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Home My WebLink AboutX2018-2684 - Permitsr, wp City of Newport Beach - Building Division "X2018-2684* COMB Permit: X2018-2684 • 6 100 Civic Center Drive, Newport Beach, CA 92660 Project NO : 2139-2018 v Permit Counter Phone (949)644-3288 o Inspection Requests Phone (949)644-3255~iktaued Date : 09/07/2018 Combination Type - MFP ELEC PLUM C -` 010 Insp�ption Area : 5 � PERMITS EXPIRE 180 DAYS AFTE SUAN • LALID fNSP TION. rz Construction Hours; Monday - Friday 7:00 a.m. to 6:30 p.m. a Satur rom BcjtQ a.m. to Q p.m. No work on dajr Holidays Job Address: 513 112 MARIGOLD AVE NB ``f{�� rD �-''``�� O• Description: MFR WINDOW REPLACEMENT (8), UPGRADE EXISTING ELEC PANEL CHEN Rfr'MOD1SF Legal Desc.: / 'O_ r Owner: AHMADIMARK Contractor. OWNERIBCDR VO Architect: GOETZANDREW r" Address: 19 MUIR BEACH CIR Address: AHMItD(MAR ��J. Address: 2855 E COAST H 34 ' j r , NEWPORT BEACH, CA 92625 CORONA D �, A 92625n',.,, Phone: 849-677-0718 Pho q Y Phone: 949-673-31 State Lic:C01849 a , Applicant: GOETZ ANDREW on StXU0,11, rEngineer:Address: 2855 E COAST HWY 9234 Lic Exp`'+"Address:CORONA DEL MAR CA 92625 Bus L,+ '`;�� !• �'�� , Phone: 949-fi73-3152 Li xp D M,,; "',; Phone:' �°� St .Lic: Code Edit: 2016i�-,Workers Ccmpen o ranee JDicv Type of Construction: V-B \4Cainer:- ' ' Occupancy Group: R3 (p Policy N:�� Added /New sq.ft. Bldg: 0 j Expire:. _ VVVV �• ' Added (New sq. ft. Garage. 0 No of Stories: 2 Vi „?'" Building Setbacks �te t Special Conditio . OWm�wB FORM ATTACHED , No of Units : 2 se,.: • ont Bldg Height: 0 Bldg Sprinklers: i ght I n....a 7- '<, - cRfJse Zone: Par q Spaces: Fir azard e Construction Valuation: $_ 10 00 0 -' 'ir' N- Building Permit Fee: $217.00 Rr�;t' Exci $0.00 e{apning Depa nt - Fire Department Plan Check Fee: $188.79 Addi a e $0.00 'o Cppfan check F $37.50 Fire Inspection: $0.00 Overtime Plan Ck: $0.00;;; radio ~ee: $0.00 ra\` Fair Shar $0.00 Fire Plan Rev $0.00 Investigation Fee: $0.00 G ing onsultarl $0.00SJH T ns : $0.00 Demolition Fee Record Management: $4.00 x ra Permit Fee: $0.00 In- u Housi F $0.00 Building Dept Adm $0.00 Energy Compliance: $56.00 PC Fee ,�,$� P is Wor De rtment - General Service $0.00 CA Seismic Safety: $0.00 Wns as : $0. Park dic tion : $0.00 Refund Deposit $0.00 Disabled Access : $0.00': P I heck $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 ElectrJ: $15.19 S D' $0.00 Building Green Fee : $1.00 MechanA4%: $0.00 D Fee: $0.00 $0.00 Plumbing IiLep: 3 $0.00 TOTAL FEE : $539.01- 'Plan C c ee : $0.00 Fee Due at Permit Issuance : $539.01 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: __ 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 ndicat below.by the checkmark(s) I have placed next to the applicable item(a) ction 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, im e, demolis r repair any structure, prior to its issuance, also requires the applicant for permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' S License Law (C ter 9(commencing with Section 7000) of Division 3 of the Business and fessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any anon of Section Tat V, any applicant for a permit subjects the applicant to a civil penalty of Ornore than five hundred dollars ($500). was owner of the property, or my employees with wages as their sole compensation, will do lusin3s and Professions Code: The Contractors' State License Law does not apply to an owne nprovements are not intended or offered for sale. If, however, the building or improvement nproved for the purpose of sale). 1 I, as owner of the property, am exclusively contracting with licensed Contractors t - nstrucl pply to an owner of property who builds or improves thereon, and who contracts f e projeii 7 1 am exempt from licensure under the Contractors' fate License Law for t ollowing Vast ry my signct�ra below I acknowledge that, except for y personal residence which I must he, all a strucb,ra that I have built as an owner -builder if has t been Gonst ucted in its entirety 'rcfessions Code is available upon request when t s ap t' n is llgnature cf Priperty Owner or Authorized Agent .!CENSED CONTRACTOR'S DECLARATI hereby affirm under penalty of perjury that I am tensed u r pii nd effect. License Class LicerySE' UORKERS'COMPENSATION DECLARATION Le' IARNING: FAI'.URO SECURE WORKERS' COMPENSATION COVERAGE I NLA OST OF COM'CNSATION, DAMAGES AS PROVIDED FOR IN SECTION 37 OF THE hereby affirm under penalty of perjury one of the followj4 declakatil I have anH,A"I' :maintain a certificate of 'ormance of the work for which this permit have ant' wil maintain workers' compel Trance carrier and policy number are: lame of Agent I certify that, in thl= pe mance of the work fi tat, if I should be s ct t the we ers c ignature of Applicant IECLARATION REG t77 G S IOt hereby affirm under anal f5 .pe ry thatthilp Ender's Name y my signature below, I certify Aac f the I am the property owner or au ' ze act I have read this application and _ 'itrfo at I agree to comply with all applicab a I authorize representatives of this cit .COL signature of Proper ACTION PERMIT EXPIRED PERMITCANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATEOF OCCUPANCYISSUED Owner or Authorized I DATE I tS or (_) portions ok work, and t structure is not intended or offered for sale (Section 7044, :rty who, thrpqZ,i r pe nal effort, builds or improves the property, provided that the $rre yeatp wner- "Ider Mi have the burden of proving that it was not built or 'ct ( on 70Professio Codl?The Contractors' State License Law does not : sed Contrache Contract State,icense Law). one year prior to completion of U I understand that a coov of the nttea or a ne tollowing vveo sl��napu/www.legmto.ca.gowcalaw.ntml. of Ch 9 c g with Section 7000) of Division 3 of the a and Pro -� Date �oi1(rrrrrr��cccccctor Signature AND SHAt.4 S ECT AN EMPLOYER TO CRIMINAL PENALTIES ARk ?V.� �$j[P TO ONE HUNDR 2 CODE INTEREST, AND AtTORNEY'S FEES. [A to sejf.-insurefor workers' compensation, issued by the Director of,]hffustriY{l P6Gcy No. O.`� Wrance, as required by Section 3700 -o'f the Labor Code, for. the perQmance of t O Policy Number �� E 17044 of the Business and 9 6' I;add my license is in full force ($100,000), IN ADDITION TO THE 3700 of the Labor Code, for permit is issued. My workers' which this permit is issued, I shall not emplo any person in any manner as to b m ubject to the workers' co pensation laws of California, and agree mpensatlon provisions of Section 3700 of tabor Code, I shall forth r[ii compl it ose provisions. —f Date/ LADING AGENCY s construction lending agent f performance of the ork for ch s permit is issued (Section 30 ,Civil Code). L d�� Address property o n have prov'd ct. my o as St ws relating buildin on ction. toe ve-id ified prope or insp Io rposes. In operty Owner's or Authorized Agent's Name _v TnI'lfi DatE _`/�o ECLARATION OF COMPLI CE WIT OD F FEDERAL FOR OFFICE USE ONLY ULATIONS PART6 FTITLE AN OMD RULE TO IS NOTAPPLICABLE TO