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Home My WebLink AboutX2018-2856 - Permits�$w1vJ City of Newport Beach - Building Division Illlll�j��l lull 11 111 llll 11 llll llllll II COMB Permit : X2018-2851 100 Civic Center Drive, Newpcn ber cn, C� 926h0 x 2 0 1 8 2 8 5 6 Project No : 2288-2018 Permit Counter Phone (949)644-3288 _ Inspection Requests Phone (94%,34»-325r , Issued Date: 0912412018 casr,;;u%"y Combination Type - MFP Inspection Area : 5 PE.RIIt:/TS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Construction Hours: n?ondcy - Fridsy 7:60 a.;I.Ito 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 503 FERNLEAF AVE NB Sc 1 FI: 1 Unit: 112 Description: MFR -WINDOW CHANGEOUT -7 LIKE FOR LIKE, CHANGE SIZE AND RELOCATE BATHROOM WINDOW Legal Desc.: CORONA DEL MAR BLK 532 LOT 3 Owner: GARVIN MICHELLE Contractor: OWNER/BLDR Architect: Address: PO BOX 283 Address: GARVIN MICHELLE Address: CDM CA 92625 Phone: 949-423-9776 Phone: Phone: State Lic: Applicant: GARVIN MICHELLE Con State Lic: OIB Engineer: Address: PO BOX 283 Lic Expire: Address: CDM CA 92625 Bus Lic: Phone: 949-423-9776 Lic Exp Date: Phone: State Lic: Code Edit: 2016 Worker's Compensation Insurance Designer: Type of Construction: V-B Carrier: Address: Occupancy Group: R31U Policy No: Added /New sq.ft. Bldg: 0 Expire: Phone: Added /New sq. ft. Garage:0 No of Stories: 11 Building Setbacks Rear: I Special Conditions: No of Units : 1 Front: / Bldg Height: 0 Left: / 0 Bldg Sprinklers. Right: I Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N LLDisableddAccess: uction Valuation: $6 000.00 g Permit Fee: $168.00 Excise Tax: $0.00 Planning Department - Fire Department heck Fee: $0.00 Additional Fee : $90.48 Plan check Fee : $40.00 Fire Inspection: $0.00 e Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 igation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee d Management: $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 y Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 ismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 ed Access : $0.00 PAN Plan Check : $0.00 Grading Bond: $0.00 dous Mat $0.00 Electrical %: $0.00 San Dist : $0.00g Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 $o.00 Plumbing %: $0.00 TOTAL FEE : $299.48 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $299.48 PROCESSED BY: 111 PUBLIC WORKS APPROVAL: ZONING APPROVAL: _T(77 i 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(s) indicated 4elow by'the cbeckmark(s) I ha,%e 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 of repai, al.y 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 (Cfu.ptoi C (commencing with £s�7on 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 L) all of or L) portions of the wor%, and the structure IF. 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 wiN have the bUrden of proving that it was not built or Im oved for the purpose of sale). 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 y 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 legall, sell a structure that I have built as an owner -builder if it has not been c s uctad in its entirety by licensed contractors. 1 understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request wh t s a liceIs I d or at yh€'follo�wing Wab sit :hftp://www.leginfo.ca.gov/calaw.htmi. c �� Signature of Property Owner or Authorized AgerL [.�V D e 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 NORKERS' 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 MST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. 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 th )erformance of the work for which this permit is issued. Policy No. 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' carrier and policy number are: Policy Number Expiration Date gerti'fy that, in the performance of the work for which 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 k X should become subject o the ers' compe rovlsions of Sectio>� 00 of the Labor Code, I shall forthwith comply with those provisions. n < /g� /,J(I nature of Applicant /iQ /i( AI �K Li Da� ` GAT CLARATION ADTNTCdNS1WUCTION LENDING AGENCY =reby 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). ider'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 count obi nces and state laws relating to building construction. I authorize representatives of this city or county to t I. ab e= I' d/�op�erty for inspection purposes. / /} j�{� �,i ��J nature of Property Owner or Authorized Agent C�Print Property Owner's or Authorized AGent's NSA r "' i Cr �r�t Le, GfU. /bateCl I Z4-I kC ACTION I DATE PERMIT EXPIRED PERMITCANCELLED ERMF CERTIFICATE CERTIFICATEICATE OF L 1\ l �✓ OCCUPANCY ISSUED DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE I SUBMITTED ASBESTOS NOTIFICATION TO NOTIFICATION IS NOTAPPLICABLE TO FOR OFFICE USE ONLY