HomeMy WebLinkAboutX2019-3198 - PermitsCity of Newport Beach - Building Division
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Permit: X2019-3198
b .100 Civic Center Drive, Newport Beach, CA 92660
'b
x 2 0 1 9 3 1 9 8
Overtime Plan Ck: $0.00
Project No
h Permit£irunter Phone (949)644-3288
$0.00
Record Management: $0.00
s"s= Inspection. Requests Phone(949)644-3255
-
$0.00 -
CA Seismic Safety: $0.00
' $0.00
Issued Date :
e,) c> Combination Type - SFP
-
Park Dedication :
Building Green Fee: $1.00.
$0.00
.Inspection Arearea :2019
3
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
$0.00
Construction Hours: Monday - Friday 7:00 a.m. to 630 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays
Job Address: 627 IRVINE AVE NB
$0.00
NMUSD Fee:
Description:. SFR - T/O BUR, APPLY 1-LYR FELT, W125 SOS CLASS "A" BUR
-
Legal Desc.:. NEWPORT HEIGHTS LOT 28 NELY 40 FT SWLY 80 FT SELY 145 FT
Owner: JORDAN ZONA Contractor OWNER/BLDR
: Architect:
Address: 987 POST RD Address:
Address:
_ INSPECTOR
COSTA MESA, CA 92626
Phone: 949-331-2590. Phone:
Phone:
State Lic:
Applicant: JORDAN ZONA Con State Lie: O/B
Engineer.
° o
Address: 987 POST RD - Lie Expire:
Address:
COSTA MESA, CA 92626 Bus Lie:
Phone: 949-331-2590 Lie Exp Date:
- Phone:.
State Lie:
Doom �
Code Edit: 2016 Worker's Compensation Insurance
Designer:
• °C°°°�',
-.Type of Construction:.. VB Carrier:.
Address:
Occupancy Group: R3/U Policy No:
Added /New sq.ft. Bldg: 0 Expire:
Phone:.
Added /New sq. ft. Garage: 0
° ° o 000co
No of Stories: 2 Building Setbacks Rear: I
Special Conditions:
CIS AUTH ATTACHED ° ° .....
No of Units; 1 Front: 7
Bldg Height:. 0 Left: I
II TOTAL FEE :
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL: _
Excise Tax:
Additional Fee:
Grading Bonds Fee:
Grading PC Consultant:
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
/Mechanical %:
Plumbing %:
Right:
kinn Rmnrar n F
$0.00
Building Permit Fee: $324.00
Plan Check Fee: -.$0.00
Plan check Fee
Overtime Plan Ck: $0.00
$0.00
Investigation Fee: $0.00
$0.00
Record Management: $0.00
SJH Trans:
Energy Compliance: $0.00
$0.00 -
CA Seismic Safety: $0.00
' $0.00
Disabled Access: $0.00
Public Works Department -
Hazardous Mat $0.00
Park Dedication :
Building Green Fee: $1.00.
$0.00
PAN Plan Check:
II TOTAL FEE :
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL: _
Excise Tax:
Additional Fee:
Grading Bonds Fee:
Grading PC Consultant:
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
/Mechanical %:
Plumbing %:
Right:
kinn Rmnrar n F
$0.00
Planning Department -
$0.00
Plan check Fee
$0.00
$0.00
Fair Share:
$0.00
$0.00
SJH Trans:
$0.00 -
In -lieu Housing Fee'
' $0.00
$0.00
Public Works Department -
$0.00
Park Dedication :
$0.00
$0.00
PAN Plan Check:
$0.00
$0.00
San Dist:
$0.00
$0.00
NMUSD Fee:
.$0.00
.$0.00
Plan Check Fee : $0.00
PUBLIC WORKS
c 0oo0ou
0 om o
0000
Fee Due at Permit Issuance : $325.00
PLAN CHECK BY:
APPROVAL TO ISSUE:
Fire Department
$0.00
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
Fee Due at Permit Issuance : $325.00
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 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, al6b requifes 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
n more than five hundred dollars ($500).
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,
usiness and Professions Cade: 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
mprovements 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
mpr(ved 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' Slate License Law).
❑ 1 am. exempt from licensure under the Contractors' State License Law for the following reason:
By 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 covered by this permit, I cannot legall,
sell a structure that I have built as an owner -builder if it s not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Professions Code, is available upon request whei ap licatio� is submitted q�@t the follov� ng Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm wUl; gtalty 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
and effept. License Class License No Date Contractor Signature
1f1IkPRS' Q0MP%NSATION DECLARATION
3NMG: FAILURE tQ SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE
Pr OFCOMPENSAAON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES
'retry affirm uadec penalty of perjury one of the following declarations:
%Iwte and v?iR 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 th
Jorgiance o-tNe Nock for which this permit is issued. Policy No.
.lave and A nWntain 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
,uWoe carrier 2nd policy number are:
Z
er: _-_ Policy Number Expiration Date
Agent • Phone #
••
y thatlint � e 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 the workers' compensation laws of California, and agre
Ihould become sgj;IKct to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of Applicant
Ireby affirm under pehalty o;/perjury that the'd is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Ider's Name Lender's Address
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 relating to building construction.
I authorize representatives of this city or county to/say.gthe above- ntified pr party for inspection purposes.
nature of Prooertv Owner or Authorized AGent �r /�f/�i✓I!�-* l�..C'.t� Print Prooertv Awner's or Authorized ADent's Nath ,� UYGGC G'/ Dat
DATE BY I REGULATIONS LARATION PART 61 OF IITLE 40 AND,
ftULECE WITH CODE OF RAL,1 FOR OFFICE USE ONLY
I SUBMITTED ASBESTOS
PERMIT EXTENDED LIAAMD
PERMITFINAL lop 51ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
CERTIFICATE OF - PROPOSE❑UJ F,�'OLITION �B
OCCUPANCYISSUED SIGNATURE✓1
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