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HomeMy WebLinkAboutX2019-3798 - PermitsIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII� II COMB Permit: X2019-3798 X 2 6 1 9 3 7 9 6 Project No : Issued Date: 1112612019 Inspection Area : 3 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 8:0Q 0®. to 6:00 p.m. No work on Sundays or Holidays Job Address: 5000 RIVER AVE NB / V Description: SFR CHANGE OUT (6) WINDOWS 'LIKE FOR LIKE' ®/t, Legal Desc.: N TR 3162 LOT 31 ° VV Owner: DELISIO DIANE Contractor: OWNERIBLDR Architect: Address: 420 E INVERNESS DR Address: AUTH AGENT: dress: ����®®e� q HIGHLAND HEIGHTS OH 44143 l� Phone: 832-62B-1533 Applicant: MILLIKEN ROBERT Address: 428 BROADWAY COSTA MESA CA 92627 Phone: 949-212-1970 Code Edit : City of Newport Beach - Building Division Type of Construction: VB c 100 Civic Center Drive, Newport Beach, CA 92660 F ifir Permit Counter Phone (949)644-3288 - - Inspection Requests Phone (949)644-3255 No of Stories: "'Combination Type -SFP IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII� II COMB Permit: X2019-3798 X 2 6 1 9 3 7 9 6 Project No : Issued Date: 1112612019 Inspection Area : 3 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 8:0Q 0®. to 6:00 p.m. No work on Sundays or Holidays Job Address: 5000 RIVER AVE NB / V Description: SFR CHANGE OUT (6) WINDOWS 'LIKE FOR LIKE' ®/t, Legal Desc.: N TR 3162 LOT 31 ° VV Owner: DELISIO DIANE Contractor: OWNERIBLDR Architect: Address: 420 E INVERNESS DR Address: AUTH AGENT: dress: ����®®e� q HIGHLAND HEIGHTS OH 44143 l� Phone: 832-62B-1533 Applicant: MILLIKEN ROBERT Address: 428 BROADWAY COSTA MESA CA 92627 Phone: 949-212-1970 Code Edit : 2016 Type of Construction: VB Occupancy Group: R3/U Added /New sq.ft. Bldg: $0.00 Added /New sq. ft. Garage: $0.00 No of Stories: 1 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: N Flood Zone: X Building Permit Fee: $168.00 Plan Check Fee: $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $169.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Phone: ROBERT4-19 0LIKEN PhoriT?: A m Stat UNA^ Con State Lic: OIB Engineer: �s � Lic Expire: Address: An® Bus Lic: e Lic Exp Date: Phone: State Lic: Worker's Compensation Insurance Carrier: Policy No: Expire: Building Setbacks Use Zone: Excise Tax: Additional Fee: Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WO Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: I Front: I Left: I Right: / $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Designer: Address: Phone: Special Conditions: LIQUEFACTION AREA HIGH DENSITY Fire Hazard Zone : N Planning Department - Fire Department Plan check Fee: Fire Inspection: Fair Share Fire Plan Rev SJH Trans Demolition Fee In -lieu Housing Fee Building Dept Adm Public Works Department - Park Dedication : $0.00 PAN Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance - I' - o FUBIa1C©WORKS APPROVAL: - o PLAN bHECK BY: � o u c o c GU3 5,4 ry �; �,6PPLZOVAL TO ISSUE: 00 O 4 r 9 O C C U - 1JG uG V0 0 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $169.00 Fire Department $0.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: Plan Check Fee: $0.00 Fee Due at Permit Issuance - I' - o FUBIa1C©WORKS APPROVAL: - o PLAN bHECK BY: � o u c o c GU3 5,4 ry �; �,6PPLZOVAL TO ISSUE: 00 O 4 r 9 O C C U - 1JG uG V0 0 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $169.00 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 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, iness 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 imp i vements 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 itm--lIprved for the purpose of sale). IGf 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 a ly 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). I 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 legal sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7 44 of the Business and Professions Code, is available upon request whe hi all is sal fitted 2tih,7111wj=:http://www.leginfo.ca.gov/calaw.html. Ilowjng Web site:http://www.leginfo.ca.gov/calaw.html. r Signature of Property Owner or Authorized Agent rl 9 �' f{ r�! D ' LICENSED CONTRACTOR'S DECLARATION 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 :RS' COMPENSATION DECLARATION 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 ($100,000(, IN ADDITION TO THE OMPENSATION, 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 rance carrier and policy number are: Policy Number Date me of Agent —Nnone A certify that, in the performance Phe work for- hich 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 agree t`if I should beco e s ject to lI c eti n pfo/�yfsloIps of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant /i r �� .'I -a. -{i ^ Da)t < ` CLARATION REGARD G C INSTRUCTION LENDING AGENCY " areby 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). tder'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 o inances n state law relating relating to building construction. f, I authorize representatives of this city or county to ,r tI ab ve Ide Ad tSr p rty for inspection purposes. nature of Prouertv Owner or Authorized ADent V ��G /"I Gi (l L—� Print Property Owner's or Authorized Agent's NarrA "`-1 �4f�r� D•alG, 1[, �' =� ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY - N. 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