HomeMy WebLinkAboutX2019-2663 - Permitsv t City of Newport Beach - Building Division(IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIII II COMB Permit: X2019-2663
a� 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 2 6 6 3 Project No
't, Permit Counter PMnc (042)644-3288 -
#' Inspection Requests Phone (949)644-3255
�',txsnY��'$ ` Combination Type -. SFP
Issued Date : 0 812 61201 9
9
Inspection Area: 1
PERMITS EXPIRE 980 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 6:00 a.m. to 6:00 p.m. No work on Sundays or Mol
Job Address:. ..1605 W BALBOA BLVD NB
Description SFR -CHANGE OUT (2) WINDOWS & (2) PATIO DOORS (RETROFIT)
Legal Desc; NEWPORT BEACH SEC B BLK 16 LOT 27
Owner: O'BRIEN THOMAS JOSEPH Contractor: P B CONTRACTING " Architect:
Address:. 1605 W BALBOA BLVD Address: 1996 FULLERTON AVE Address: -
NEWPORT BEACH CA 92663
-
COSTA MESA CA 92627
$0.00
e e o o °
#41 O
Phone: 415.902.7293
Phone:
949-650.1408
Phone:
State Lic: eo=a°
e
Applicant: P B CONTRACTING
Address: 1996 FULLERTON AVE
Con State Lic:
Lic Expire:
831793
02I28I2020
Engineer:
' Address:
Aa
e o e
r VO CONS
e
a ° °
COSTA MESA CA 92627
Bus Lic:
BT30031698
_
e, °
Phone: 949-650-1408 -
Lic Exp Date:
04/3012020
Phone:
Stafe'LC,"��
°
Code Edit 2016
Workers Compensation Insurance
.
'aQ
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Construction:
Type of 3
Group: RU
Carrier:
PolicyNo:
EMPLOYEES)
Address:
A
mOcups
Added /New sq.ft. Bldg: 0
.Expire;
NO
Phone:
e
Added /New sq. ft. Garage: 0
`
No of Stories: 2
Building Setbacks
Rear. I
Special Conditions:
p
No of Units: 1
Front: l
Bldg Height: 0
Left: I
Bldg Sprinklers:.
Right:
Flood Zone:
Use Zone: Parking Spaces: 0
Fire Hazard Zone : N
ce nnn nn
Building Permit Fee: $136.00
- Excise Tax:
Plan Check Fee: $0.00
Additional Fee :
$0.00
Overtime Plan Ck:
$0.00
Grading PC Consultant:
Investigation Fee:
$0.00
$0.00
Record Management:
$0.00
WQ Insp. Fee:
Energy Compliance:
$0.00
$0.00
CA Seismic Safety :
$0.00
Plumbing %:
Disabled Access:
$0.00
_
Hazardous Mat
$0.00
Building Green Fee:
$1.00
- Excise Tax:
$0.00
Additional Fee :
$0.00
Grading Bonds Fee:
$0.00
Grading PC Consultant:
$0.00
Grading Permit Fee:
$0.00
Grading PC Fee:
$0.00
WQ Insp. Fee:
$0.00.
Electrical %:
$0.00
Mechanical %:
.$0.00
Plumbing %:
$0.00
IITOTAL FEE: $137.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Planning Department -
Plan check Fee
Fire Department
Fair Share
$0.00
SJH Trans:
$0.00
In -lieu Housing Fee:
Fire Plan Rev
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Plan Check Fee
$0.00 Fee Due at Permit Issuance : $137.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY: - /
APPROVAL TO ISSUE:
Fire Department
$0.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
- Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
_
Grading Bond:
$0.00
$0.00
$0.00.
$0.00 Fee Due at Permit Issuance : $137.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY: - /
APPROVAL TO ISSUE:
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) I have pieced next to the applicable item(s) .,
Iction 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior td -it's i'ssdance, 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
Ifessions 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
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 (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
ainess 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
)rovements 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
)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).
I am exempt from licensure under the Contractors' State License Law for the following reason:
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 legally
a structure th#Ll.f ave 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
Ifessions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.htmi.
S)jtl)p of Propeit'ybwner or Authorized Agent Date
TENSED COTIY144CTOR'S DECLARATION
3reby affirm uifdeTpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700010 Division 3 of the Business and Pr a Sion C de, R my license is in full force
i effect. License Class - - License No Date ata' Contractor Sig re
ERS' C011QP1,NSATION DECLARATION
: FAILURE?TT SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP
COMPENSAinDA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
affirm.Av6denalty of perjury one of the following declarations:
1$100,0001, IN ADDITION TO THE
i heve and vAll 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
foribance Qf!he w srk for which this permit is issued. Policy No
-have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code,
oaence cagldr%ndpolicy number are:
Her "' • Policy Number
%w of Agent '•,
for the performance of the work for which this permit is issued. My workers'
Date
:ertify that, in the pert Eric'
work for ich 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(
if I should become at bje o he orkers' c pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. G
sture of Applicant Date_
CLARATION REGA ING C $T20GTiflAiLENDING AGENCY
:reby affirm under peva p ry 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 pr rt own s behalf.
I have read this application and the info r a provid� 's correct.
I agree to comply with all applicable city =and rd'n r ces nd state laws relating to building construction.
I authorize representatives of this city or count to he ove-ldentlfie property for inspection purposes. A&
1/
nature of Prooertv Owner or Authorized Aaent Print Property Owner's or Authorized Agent's Name /�yy%j�LCf_ Lod
ACTION I DATE I
PEFMITCANCELLED
PERMIT EXTENDED
PERMIT FINAL V x -19 _>'(2-
CERTIFICATE OF
OCCUPANCYISSUED
OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
PART 61 OF TITLE 40 AND AQMD RULE
1403
Ll I SUBMITTED ASBESTOS NOTIFICATION TO
NOTIFICATION IS NOT APPLICABLE TO
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