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HomeMy WebLinkAboutx2019-2926 - PermitsCity of Newport Beach Building Division I IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II 100 Civic Center Drive, Newport Beach, CA 92660 X 2 6 1 9 2 9 2 6 Permit Counter °hone (949)644-3288 Inspection Regllisste, Phone (949)644-3255 •'+tvxu,� Combination Type - MFP COMB Permit: X2019-2926 Project No : Issued Date : 0911612019 Inspection Area : 1 PERMITS EXPIRE 180 DAYS AFTER ISSUANGC Un LAa+vnuu uvorc+. Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:0 0 a.m: to 6:00 o work on Sundays or Holidays Job Address: 126 46TH ST NB . p Description: MFR CHANGE OUT (1) WINDOW "LIKE FOR LIKE" V�A Legal Desc.: RIVER SECTION BLK 45 LOT 13 Owner: MACKAY DAN Contractor: OWNER/BLDR Address: 126 46 ST Address: MACKAY DAN NEWPORT BEACH CA 92663 Fire Plan Rev In -lieu Housing Fee: Phone:. Phone: Park Dedication : Applicant: MACKAY DAN Con State Lic: O/B Address: 126 46 ST Lic Expire: NMUSD Fee: NEWPORT BEACH CA 92663 Bus Lic: $0.00 Phone: 714.305-0553 Lic Exp Date:. - Code Edit : 2016 Worker's Compensation Insurance Type of Construction: VB Carrier: Occupancy Group: R3/1.1 Policy No: Added /New sq.ft. Bldg: 0 Expire: Added /New sq. ft. Garage: 0 No of Otones: 1 Building Setbacks Rear: I No of Units : 2 - Front: / Bldg Height: 0 Left: I Bldg Sprinklers: ', Right: 1 Flood Zone: X Zone Parking Spaces: Construction Valuation: $1,000.00 Building Permit Fee: $104.00. Excise Tax: $0.00 Plan Check Fee: $0.00 Additional Fee : $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Investigation Fee: $0.00 Grading PC Consultant : $0.00 Record Management: $0.00 Grading Permit Fee: $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 Building Green Fee'. $1.00 Mechanical%: $0.00 Plumbing %: $0.00 TOTAL FEE: $105.00 Architect":1 Address: ��� Phone: St e i Engineer: Address: Phone: ®State Lic: Designer: Address: Phone: Special Conditions: Planning Department - Fire Department Plan check Fee $0.00 Fair Share: $0.00 SJH Trans : Fire Plan Rev In -lieu Housing Fee: $0.00 Public Works Department - Park Dedication : $0.00 PM Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Plan Check Fee : $0.00 IT $0.00 $0.00 Fee Due at Permit Issuance: $105.00 o� aim v ... _ PROCESSED BY: < < o �; G FIUBLIC.NORA APPROVAL: � c o c. co o ZONING APPROVAL: V e E ®� ° J PLAN CNECK`BY: C -.,QAPDING APPROVAL:- APPROVAL TO ISSUE: ��•, 4 Q p C80 d0 O o 9 4 6 'e O • " F C B yL O © 000 b1N 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: $105.00 o� aim v ... _ PROCESSED BY: < < o �; G FIUBLIC.NORA APPROVAL: � c o c. co o ZONING APPROVAL: V e E ®� ° J PLAN CNECK`BY: C -.,QAPDING APPROVAL:- APPROVAL TO ISSUE: ��•, 4 Q p C80 d0 O o 9 4 6 'e O • " F C B yL O © 000 b1N 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 items) (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 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 U all of or (_) 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 improved for the purpose of sale). 'f 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' State 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 perit, I ca not legall sell a structure that I have built as an owner -builder if has not be onstructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the usine s and Professions Code, is available upon request when a y s submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html 9 / Signature of Property Owner or Authorized Agent tay�— OR [7 y LICENSED CONTRACTOR'S DECLARATIQIN I 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 and effect. License Class License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), 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: 1 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 the )erformance 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' rance carrier and policy number are: ie of Agent certify that, in the performance of .if I should become subject to the of Policy Number Expiration Date work for which thy.permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation ews o California, and agre 'kers' compe Ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. C � ✓ 11=.LA1 I IUM Kelin"U UUNST otaTION LENDING AGENCY hereby affirm under 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 ly 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. 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