HomeMy WebLinkAboutX2019-1721 - Permitsn City of Newport Beach - Building Division
a 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
'mrrtr ss ." Combination Type - SFP
COMB Permit: X2019-1721
X 2 0 1 9 1 7 2 1�� II
Project No :
Issued Date : 05/3012019
Inspection Area : 1
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: 220 VIA PALERMO NB -
Description: SFR REPLACE (2) WINDOWS "LIKE FOR LIKE" ® 4?^ x
Legal pesc.: N TR 907 LOT 113 �" r
Owner:
JOHNSON & BLANDINO
Address:
103 SHORECLIFF DR
Record Management:
CORONA DEL MAR CA 92625
Phone:
$0.00
Applicant:.
ENVIRO - TEK REMEDIATION
Address:
241 CALIFORNIA CT
Hazardous Mat
MISSION VIEJO CA 92692
Phone:
949-525-1348
Code Edit: 2016
Type of Construction:. VB
Occupancy Group: R31U
Added /Newsq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation:
Building Permit Fee: $232.00
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: $233.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor:
ENVIRO -TEK REMEDIATION
Address:
241 CALIFORNIA CT
Bus Lie:
MISSION VIEJO CA 92692
Phone:
949-525-1348
Con State Lie:
977722.
Lie Expire:
10/3112020
Bus Lie:
BT30066864
Lie Exp Date:
04/30/2020
Worker's Compensation Insurance
Carrier: EXEMPT NO EMPLOYEES
Policy No:
Expire:
Building Setbacks
Excise Tax:
Additional Fee:
Grading Bonds Fee:
Grading PC Consultant:
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: I
Front: I
Left: /
Right: /
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
Planning Department -
Fire Department
Plan check Fee:
Fire Inspection:
Fair Share:
Fire Plan Rev
SJH Trans :.
Demolition Fee
In -lieu Housing Fee:
Building Dept Adm
Public Works Department -
Park Dedication:
$0.00
P/W Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
- Plan Check Fee:
State Lie:
State Lie:
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$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $233.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
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$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) 1 have placed next to the applicame 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
is 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
'rofessions 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
of more than five hundred dollars ($500).
1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness and Professions Code: The Contractors' State License Law does not apply town owner of property who, through employees' or personal effort, builds or improves the property, provided that the
nprovements 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
Troved 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 does not
pply 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:
ly 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)
ell 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectii 00) o Division 3 of the Business and Hessi d nd my license is in full force
nd effect. LicanseClass License No Da �� Contractor Signat
YORKERS' COIYIIDENSATION DECLARATION
'ARMING: FAILURL-M SECC�URE 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
OST OPCOMPEr.SATl... AMAGES AS PROVIDED FOR IN SECTION 7705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
herebxaffirm unger penalty of perjury one of the following declarations:
T (•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
Arjorthance of24e war% for which this permit is issued. Policy No.
and vi;ilf trIftain 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'
carnerend policy number are:
• Policy Number Expiration Date
GEnifN that, in the performanc f 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 agree
t,A should blAftielubject t ' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
.nature o licant' ate3�—("1
CLARA REGARDING CO TRUCTION LENDING AGENCY
:reby a irm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 97, 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 county trdipances and state laws relating to building construction.
I authorize representatives of this cil or county toe ter a abo e -Identified property for inspection purposes. _ �,. p
nature of Prooertv Owner or AuLized Agent Print Propertv Owners or Authq gent's Name 3ESW 1ZDy ("C Dat 9- 3'3
ACTION DATEI' BY DECLARATION OF I REGULATIONS PART 061 OF ILT E 40 AND ACMD RULECE WITH CODE OF RAL I FOR OFFICE
PERMIT EXPIRED L -I I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED DEPA
PERMITEXTENDED D
PERMITFINAL f -T 1` AS STOS NO IFICAT IS NOTAPPLICABLE TO
CERTIFICATE OF PR PO ED I EMCIFIOI�
OCCUPANCY ISSUED SIGNArffw/
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