HomeMy WebLinkAboutX2019-0866 - Permitsw,•r�p t City of Newport Beach - Building Division IIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIII�II IICOMB Permit X2019-0866
ti"s 7 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1. 9 0 8 6 6
4Project No: 0130-2019
H Permit Counter Phone (949)644-3288 II
u Inspection RequestsPhone (94 )64a-•+9
Combinatio Type - BLDG PLUM Issued Da : 0/18/2019
d,:iGi$'�':. �.rj �( If applicable: Inspecho Ari : 1
'•' PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID 1NSPE ION
Conatfu bn nday- y7: a:m 6. C�d from8�����®OClrr1�(or&®flHlla olidays
Job Address: 3004 W OCEAN F NT -�,JobA pbon: DEMO SFR W„IATT AR ER 0 SF 4Legal Desc.: NEWPORT BEA! CI T 3 to whom:---
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Owner. VAN DAELE MICHA L IS Contractor: OWNER/BLDR Architect: ° "a 40' ^ .
Address: 3004 W OCEAN. FRI N EMU Xre V M Address:NEWPORT BEACH A 9263 Phone: 951-255-9349 Phone: State ic.. 1�." _4'Applicant. GUIDERO BILL' O Engineer: GABRIEL MICHAEL R
ED
Address: 425 30TH ST STE 2 tic Expire: Address: 483 E20TH STREET" °
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NEWPORT BEACH A 92663 Bus Lie COSTA MESA CA _92627 0 °
Phone 949-675-2626 Lie Exp Dat . Phone: %49-646-%596 State ic:S 02939MR
. ` e o ° • • ° o
Code Edd 2016 's 0 p mance Di a�° e r@ UI �OIJ,gAp
Type of Construction: F er ress:. 25,,TiT STE 23
Occupancy Group: R31U p1 ,ted PORT BEACH CA 92 3
Added /New sq.ft. Bldg: 0 (work ��'@i �.. (no woX� start
Added /New sq. ft. Garage. 0 mO°o°o oomo°.
No of Stories: 0Building Setbacks Rear: / Special Conditions: JD DEMO TO HAUL B
A� o
No of Units: 1 i !late.
Bldg Height 0 - Left: I
Bldg Sprinklers::. _ Riaht I' Insp. initials: r °
Flood Zone: Use Zone: Parkin S aces: 0
0
Construction Valuation: $10. d. oue.o "
Building Permit Fee: $103.00 Excise Tax: - $0.00 - Planning Department - Fire Department
Plan Check Fee: $208.00 Additional Fee.`. $0.00 Plan check Fee: $90.00. Fire Inspection: $0.00
Overtime Plan Ck: $0.00 - Grading Bonds Fee .:$0.00 .Fair Share: $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 - $26.00
Energy Compliance: Compliance: $0.00. 'Grading PC Fee: .$0.00 Public Works Department.- General Service < $210.00
CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication,: $0.00 Refund Deposit. $1,692.00
Disabled Access : $0.00 P/W 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 %: $9.27 .$0.00
TOTAL FEE: $2,339.27 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $2,339.27
PROCESSED BY: PUBLIC WORKS APPROVAL:
ZONING APPROVAL! PLAN CHECK BY: -
GRADING APPROVAL: APPROVAL. TO ISSUE:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s)
action 7031.5, Business and Professtdrre•E eiiiH% y RVAF ouat' roar rP�I liT..�ss.A_permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
I permit to file a signed statement t t he or she is licensed pursuant to the provision'�ns o�flie'C3 *(%ctors' Sfate°L4eense"w4GtiOgt-qr, g_gy);en.cin with Section 7000) of Division 3 of the Business and
)fessions Code) or that he or she is'exam Vpm licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any appllcan o' j�DEs a applicant to a civil penalty of
of more than five hundred dollars ($ O). Mi 10: _ % a 5— / 7
I, as owner of the property, or my imployees with wages as their sole compensation, will o a ofar[rportions of tlfd Al Rila3tfilsirefure is not intended or o
lusiness and Professions Code: The ontr Licens does t appl to an owner of property who, through employees' or personal effort, builds or improv
n rovements are not intended or off d f 's I wev p m t i th e f com e l w n d a the burden
P for the purpose of sale)."}Iildi im $. {j P�r8W. B tl PdMbf4p f,heURenBe owner of the property, am a lusiv g wit o to�st t th r c ec n 7044, Business and Professions Code: The Contras
fved
to an owner of property who bui s or I '- reon, a h ntra f thegAbja a tg W torbc rWPJ t6rTa Contractors' StateLicense La
m exempt from licensure unde the Contractors' State License Law for the following reason:
sy. my signature below 1 acknowledg[qua
that, y pe n I t resided for at least one year prior to completion of the improvements c
ell a structure that I have built as anne builder i has n enc In I n tr understand that a dopy of the applicable law, Se
'rofessions Code, is available upon when th su ed o - b info.ca.gov/calaw.html.
signature of Property Owner orAuthed C
.ICENSED COr1;1iACTOR'S DLA
hereby affirm under penalty of perju that I am licensed and r provisions of C er 9 (commencing with Section 7000) of Division 3 of the Business and Professions C
Ind effeig. Lice rise'Class License No Date Contractor Signature
f9KIRS'IbMPt-61SATION C O
:NINE: FAILURE TO SECURE WORKERS' OMP NSATI Cl@V� E IS F L, P T AN EMPLOY IMI L 9MEES(!Dt�'�'VyIL(FIINEE'S IPP TO ON rj HUN RED THO
�t OF eOMPENSATIbN, DAMAGES ASP VIDE EC 0 OR E�p7E I T NO ATTORNE . 9 i _ ,r+"ff Y 1 ! FL]ry"`'} S[(
reby affirm urdg �p�eralty of perj11, one of the follow jna tleclpJatigln�s:r,tgr f ` ed Rs' R -+fl F a
i baxie and will maintain a certiate of consent to self -insure for workkfi compensation, issued by the Di fA b? W tWggtr tAiiIl las provided for by
gWnce of fpbA%for which themit}}iGGsee issued. Policy No. /
#lade and will maintain workers19eati re wired b Section 3700 of the Labor Code, for the performance of the work for which this pe
II:NIG9 carrier and policy number .
• ' Expiration Date
rier : ...... rs PDlic Number P
ne.of Agent
C2rtlfy that, iR It4pe'rformance of the work for which this permit is issued, I shall not amp oy any he workers' I
if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
for sale (Section 7044,
property, provided that the
vino that it was not built or
State License Law does not
"ed by this permit, I cannot legal
17044 of the Business and
and my license is in full force
IN ADDITION TO THE
3700 of the Labor Code, for
issued. My workers'
signature of Applicant vara_
IECLARATION REGARDING CONSTRUCTION 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
Iy',,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 providedis c t
I agree to comply with all applicable city and county ordinances a J sta laws relating to building construction.
I authorize representatives of this city or county tante a bo a-ide i d property for inspection purposes. `
•:.....,.,,.n ,.r o.....ea„ n,.,.,a� ,.� A,ah...I�eH n�en7 \ 4' Print Prooertv Owner's or Authorized Aaent's aIQ me M C K--+2
DATE BY DECLARATION OF I I REGULAT ONS PA T 61 OF COMPLIAILT E 40 AND AQMD RULE CE WITH CODE OF SL FOR OFFICE USE ONLY
I SUBMITTED ASBESTOS
PERMITCANCELLED
PERMITEXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
IS NOTAPPOCASLB TO
laws of California, and