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Home My WebLink AboutX2019-1012 - Permits0f,17;5ua"'� -City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - SFP Ili iiiiiiiiiii II COMB Permit: X2019-101 Project No : Issued Date : 04101/2019 Inspection Area : 5 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 8:00 a.m, to 6:00 p.m. No work on Sundays or Holidays Job Address: 515 CAMEO HIGHLANDS DR NB Description: SFR WATERPROOFING DECK USING WESTCOAST WP-40 ESR # 2201 230 SF Legal Desc.: N TR 3519 LOT 117 Owner: SANDRA DUDUM Contractor: OWNERIBLDR Architect: Address: PO BOX 4337 Address: AUTH AGENT: Address: WALNUT CREEK CA 94596 JOHN REUTER Phone: 925-766-7316 Phone: Phone: State Lic: Applicant: REUTER JOHN Con State Lic: Ole Engineer: Address: 515 CAMINO HIGHLAND Lic Expire: Address: NEWPORT BEACH CA 92625 Bus Lic: Phone: 949-842-1199 Lic Exp Date: Phone: State Lic: Code Edit: 2016 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: Address: Occupancy Group: R3/11 Policy No: Added /New sq.ft. Bldg: 0 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear. / Special Conditions: O/B FORM W/ X2019-0506 No of Units : 1 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: Right: / Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $9,750.00 Building Permit Fee: $232.00 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 PAN 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: $233.00 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 : $233.00 PUBLIC WORKS APPROVAL: _ PLAN CHECK BY: 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(s) indicated below by the checkmark(s) I have placed next to the applicable item(:) (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 Cade) 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, 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 roved for the purpose of sale). s 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 gWneF of property who builds or improves thereon, and who contracts f e projects with a licensed Contractor pursuant to the Contractors' State License Law). Ellam exempt trom licensure under the Contractors' State License Law f t Ilowing reas Fr.1y signal'uie below I acknowledge that, except for my personal resi c which I mus ve resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally sell a structure Hmt I have built as an owner -builder i it has not b cte .„��o•.,ontractors. I understand that a copy of the applicable law, Section 7 4 of th u 'nass and Protessions Coda, is available upon request when t is app' I ollowing Web site:http://www.leginfo.ca.gov/calaw.html. Signature of PronPr'y Owner or Authorized Agent Date '_ICENSED CONTRACTOR'S DECLARATI I derby affirm under oerealty of perjury that I am li res 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 Pffect. U—n,-e. Class License No Date Contractor Signature Wi'PKERS' COMPENSATION DECLARAT ON PIP PNI'J 3: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE CC3T OF COMPEHCATION; DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Irr-h-llereby affirm under penalty of perjury one of the following declarations: 4{ 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 the performance 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' compensatiol trance carrier and policy number are: rise olic mber Expiration Date Tie of Agent Phone # certify that, in the perlo once of the w th' er ' ' issued, I shall not employ any person in any manner so as to become subject to the workers' mpensation aws of California, and agre t, if should becomes ject to thew s ti r I action 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant DaI 7 CLARATION REGA G C U TI L DI AGENCY ereby affirm under p alty of Cury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 , Civil Code). Ider's Name Lender's Address my signature beIoyLjx6rtlfy 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 edinances and s elatin IIdin construction. I authorize representatives of this city or county t nter th ov r inspection purposes. nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name �� Date TION DATE BY ECLA ION OF COM PLIANC WITH CODE OF FEDERAL FOR OFFICE USE ONLY RE LATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMITEXPIRED i i /f L_L I SUBMITTED ASBESTOS PERMIT EXTENDED PERMITFINAL CERTIFICATEOF l OCCUPANCYISSUED