HomeMy WebLinkAboutX2019-1587 - PermitsCity of Newport Beach Bltlildin°g dM40t;
100
864
fs - 100 Civic Center Drive, Newport Beach, A-92' E - X 2 0 1 9 1 5 8 7
-: Permit Counter Phone (949)644-3288 • ° e �, a °._
Inspection Requests Phone (949)644-32°56 °.
W ° 4
r.� rtrws'tr Combination Type - MFP
COMB Permit: X2019-1587
Project No :
Issued Date : 05/2012019
Inspection Area : 8
No of Units :
PERMIT$ EXPIRE 18q DAYS 4FTER ISSUANCE OR LAST VALID INSPECTION.
Construction Hours: Monday - Friday 7:00 a.m. to 6:16 p°ht. and Saturday from 8:00 a.m, to 6:00 p.m. No work on Sundays or Holidays
Job Address:
314 AVENIDA CUMBRE NB
Bldg Sprinklers:
Description:
MFR - TIO (E) CLAY TILE. REPLACE PLYWOOD AS NECESSARY. NEW SHEATHING, RE -USE (E) CLAY TILES. REPLC BROKEN TILES AS NEEDED. 20 SQ
Legal Desc.:
TR 5435 (L.L.84-214024) PAR 17
Construction Valuation: $10.00[
Owner:.
ESTABROOK MICHAEL
Contractor: OWNERIBLDR Architect:.
Address:
314 AVENIDA CUMBRE
Address: ESTABROOK MICHAEL Address:
'
NEWPORT BEACH, CA 92660
$0.00
Phone::
Investigation Fee:
Phone: Phone: State Lie:
Applicant:
ESTABROOK MICHAEL
Con State Lie: O/B Engineer:
Address:
314 AVENIDA CUMBRE
Lie Expire; Address:
Fire Plan Rev
NEWPORT BEACH, CA 92660
Bus Lie:
- Phone:
949.903-1611
Lie Exp Date: Phone: State Lie:
Code Edit
2016
Worker's Compensation Insurance Designer:
Type of Construction: V -B
Carrier: Address:
Occupancy Group:.
R3/U
Policy No:
Added/New sq.ftBldg: 0
Expire: Phone:
Added /New sq.. ft.. Garage: 0
$0.00
No of Stories:
2
Building Setbacks Rear: / Special Conditions:
No of Units :
1
Bldg Height:
0
Bldg Sprinklers:
Flood Zone:
0
Construction Valuation: $10.00[
Building Permit fee:
$324.00
Plan Check Fee: $0.00
Planning Department -
Overtime Plan Ck:.
$0.00
$0.00
Investigation Fee:
$0.00
$0.00
Record Management:
$0.00
Fair Share :
Energy Compliance:
$0.00
Fire Plan Rev
CA Seismic Safety:
$0.00
Disabled Access
$0.00
$0.00
Hazardous Mat
$0.00
$0.00
Building Green Fee:
$1.00
TOTAL FEE: $325.00
PROCESSED BY: 111.81
ZONING APPROVAL:
GRADING APPROVAL:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical%:
Plumbing %:
Front: /
Left:. /
Right:
3arking Spaces:
0
Fire Hazard Zone : N
0
$0.00
Planning Department -
Fire Department i
$0.00
Plan check Fee :
$0.00
r _.
Fire Inspecdon
$0.00
Fair Share :
$0.00
Fire Plan Rev
$0.00
SJH Trans :
$0.00
Demolition Fee
$0.00
In -lieu Housing Feer
$0.00
Building Dept Adm
$0.00
Public Works Department-
General Service
$0.00
Park Dedication :
$0.00
Refund Deposit
P/W Plan Check.:
$0.00
.Grading Bond:
$0.00
San Dist:
$0.00.
$0.00
NMUSD Fee:
$0.00
-$0.00
Plan Check Fee
: $0.00
Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$325.00
. 00
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the ressoa(s) indicAteB below by"the checkmark(s) I have placed next to the applicable items)
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, irrprrfve•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 (coptmenc hip 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 7931.5,616any apjr1cant 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 (_) ppalbris ®f the Jorl4t a0rjthe 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 whot t hrok&,empld)lees' 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).
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
a to
ai 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 m exempt from licensure under the Contractors' State License Law for the following reason: /a �� eon .t�v:L�F/Z
In
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 legal)
se tructure that I have built as an owner -builder if ithasnot Dean co s ucted in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Professions Code, is available upon request when ,t(ris(�tpp�caKpn igs Itted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent (,� i" c /Y- 7 DaimT�
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
WORKERS' 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
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I 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 IN
performance of the work for which this permit is issued. Policy No.
❑I 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' compensatior
insurance carrier and policy number are:
of Agent
rtify that, in the performance of the work
V,tat, f I should become subject t th workers' pensatlon provisions of Section 3700 of the Labor Code, I shall forthwith Comply with t ose provisions.
ignature of Applicant Dat
DECLARATION REG G CbNSTRUCTION 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, Civil Code).
ender's Name Lender's Address
y 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 ordinances and state laws relating to building construction.
I authorize representatives of this cit or cou�n�Y to n,1fCy� th ab Pied p rop erty for inspection purposes.
..f D.,...P d„ n ... n.1 „� A„rr,,,�i� An<niY .LY Print Pro ertv Owner's or Authorized Agent's Name; /rl� GVIICL” I Lir-'Y- Date 3/�lJ�/�
Policy Number
Date
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
I
DATE BY dDECLARATION OF I REGULATIONS PART061 OF IITLE 40A D AQMD RULE CE WITH CODE OF AL FOR OFFICE USE ONLY
I SUBMITTED
PERMIT EXTENDED
UAQMD
PERMITFINALpp
CERTIFICATE OF
c/
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ASBESTOS NOTIFICATION IS, NPT APPLICABLE TO
PROPOSED DEMbL4�ll �"(f.'
OCCUPANCYISSUED
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