HomeMy WebLinkAboutX2019-1003 - Permits�1 City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
C1 Permit Counter Phone (949)644-3288
i Inspection Kequsss Phone (949)644-3255
rd Combination Type - BLDG
IIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIII II COMB Permit: X2019-1003
x 2 6 1 9 1 0 0 3 Project No: 1497-2018
Issued Date : 03/2912019
Inspection Area : 3
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: 1046 WEST WIND WAY NB
Description: SFR BLOCK WALL W/GLASS 6'X 85 LF, 72 LF & 16 LF (INSIDE PIL) PART OF POOLISPA BARRIER
Legal Desc.`.. N TR 4224 LOT 188
Owner: JOHN & ALLISON PENCE
Contractor:
OWNER/BLDR
Architect:
Address: 707 ST JAMES RD
Address:
PENCE ALLISON
Address:
NEWPORT BEACH CA 862663
.;.�
Phone:
Phone:
Phone:
State Lie:
're°'���---m
Applicant: PENCE ALLISON
Can State Lie:
0/8
Engineer:
HERMAN RICH
tr
Address: 707 ST JAMES RD
Lie Expire:
Address:
4854 MAIN ST-.'
NEWPORT BEACH CA 962663
Bus Lie:
YORBA LINDA, CA 92886
Phone: 949.874-1666
Lie Exp Date:
Phone:
714-777-3765 State Lic:S-003255
Code Edit: 2016
Worker's Compensation Insurance
Designer:
Type of Construction:
Carrier:
Address:
Occupancy Group: U
Policy No:
Added /New sq.ft. Bldg: 0
Expire:
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 0
Building Setbacks
Rear: 6'
Special Conditions:
^
No of Units : 0
Front: 10'
Bldg Height: 0
Left: 6'
Bldg Sprinklers:
Right: 6'
Flood Zone: X
Use Zone: Parkin g Spaces:
0
Fire Hazard Zone : N
Construction Valuation: $13.000.00
Building Permit Fee: $412.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee:. $365.00
Additional Fee :
$0.00
Plan check Fee:
$40.00 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: $2.00
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 :
$0.00
Refund Deposit
$0.00
Disabled Access : $0.00
PAN Plan Check:
$0.00
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical Mo:
$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
TOTAL FEE: $820.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan Check Fee : $0.00 Fee Due at Permit Issuance : $820.00
c•-x-c_vcr� -
, i! RIBLIC WORKS APPROVAL: .
PLAN CHECK BY:
v <. .APPROVAL TO ISSUE:
LL
li.L GG c, . U V G.0 ti0�
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,1lso 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 (commencing with Section UTO) 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).
❑ 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,
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
Apromements 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 1t was not built or
improve ;for the purpose of sale).
❑ tmytoEexempt
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
n 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).
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 Iega11)
sell a structure that I have built as an owner -builder if IVES no been constru9tP4 in its entirlicensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Professions Code, is available upon request when i applicatl i s mite o at t e foil) eb site:htt : .le ginfo.ca.gov/colaw.html. _ 2- _•
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATIO
1 hereby affirm under penalty of perjury that I am licensed under provisi hapter mencing 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
COMPENSATION DECLARATION
IARNING: 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 ($700,000), IN ADDITION TO THE
'OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
7 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
erformance of the work for which this permit is issued. Policy No.
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'
rance carrier and policy number are:
:arrier Policy Number Expiration Date
lame of Agent Phone #
I certify that, in the performance of the work for which this a 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
I
if I should becomme subject the workers' c((\mm�enJsa_tion ovist ns of Section 3(700 of the Labor Code, I shall forthwith comply with those provisions. c,
signature ofApplicantY
IECLARATION REGA ONS RUCTION N IN
hereby affirm under penalty of perjury that 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
ly 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 o inances and ate la r acing to building construction.
I authorize representatives of this city or countytole the ab ve- en 'fled p dy for inspection purposes. _
i nature of Property Owner or Authorized Agent ' t Property Owner's or Authorized Agent's Name , ) SU U t �f) CC Da
%CTION DATE BY PLIA H CODE OF FEDERAL FOR OFFICE USE ONLY
ULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMITEXPIRED U I SUBMITTED ASBESTOS NOTIFICATIONTO • • • • • s
• • s
PERMIT CANCELLED DEPA
PERMIT EXTENDED LJAQmD • •
PERMITFINAL ' l -LI -ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
CERTIFICATE OF PROPOSED DEMOLITION
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