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Home My WebLink AboutX2019-0686 - Permitsa City of Newport Beach- Building Division lllllllllllllll�llllllllllllllllllllll COMB Permit: X2019-0686 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 0 6 6 6 Project No : 0473-2019 Permit Counter Phone (949)644-3288Inspection Requests Phone (949)644-3255 Combination Type - BLDG Issued Date: 03/0412019 l Inspection Area : 2 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: 407 FULLERTON AVE NB Description: SFR INSTALL POOL FENCING VX 103 LF (INSDIE PAL) Legal Desc.: FIRST ADD TO NEWPORT HEIGHTS BILK 28 LOT 23 Owner:. KOCIUBA JAMES/KAY Address: 407 FULLERTON AVE NEWPORT BEACH CA 82663 Phone: 949-933-0145 Applicant: KOCIUBAJAMES Address: 407 FULLERTON AVE NEWPORT BEACH CA 92663 Phone: 949-933-0145 Code Edit.: .2016 Type of Construction: _ Occupancy Group: U Added /New sq.ft. Bldg:. 0 Added /New sq. ft. Garage: 0 No of Stories: 0 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Building Permit Fee: ' $152.00 PROCESSED BY: Contractor: Plan Check Fee: $132.24 Address: Overtime Plan Ck: $0.00 Phone: Investigation Fee: $0.00 Con State Lie: Record Management : $0.00 Lie Expire: Energy Compliance: $0.00 Bus Lia IIA Seismic Safety: $0.00 Lie Exp Date: Disabled Access: $0.00 Worker's Compensation Insurance Hazardous Mat $0.00 $0.00 Building Green Fee : $1.00 PROCESSED BY: Contractor: OWNERIBLDR Address: KOCIUBAJAMES Phone: Additional Fee : Con State Lie: O/B Lie Expire: Bus Lia $0.00 Lie Exp Date: $0.00 Worker's Compensation Insurance Carrier: $0.00 ' Policy No: $0.00 Expire: Grading Permit Fee: Building Setbacks Rear: 5 $0.00 Front: 20 Grading PC Fee: Left: 4 Public Works Department - Right: 4 Architect: Address: Phone: Engineer: Address: Phone: Designer: Address: Phone: State Lic:0004103 J . State Lia ov," Special Conditions: *EQUALS 1 DROWNING PREVENTION DEVICE Excise Tax: $0.00 Planning Department - Additional Fee : $0.00 Plan check Fee: $40.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee :. $0.00 Grading PC Fee: $0.00 Public Works Department - WQ Insp. Fee: $0.00 Park Dedication : $0.00 PAN Plan Check: $0.00 Electrical %: $0.00 .San Dist: $0.00 Mechanical $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 TOTAL FEE: $325.24 ZONING APPROVAL: GRADING APPROVAL: Fire Department Fire Inspection: Fire Plan Rev Demolition Fee Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee: $0.00 fee Due at Permit Issuance : $325.24 Y O 4 d Ado 4 _vPUE{LI: WORKS APPROVAL: - Q. CGI 6 4 PLAN CHECK BY: C ' ` o ` „"� -° `APoiROVAL TO ISSUE: G C` 00+. sI 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 applicable item(s) ction 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 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 IM 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 In a than five hundred dollars ($500). I, a) owner of the property, or my employees with wages as their sole compensation, will do*1dwithin of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, fess and Professions Code: The Contractors' State License Law does not apply to an ownoperty who, through employees' or personal effort, builds or improves the property, provided that the rovements are not intended or offered for sale. If, however, the building or improvement is one year of completion, the Owner -Builder will have the burden of proving that it was not built or roved 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 ly 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). J 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 legs ell a structure that I have built as an owner -builder if it has not beeq, constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7 44of the Business and 'rofessions Code, is available upon request when th' applica'o submitted or follow' g Web site:http://www.leginfo.ca.gov/calaw.htmi. signature of Property Owner or Authorized Agent Dat .ICENSED CONTRACTOR'S DECLARATI N hereby affirm under penalty of perjury that I am licensed and r provisions of Chapter 9 (commencing with Section 7nnm �f Division 3 of the Business and Professions C de, and my license is in full force nd effect. License Class License No Data' Contractor Signature IIORKERS' COMPENSATION DECLARATION DARNING: 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 AUDITION 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: 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 xmance 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' compensa rance carrier and policy number are: Policy Number Date me of Agent -enone If I 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 1* if I should become bject t_ su o t s' compensa ogs,of i p)ovisiSe ' n 3700 of the Labor Cade, I shall forthwith comply with those provisions. mature of Applicant /-) Da�/� rZ CLARATION REG DING CONSTRUCTION LENDING AGENCY :reby 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). 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 ordinances and state laws relating to building construction. I authorize representatives of this city or cour o e tithe above-identifi roperty, for inspection purposes. , mature of Prooertv Owner or Authorized Aoent �/ /7 /1 __ ,riot Property Owner's or Authorized Agent's Name ]l J �17M 'G S 0 vl bf, LD ACTION DATE I BY 7 DE'ELA.RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY /REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO :•• : : > - a + • • • PERMIT CANCELLED QEPA ++ •� • PERMIT EXTENDED LIAQMD PERMITFINAL EIAS13ESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF PROPOSED DEMOLITION •• +•• • • •+• OCCUPANCY ISSUED / • • + IGNATURE: • • + • +