HomeMy WebLinkAboutX2021-2107 - Permits (3)�rx.,•,.,,� City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
cr C Inspection Requests Phone (949)644-3255
Combination Type - SFP
Job Address
Descriptions
Legal Desw:
Owner:
Address:
Phone:
Applicant:
Address:
Phone:
*X2021-2107*
U
'SPE1
iV
COMB Permit: X2021-21
Project No :
Issued Date : 08/10/2021
Inspection Area : 2
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST SE COMPLETED BY 0811012024 OR PERMIT WILL BE INV,
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
1305 N BAY FRONT NB
SFR CHANGE OUT (2) WINDOWS *NO HEADER CHANGE*
BALBOA ISLAND SEC 4 BLK 13 LOT 18
RUBELI PAUL
1305 NORTH BAY
NEWPORT BEACH, CA 92662
602-663-4933
RENEWAL BY ANDERSEN OF OC
22982 ALCALDE DR #100
LAGUNA HILLS CA 92653
714-259-5120
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: 1
Bldg Height: 0
Bldg Sprinklers:
Flood Zone:
Construction Valuation: $1,500.00
Building Permit Fee: $110.00
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: $111.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor:
RENEWAL BY ANDERSEN OF OC Architect:
..I
Address:
22982 ALCALDE
DR #100 Address:
G
LAGUNA HILLS CA 92653
co
U
Phone:
714-259-5120
Phone:
State Lic:
Con State Lic:
990416
Engineer:
Lic Expire:
0212812022
Address:
C
i®
Bus Lic:
BT30046925
X
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Lic Exp Date:
0413012022
Phone:
State Lic:
Workers Compensation Insurance
Designer:
Carrier:
OLD REPUBLIC INS CO Address:
Z
Policy No:
Expire:
MWC31415820
10/01/2021
Phone:
(n
Building Setbacks
Rear: /
Special Conditions:
Q
Front: /
Left: /
Right: /
Use Zone' Parking Spaces:
0 Fire Hazard Zone : N
Excise Tax:
$0.00
Planning Department -
Fire Department
Additional Fee :
$0.00
Plan check Fee : $0.00
Fire Inspection:
$0.00
Grading Bonds Fee:
$0.00
Fair Share: $0.00
Fire Plan Rev
$0.00
Grading PC Consultant :
$0.00
SJH Trans : $0.00
Demolition Fee
Grading Permit Fee:
$0.00
In -lieu Housing Fee: $0.00
Building Dept Adm
$0.00
Grading PC Fee:
$0.00
Public Works Department-
General Service
$0.00
WQ Insp. Fee:
$0.00
Park Dedication : $0.00
Refund Deposit
$0.00
PM/ Plan Check : $0.00
Grading Bond:
$0.00
Electrical %:
$0.00
San Dist: $0.00
Mechanical %:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00
$0.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance :
$111.00
1
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(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,
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
improved for the purpose of sale).
1, 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 dces 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 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 legal1
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, action 7044 of the Business and
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm].
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 ) of vis on 3 of the Business and Pr a sic ode n my license is in full force
and effect. License Class License No Date Contractor Signature
NORKERS' COMPENSATION DECLARATION ✓ - J I ✓ )
YARNING: 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 15100,0001, IN ADDITION TO THE
:DST OF COMPENSATION, 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, forth
ierformance of the work for which this permit is issued. Policy No.
ave 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 ura snce carrier and policy number are: 'Y _
;arrier d9L� 1K�1M3Ll(- Policy Number mwZ-3N) t1b Expiration Date I '
Jame of Agent N Phone #
I certify that, in the perform a of the r for which this permit is issued, I shall not employ any person in any manner so as to become subject to the worker compensati h laws of California, and agre
hat, if I should bec a bjec t t e war rs' mp ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /'�
signature of Applicant Date �5 y
)ECLARATION REGARD G O STRUCTION 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, Ci I Code).
.ender's Name 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 party o ner's behalf.
I have read this application and the information I ha rovide i orrect.
I agree to comply with all applicable city and coun � 1 ances tat s relating.to building construction.
1 authorize representatives of this city or county e t ab -id fled property for insp-etion purposes. '11
signature of Property Owner or Authorized A en Print Property Owner's or Authorized Agent's Name N Date
ACTION DATE BY RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED I SUBMITTED AS ESTOS NOTIFICATION TO
PERMIT CANCELLED "ATL�,F
PERMIT EXTENDED
PERMIT FINAL p�l,.p...IS APPLICABLE TO
CERTIFICATE OF -20-21 L OCCUPANCYISSUED