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Home My WebLink AboutX2021-3131 - Permitsw.ro$ City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 °.' Permit Counter Phone (949)644-3288 'ti.. Inspection Requests Phone (949)644-3255 Combination Type - SFP Illllllllllllllllllll�llllllllllllllll�q II COMB Permit: X2021-3131 Project No : Issued Date : 11/1812021 Inspection Area : 2 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1111812024 OR PERMIT WILL BE INVALID 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: 221 APOLENA AVE NB Description: SFR CHANGE OUT (2) WINDOWS Legal Desc.: BALBOA ISLAND SEC 3 BLK 7 LOT 27'°'�' Owner: BREWER JOHN Contractor: RENEWAL BY ANDERSEN OF OC Architect: Address: PO BOX 5020 Address: 22982 ALCALDE DR #100 Address: NEWPORT BEACH, CA 92662 LAGUNA HILLS CA 92653 Phone: Phone: 714-259-5120 Phone: State Lic: Applicant: REDIRA ROBIN Con State Lic: 990416 Engineer: Address: 22982 ALCALDE DR #100 Lic Expire: 02/28/2023 "- Address: LAGUNA HILLS CA 92653 Bus Lic: BT30046925 Phone: 714-259-5120 Lic Exp Date: 0413012022 Phone: State Lic: Code Edit: 2019 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: OLD REPUBLIC INS CO Address: Occupancy Group: R3/U Policy No: MWC31415821 Added /New sq.ft. Bldg: 0 Expire: 10/0112022 Phone: Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: I Special Conditions: No of Units : 1 Front: I Bldg Height: 0 Left: I Bldg Sprinklers: Right: I Flood Zone: X Use Zone: Parkin S aces: 0 Fire Hazard Zone : N Construction Valuation: $1,100.00 Building Permit Fee: $110.00 Excise Tax: $0.00 Planning Department- Fire Department Plan Check Fee: $0.00 Additional Fee : $0.00 Plan check Fee : $0.00 Fire Inspection: Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share: $0.00 Fire Plan Rev Investigation Fee: $0.00 Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department- General Service CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit Disabled Access : $0.00 P/W Plan Check: $0.00 Grading Bond: Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 TOTAL FEE: $111.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Plan Check Fee : $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $111.00 ' UBLI001011rS APPROVAL: WQ PLAN CHECK BY: t hPPPQVAU 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, priorto 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 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 Tot more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) 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 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 improved 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' State License Law). ❑ I am exempt from [!censure 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 c vered by this per it, I cannot legally 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, Se lion 70 of the usiness and Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent "teLICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 ) of Division 3 of the Business and Prd y i ense is in full force and effect. License Class License No Date Contractor Signatur 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for thI per$Jrmance of the wgrk for which this permit is issued. Policy No. PI have and wJ rkers' coo ensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation isurance carriember ire: R )arrier 1 u Expiration Date lame of Agent + Phone # 3I certify that, ince of t rk fo ich 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, hat, if I should bt thew I'compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.signature of ApDate )ECLARATIONON TR TION 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 L Lender's Address 3y my signature below, I certify to each of the following: I am the property owner or authorized to act on the pr erty ow el's behalf. I have read this application and the information Ii ovided correct. I agree to comply with all applicable city and cou1 ances d s e laws relating to building construction.I authorize representatives of this city or count 'bo a d nt led property for inspection purposes. (�� i/Y� signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name '' WW a ACTION DATE BY RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REG TIONS PART 61 OFTITLE 40 AND AQMD RULE 1403-., PERMITEXPIRED I SUBMITTED ASBESTOt V•OTIFICATIONWO• • :• •• PERMIT CANCELLED EPA PERMITEXTENDED ^•" +` QM® IA PERMIT FINAL SBESTO NOTIF TION IS NO AP LICABLE TO CERTIFICATEOF R OSEDDMOU OCCUPANCYISSUED ATURE• +•• " ° • e + o m PA,