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HomeMy WebLinkAboutX2020-0082 - Permitst6wno�P City of Newport Beach - Building Division c 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 v. 't Inspection Requests Phone (949)644-3255 �rrnusY& Combination Type - MFP ELEC MECH PLUM III IIIII�III0IIIIII0�I�III0�II0III�II� II COMB Permit: X2020-0082 Project No: 0075-2020 Issued Date : 0111012020 Inspection Area: 2 Applicant: JANSSEN TERRY PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. P.O. BOX 5380 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: 218 COLLINS AVE NB CA Seismic Safety: Description: MFR - KITCHEN AND BATH REMODEL $0.00 Legal Desc.: BALBOA ISLAND SEC 3 BLK 11 LOT 19 Building Green Fee : Owner: JANSSEN TERRY Contractor: OWNERIBLDR Architect: HUSSEY DIANE Address: P.O. BOX 5380 Address: JANSSEN TERRY Address: 219 A MARINE AVE $0.00 NEWPORT BEACH CA 92662 OIB FORM ATT NEWPORT BEACH CA 92662 ...... Phone: 949-933-0283 Phone: Phone: 949-275-6551 State Lic: 015707 °O°0 Applicant: JANSSEN TERRY Address: P.O. BOX 5380 Record Management: NEWPORT BEACH CA 92662 Phone: 949.933-0283 Code Edit : 2019 Type of Construction: V -B Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 2 Bldg Height: 0 Bldg Sprinklers: Flood Zone: Construction Valuation: $6.200.00 Building Permit Fee: $184.00 Plan Check Fee: $160.08 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 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: $431.88 PROCESSED BY: ZONING APPROVAL: Con State Lic: 0/B Lie Expire: Bus Lie: Lie Exp Date: Worker's Compensation Insurance Carrier: Policy No: Expire: Building Setbacks Excise Tax: Additional Fee: Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: I Front: I Left: I Right: I Engineer: Address: Phone: Designer: Address: e o Doom• O C ccmcoc o c a o N�1° o e o C® oo�o °p °mom j�"9momoo� "° n@dCTI@,d Pe�m�11At{�eaoo Dm®0`b C ° 0000r Phone: P9pp em , ON pOYNiO� Special Conditions: THE EK m ° a $0.00 o n mccc $40.00 0000 $0.00 $0.00 Planning Department - Fire Department $0.00 Plan check Fee : $40.00 Fire Inspection: $0.00 $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 $0.00 SJH Trans : $0.00 Demolition Fee $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 $0.00 Public Works Department - General Service $0.00 $0.00 Park Dedication : $0.00 Refund Deposit $0.00 PAN Plan Check: $0.00 Grading Bond: $0.00 $12.88 San Dist: $0.00 $7.36 NMUSD Fee: $0.00 $0.00 $16.56 $0.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $431.88 PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: r 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 he 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 '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 ore 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, slness 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 mprovemgnts 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 %pirpedlor 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 pur�Ll#nt to th C==:tractors' State License Law). 1 am exempt from licensure under the Contractors' State License Law for the following reason ,L�r✓J�G e�'� 3y my signature below I acknowledge that, except for my personal residence in-Vhich I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally ;ell a structure t4dt1 fi%e built as an owner -builder if it has not been c truct o in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of th Business and 3rofessions Code! icgvailable upon request when this a ation i i or at the Hawing Web site:http://www.leginfo.ca.gov/calaw.htmi. r� 3,''ignaiurs of Property Owner or Authorized Agent D � 10EN9ED COIATlI DECLARATI tgrpb§ Sffirm under penalty of perjury that I am li ensed under&olilisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force lied eff@ct. License Class License No Date Contractor Signature VORMRS' CONMPEaSATION DECLARATION ARNIAG: FAILURE TDiSE%URE 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 :06"F.COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. kloreby affirm under penalty of perjury one of the following declarations: . %-Iu4 and will mijigtain 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 thl �erformarice of the wcirk.for which this permit is issued. Policy No. 3? Tiav'e,and will,rpaigtain 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' compensatior isUfdInte carrier%"dticy number are: Policy Number Date ne of Agent Phone # certify that, in the 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 , if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. mature of Applicant Date_ CLARATION REGARDING CONSTRUCTION LENDING AGENCY :reby 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). 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 o,�nes half. I have read this application and the information I have prgv €d is CoCrrect I agree to comply with all applicable city and county a d state laws relating to building construction. I authorize representatives of this city or county to a -i a 'ed property for inspection purposes. nature of Pmnerly Owner nr Authnrized Aaent / Print Pronertv Owner's or Authorized Aaent's Name .00 ACTION DATEBy REGZTIONS PAR O61 OFTION OF IITLE 40ANOAQMD RULECE WITH CODE OF FEDERAL FOR OFFICE USE ONLY 1403 PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED 13EPA PERMIT EMENDED 4ZVAD PERMITFINALSBESTOS CERTIFICATEOF OCCUPANCYISSUED L� I /t q /, �I/ ID NOTIFICATION IS NOT APPLICABLE TO OPOSED DE�`'�0 TION SIGNATURE: V 1 4�, '.2;9 U a) w O = LL- o- p 0 'O ���ffffff N 0. 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