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Home My WebLink AboutX2019-1267 - Permitsk$ City of Newport Beach -Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2019-1267 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 1 2 6 7 Project No : 0741-2017 Permit Counter Phone (949)644-3288 $0.00 : - Inspection Requests. Phone (949)644-3255. $35.00 >Combination Type - SFP ELEC PLUM MECH Issued Date: 2019 $0.00 Inspection Area: 3 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. ees• .Consfrucfion 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. 4oJb, djess: 20R4 NAUTILUS LN NB Grading PC Consultant: Descripgon: !JFJ%6P1) 40 SF TO BATHROOM AND NEW DECK 65. SF *ADDITIONAL SCOPE TO NEW SFR* *CHANGE OF CONTRACTOR TO O/B*. - i o9m l D msc.: N TR 3763 LOT 75 Record Management: $0.00". i Grading Permit Fee: 6*fl6r° a HMIDAY JULIE & ADAM Contractor: OWNER/BLDR Architect: VOLBEDA PETE Pl"66t: 2424'N415TILUS LN Address: HOLIDAY ADAM Address: 180 N BENSON AVE #D e ° NEWPOIT BEACH CA 92660 UPLAND CA 91786 Phone: Phone: 909-519-8670 State Lic:C013077 Applicant: HOLIDAY ADAM Con State Lie: O/B Engineer. - Ad'dres°s: 2024.NAUTILUS LN Lie Expire: Address: NFWPDRT BEACH CA 92660 Bus Lie: $0.00 Phone Exp Date: Phone: State Lie: m ° m m .Lie Hazardous Mat Code Edit : ° °O ° 2016 Workers Compensation Insurance - Designer: Type of Construction: V-B-SPR Carrier Address: Occupancy Group: R3/U Policy No: $0.00 Added /New sq.ft. Bldg: 40 Expire: Phone: , r, ' ria a Added /New sq. ft. Garage: 0 Fr > v a No of Stories: 2 Building Setbacks Rear: I Special Conditions: REV18 0328 r r c ? $0.00 No of Units : 1 Front: / TOTAL FEE : $35.00 Bldg Height: 0 Left: / M Bldg Sprinklers: Y Right: / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone: N - i PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL Planning Department- Building Permit Fee: $0,00 Excise Tax: $0.00 Plan check Fee: Plan Check Feer $0.00 $0.00 : Additional Fee: $35.00 Fair Share: Overtime Plan Ck: $0.00 Grading Bonds Fee: $0,00 SJH Trans : Investigation Fee: $0.00 Grading PC Consultant: $0.00 In -lieu Housing Fee : Record Management: $0.00". i Grading Permit Fee: $0.00 Public Works Department - Energy Compliance: $0.00. Grading PC Fee: $0.00 $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee: ` $0.00 $0.00 Disabled Access : $0.00 $0.00 San Dist: $0.00 Hazardous Mat $0.00 Electrical W $0.00. $0.00 Building. Green Fee : $0.00 Mechanical %: $0.00 - Plumbing %: $0.00 Fee Due at Permit Issuance : TOTAL FEE : $35.00 Plan Check Fee PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL Planning Department- Fire Department Plan check Fee: $0.00 : Fire Inspection: $0.00 Fair Share: $0.00 Fire Plan Rev $0.00 SJH Trans : $0.00 Demolition Fee In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Public Works Department - General Service $0.00. Park Dedication : $0.00 Refund Deposit $0.00 P/W Plan Check: $0.00 Grading Bond: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 $0.00 - $0.00 $0.00 Fee Due at Permit Issuance : $35.00 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 the applicable item(s) (Section 7031.5, Business and Professions Cade: 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 not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U 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, g ovided 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 ilot built •Or... imp roved 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 Lice•rmed.ew does sot Lp)kiyAo 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). eeeao ❑ ( m exempt from licensure under the Contractors' State. License Law for the following reason: _. • ...,. By not signature below I acknowledge that, except for my personal residence in whic4 I must ha sided for at least one year prior to completion of the improvements covered by thisyiiftpit, J cannot jegllb sell structure that I have built as an owner -builder if it has not b en a ucte i s entir ' ensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and r esalons Code, is available upon request when t is applicaf n i miffed r t the f o eb site:http://www.leginfo.ca.govicalaw.html. a , .. , •• Signature of Property Owner or Authorized Agen Date LICENSED CONTRACTOR'S DECLARATI0 • • ' I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 ( mmencing with Section 7000) of Division 3 of the Business and Professions Code, and my ILcVV%e is in full force and effect. License Class License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION NARNING: 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 (5100,000)+IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under 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 'ormance of the work for which this permit is issued. Policy No. 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' compensa Trance carrier and policy number are: Policy Number Expiration Date clortify that, in the performance of the workfpr whic is pe Lied, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agrer Of I should become subject to the rk ' o pe ation o of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant Datl� CLARATION REGARffINb CONIaTUCTIO DI GAGE Y Ireby affirm under penalty of perjury that there is constructio 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 S t aw I Ing to building construction. /// I authorize representatives of this city or count to enter. a ffKoyk-i n e pr arty for inspection purposes. / /„ nature of Pronertv Owner or Authnrized ADent I i� Print Pronertv Owner's or Authorized ADent's Name Af Lt;41 f itI, Date ACTION DATE BY DECLLATION OFUebIVIP RU LIFyICE WITH CODE OF FEDERAL FOR OFFICE USE ONLY EGTIONS PART 61 O TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO gF'�' �� [ rww/ - f 2. 0rS PERMITCANCELLED EPA rr �T /` PERMIT EMENDED qM D PERMITFINAL ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: