HomeMy WebLinkAboutX2019-3251 - PermitsCity of Newport Beach - Building Division
*X20193251*
COMB Permit: X2019-3251
100 Civic Center Newport
Beach, CA 92660
Drive,
Project NO
Permit Counter Phone (949)644-3288
Insipection Phone (949)644-3255
.Requests
P"'xMwvY.e� Combination Type-. SFP
Issued Date: 10/1112019
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: 42015TH ST NB
-
-
Description SFR REROOF*"DETACHED STRUCTURE*" W/ CLS"A" COMP, TIO COMP (4 SQS)
Legal Desc.: N TR 1218 LOT 44Owner:
-
PESCHELT JOHN E
P
-1r O
I S EC
Address: 420 1 STH ST
Address: SCHELLTDJOHN Address:
1 T
NEWPORT BEACH, CA 92663
Phone. 949-254-5734
Phone:
Phone:
State Lic:
Applicant PESCHELT JOHN E
Cod State Lic: OIB
_Engineer.
Address: 420 15TH ST
Lic Expire:
Address:
NEWPORT BEACH, CA 92663
Bus LIC
°
Phone:
Lic Exp Date
Phone:
State Lic:
m
Code Edit2016
Worker's Compensation Insurance
` Designer: -
,• •
ommo
°
®. °
Type of Construction:.
Carrier.
Address:
• °
Occupancy Group: U
Policy No:
Added/New sq.ft. Bldg' 0
Expire:
Phone:
Added /New sq. ft. Garage:. 0
No of Stories 0
Building Setbacks Rear: . I
.Special Conditions:
OIB AUTH FORM ATTACHED
00 °
No of Units:. 1
Front: I
[-PERMIT FOR HOUSE &GAR
Bldg Height: 0
Left:.. /
COMB19.0200
Bldg Sprinklers:
Right: /Flood
Zone:
Use Zone: Parking Spaces:
0 Fire Hazard Zone :
N
' Construction. Valuation: $2.000.00
.......
Building Permit Fee: : $0.00
Excise Tax: $0.00
Planning Department -
Fire Department L OO.
Plan Check Fee: $0.00
Additional Fee i $35.00
Plan check Fee : $0.00
Fire Inspection: $0.00
Overtime Plan Ck $0.00
Grading Bonds Fee: $0.00
Fair Share . $0.00
Fire Plan Rev $0.00
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 : ;.$0.00
Grading Bond: - $0.00-
Hazardous Mat -$0.00
'. Electrical %: $0.00
San Dist: $0.00
Building Green Fee : $1.00 -
.Mechanical W $0.00
NMUSD Fee: ..$0.00
$0.00
Plumbing%: -:-$0.00
$0.00
TOTAL FEE :` $36.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance : $36.00
PROCESSED BY:
- PUBLIC WORKS APPROVAL:
ZONING 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) I 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 $kof 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 civilpenalty of
not more than five hundred dollars ($500).
❑ 1, as. owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) 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
ipedhaa
e purpose of sale).
'i�aJ.'', , ow�ner 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 taw). — -
❑ 1 am exempt from licensureunder the Contractors' State License Law for_!,4e following reason:
By my signature below I acknowledge that, xcept personal residen I which I must have resided for at least one year prior to completion of the improvements overed by this permit, Icannot Iegalli
sell a structure that I have built as an own r-bui er if it ha not en co tr ed in it ntirety by licensed contractors. I understand that a copy of the applicable law, S ction /7044 of the Business and
Professions Code, is available upon a est whe lic on is fitted or he fol win b site:http://v�.leginfo.ca.gov/calaw.htmi.
.leginfo.ca.gov/calaw.htmi. te! v�//��
Signature of Property Owner or Author' d Agent
LICENSED CONTRACTOR'S D CL RATIO
I hereby affirm under penalty of perjury that I am sed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professiont Code, and my license is in full force
and effect. License Class License No Date Contractor Signature
WORKERS' 66M ISISATION DECLA TION
f® 43CURE 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
S �10N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
ider penalty of perjury one of the following declarations:
I 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 the Labor Code, for
p4iiince of1ITe,&8rt for which this permit is issued. Policy No.
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'
. .
carrier oaane .policy number are:
Policy Number
Date
in the rformance of the work for this permit is issued, I shall not employ any person in any manner so as to become subject to the works s' compensation laws of California, and
ai cb e!subiaMo the Workers' coft6nsatiorArovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Ap�licAnt IONENCY UPlu 'r
)ECLARATION REGARD NSTRUCTLENDING AG
hereby affirm under pen It f 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
3y, my signature below, certify to each of the following:
I am the property owner or authorized to act on the property owner's be
I have read this application and the infor ve provided is c ec
I agree to comply with all applicable and county rdi nces dd s e I WE relating to building construction.
I authorize representatives o th d or county the a - dentif' d prop spection purposes. ��N �p���
ii nature of Pro arty Owner or o'zed Agen Print Pro ert Owner's or A 'zed Agent's Name �. Z9
ACTION DATE DECLA ATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED v LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITC4NCELLED DEPA
PERMIT EXTENDED QMD
PERMITFINAL ��` SNOTIFl ATIO ISNOT AE
CERTIFICATE OF �-1—�� J� PROPOS DEMOLIT N
OCCUPANCYISSUED 51 / I
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