR 907 LOT 587(AND SWLY1/2 LOT 586 e • Owner: CORDERO ALFONSOIMERCY Contractor: OWNER/BLDR Address: 520 VIA LIDO SOLID Address: MERCY B CORDERO NEWPORT BEACH, CA 92663 $0.00 CA Seismic Safety: Phone: Phone: $0.00 Applicant: CARLSON JAMES Con State Lie: O/B Address: 2300 CLIFF DR Lie Expire: 949-645.3051 State Lic:C013773 NEWPORT BEACH CA 92663 Bus Lie: $0.00 Phone: Lie Exp Date: Engineer: Code Edit : 2016 Worker's Compensation Insurance Type of Construction: V -B Carrier: Occupancy Group: R31U Policy No: Added /New sq.ft. Bldg: 0 Expire: eo°0o m Added /New sq. ft. Garage: 0 State Lie: , No of Stories: 2 Building Setbacks Rear: I No of Units: 1 ooe000 Front: I Bldg Height: 0 Left: I Bldg Sprinklers: Right: / Building Permit Fee: $392.00 Plan Check Fee: $341.04 Overtime Plan Ck: $0.00 Investigation Fee: $392.00 Record Management: $10.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $1,295.69 PROCESSED BY: ZONING APPROVAL: Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WO Insp. Fee: Electrical %: Mechanical %: Plumbing %: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.44 $15.68 $35.28 Plan Check Fee Planning Department - Fire Department oee• $40.00 Architect: CARLSON JAMES `9 Fire Plan Rev Address: 2300 CLIFF DR e Park Dedication : $0.00 NEWPORT BEACH CA 92663efdi• $41.25 San Dist: Phone: 949-645.3051 State Lic:C013773 ° Refund Deposit $0.00 ooeeoe _ Engineer: e• °�° Address: +e•e °O ° ° oomm eo°0o m Phone: State Lie: , • ° ° ° e Designer: o e ooe000 Address: 0 00 000000 Phone: e•om •OOO Special Conditions: OWNER/BLDR ATTACHED . Planning Department - Fire Department Plan check Fee $40.00 Fair Share: $0.00 SJH Trans : Fire Plan Rev In -lieu Housing Fee: $0.00 Public Works Department - Park Dedication : $0.00 P/W Plan Check : $41.25 San Dist: $0.00 NMUSD Fee: $0.00 $422.29 Fee Due at Permit Issuance : $673.40 PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: Fire Department $40.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 $422.29 Fee Due at Permit Issuance : $673.40 PUBLIC WORKS APPROVAL: PLAN 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) 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 aptAcant for 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 Bu ness and 'rofessions 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 more than five hundred dollars ($500). 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or roved for the purpose of sale). �Wlas owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law doesnot pply to an ov€ner of property who builds. or improves thereon, and who contracts. for the projects with a licensed Contractor_pursuant to the Contractors State License Law). _ I am exem i from licensure under the Contractors' State Li ense Law for the following reason: army glgnatule'&Iow I acknowledge that, except for my p nal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legallt ell a structure thaNl'have built as an owner -builder i it In t been construc din its tire ty by licensed contractors. I understand that a copy of the applicable law, Section 44 of the Business and %fessions Code! is available upon request when I' 's ub i Core following Web site:hftp://www.leginfo.ca.gov/calaw.html. ligdature of Property Owner or Authorized Agent Dat .flsEN$ED CURMCTOR'S DEC LARAricened hereby affirm yp1�f penalty of perjury that I a 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 adef$ect. Licen%EPQoss License No Date Contractor Signature YORKERS' COp11PENSATION DECLARATION IMMINCOFAILURE TO SECWRE 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 §'OMPEN%%TM1MMAGES AS PROVIDED FOR IN SECTION 3908 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. he ;epy affirm under penalty of perjury one of the following declarations: .. 9.I.have and tlViJI jtgiAtain 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, erformance of the work for which this permit is issued. Policy No. ]I 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' compensatiol Isurance carrier and policy number are: :arrier Policy Number Expiration Date lame of Agent Phone # ]I certify that, in the perfo ce of the work for w 'ch this p It is issued, I shall not employ any person in any manner so as to become subject to the workers' c pensation laws of California, and agre Hat, if I should becomes ) t @ w ' co ensati vision's o»�Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date p ignature of Applicant j ii//� // f5— /�Z / ,ECLARATION REG RDIING CONSTRUCTION LENDING AGENCY hereby affirm unde penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil 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 prov' ed is correct. 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