HomeMy WebLinkAboutX2019-1125 - Permitsi
n City of Newport Beach - Building Division *X2019-1125* COMB Permit: X2019-1125
100 Civic Center. Drive, Newport Beach, CA 92660 Project NO.:
Permit Counter Phone (949)644-3288
r 'Inspection Requests Phone (949)644-3255
n Combination Type -SFP Issued Date: 04/1012019
r" Inspection Area : 2
PROCESSED BY: - PUBLIC WO KSAPPROVAL:
ZONING APPROVAL: PLAN CHEC BY:
GRADING APPROVAL: APPROVAL TOI EL7
Construction Valuation: - $1.800.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
o I °
Code Edit - 2016
ConstructionHours: 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:
526 WESTMINSTER AVE NB
Type of Construction VB
Carrier STARNET INS
Address:
- ° • ° ®°
° • b ° a °
Description:
SFR - REFRAME DRYROTTED WOOD - REPL STUDS 8: DRYALL IN LAUNDRY WOOD (2) 2X4
Plan Check Fee: $0.00,
Legal Desc.:
FIRST ADD TO NEWPORT HEIGHTS
BLK 30 LOT 7
:. Plan check Fee:
Added /New sq. ft. Garage: 0
Fire Inspection:
$0.00
Overtime Plan Ck
No of Stories: 0 -
Building Setbacks Rear: /
Special Conditions:.
I
Owner:
BURCHELL QUENTIN
Contractor
911 RESTORATION
Architect:
' a
- Bldg Height: 0
Address:
626 WESTMINSTER AVE ;
Address.
1020N BATAVIA ST#P
Address:.
Right: /.
NEWPORT BEACH, CA 92663
Flood Zone:
ORANGE CA 92867_
Fire Hazard Zone : N
: In -lieu Housing Fee:
° ••••
Phone:
949.394-0704
Phone:
949-502-0002 -
Phone:
State Lie:
Grading PC Fee:
$0.00
Public Works Department -
-
General Service
'' $0.00
eooa •.
°
Applicant:
911 RESTORATION
Con State Lie:
990168
Engineer:
.... e
. Address: -
1020. N BATAVIA ST#P
Lie Expire:
01/3112020
Address:
° e
$0.00.
ORANGE CA 92867
Bus Lie:
- BT30066833
Hazardous Mat
°
Phone:
949.502-0002
Lie Exp Date: "
04/30/2020
Phone:
State Lie,:
°
e ° • ° a ®. a
PROCESSED BY: - PUBLIC WO KSAPPROVAL:
ZONING APPROVAL: PLAN CHEC BY:
GRADING APPROVAL: APPROVAL TOI EL7
Construction Valuation: - $1.800.00
o I °
Code Edit - 2016
Worker's Compensation Insurance
Designer:
°°°••
°�° �.
Type of Construction VB
Carrier STARNET INS
Address:
- ° • ° ®°
° • b ° a °
Occupancy Group: R3111
Policy No: BNUWC0146465
Plan Check Fee: $0.00,
Added /New sq:ft. Bldg 0
Expire: 02120/2020
. Phone;
:. Plan check Fee:
Added /New sq. ft. Garage: 0
Fire Inspection:
$0.00
Overtime Plan Ck
No of Stories: 0 -
Building Setbacks Rear: /
Special Conditions:.
Fair Sharer
No of Units : 1
Front: /
.$0.00
•
' a
- Bldg Height: 0
Left: /
$0.00
SJH Trans ,.
Bldg Sprinklers:
Right: /.
Record Management:
Flood Zone:
Use Zone '. Parking Spaces: 0
Fire Hazard Zone : N
: In -lieu Housing Fee:
-
PROCESSED BY: - PUBLIC WO KSAPPROVAL:
ZONING APPROVAL: PLAN CHEC BY:
GRADING APPROVAL: APPROVAL TOI EL7
Construction Valuation: - $1.800.00
Building Permit Fee: : $104.00
Excise Tax:
- $0.00
Planning Department-
Fire. Department
Plan Check Fee: $0.00,
Additional Fee:
$0.00.
:. Plan check Fee:
$0.00
Fire Inspection:
$0.00
Overtime Plan Ck
-$0.00
Grading Bonds Fee:
$0.00
Fair Sharer
$0.00.
Fire Plan Rev
.$0.00
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
$0.00
Energy Compliance:
$0.00
Grading PC Fee:
$0.00
Public Works Department -
General Service
'' $0.00
CA Seismic Safety:
$0.00
WQ Insp. Fee:
$0.00
Park Dedication 1
$0.00
Refund Deposit
$0.00
Disabled Access :
$0.00
PAN Plan Check.: -
$0.00.
Grading Bond:
$0.00
Hazardous Mat
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Building Green fee::
$1.00
Mechanical%:
$0.00
NMUSD Fee:
$0.00
:
$0.00
Plumbing %:
$0.00
$0.00 I
i
TOTAL
E : $105.00
Plan Check Fee:
$0.00
Fee Due at Permit Issuance :
$105,00
PROCESSED BY: - PUBLIC WO KSAPPROVAL:
ZONING APPROVAL: PLAN CHEC BY:
GRADING APPROVAL: APPROVAL TOI EL7
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 require&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 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
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).
❑ 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).
❑ 1 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 constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Professions JWa is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Sigpature of Pjaperty Owner or Authorized Agent Date
• hrENSEU gIPVJRACTOR'S DECLARATION
' I herebyaffirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0) Ivision of the Business and Profs ns Code, and my license is in full force
ndeffect. License 'ense Class License No Date *Stl Contractor Signature
' 6RKERV46+ENSATION DECLARATION
• WARNOF CO FAILURE
TO SECURE DAMAGES AS PROVFOR IN SECT WORKERS'COMPENSATION
ON GE ISF THE LABOR CODE, LL SUBJECT N EMPLOYER
MP EY FEES.
UNLAWFUL, AND RTO RIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
C121891-
• Itlefepy afflAkMe2r penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
f 'rmance gf$tlelwsrk for which this permit is issued. Policy No.
h•R a and will maikitain 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' compensatioi
1�a a carrier and policy number are:
of Agent
Policy Number Expiration Date
Phone #
certify 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
if I should become`suu ''q/ct to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /� n
lature of Applicant �✓ `tif/� Data �j��/�✓
:LARATION REGA DING CONSTRUCTION LENDING AGENCY
reby affirm under pe ally 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).
der's Name Lender's Address
ny 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. n`)
I agree to comply with all applicable city and county ordinances and state laws relating to building construction. `Vu I Orel
I authorize representatives of this city or county` to�tey(he. a�o'vIe-Id�e flied property for inspection purposes. �_J,�
lature of Prooertv Owner or Authorized ADent �-!' . — 'S ! Print Property Owner's or Authorized Agent's Nam�.� ,' D4fe
DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMITCANCELLED
PERMITEXTENDED
PERMITFINAL1fAP IASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
CERTIFICATEOOCCUPANCYISF ' I I I li� SICNPROPOSEDATLIAFU ' �&
OCCUPANCY ISSUED VT