HomeMy WebLinkAboutX2019-2700 - PermitsCity of Newport Beach - Building Division IIII�IIIII IIIIII�� II IIIIIIII I�I III II IICOMB Permit: X2019-2700
+� 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 2 7 0 0 Project No:
�*. Permit Counter Phone (949)644-3288
$`rt Inspection Reque�5lhone (949)644-3255.
"'rsrvr,u.�+`' Combination Type - MFP Issued bate'. 08/30/2019
6
Inspection Area : 1
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. t0 6:00 p.m. No work on Sundays or Holidays
Job Address: 2209 CHANNEL RD NB -
Description SFR CHANGE OUT (3) WINDOWS & (1) FRENCH DOOR -
Legal Desc : -N TR 940 LOT 83 y _
Owner OAKES STUART/GLORIA Contractor RENEWAL BY ANDERSEN OF OC Architect /`/®
Address: 2209 CHANNEL RD Address. 22982 ALCALDE DR #100 Address:
NEWPORT BEACH, CA 92661 LAGUNA HILLS CA 92653 _ 90
Phone. - Phone 714-259-5120 Phone: Lic:
Applicant: RENEWAL BY ANDERSEN OF OC Con State Lic: 990416 Engineer.. /l� -
Address 22982 ALCALDE DR #100 Lic Expire. 0212812020 Address: 0, QA/ �®
LAGUNA HILLS CA 92653. Bus Lic: BT30046925 IAA
Phone: 714-259-5120. Lic Exp Date: 04/30/2020 Phone: ® Itq State Lic: t177r_ -
Code Edit: 2016 Worker's Compensation Insurance Designer: 1, V
Type of Construction: V13 Carrier: EVEREST NATIONAL Address: C h
Occupancy Group: R311.1 Policy No: MWC31415800 Z.0
Added /New sq.ft. Bldg: 0 Expire: 10/01/2019 Phone:
Added /New sq. ft. Garage: 0
No of Stories: 0 Building Setbacks Rear: I Special Conditions: LIQUEFACTION. AREA
No of Units : 1 Front: I
Bldg Height: 0 Left: /
Bldg Sprinklers: Right:
Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone: N
Construction Valuation: $7,900.00
Building Permit Fee: $200.00 Excise Tax: $0.00 Planning Department - Fire Department
Plan Check Fee: $0.00 Additional Fee: $0.00 Plan check Fee : $0.00 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 $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 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 %: $0.00 $0.00
TOTAL FEE : $201.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $201.00
m �
PROCESSED BY:. ° bPOBL!'C W:7R`KS APPROVAL:
ZONING APPROVAL: PLAN CHECK BY:
GRADING APPROVAL f PI?ROVAL�TO ISSUE: - V
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) 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, also requires the applicant for
ie 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 Se°^*vt,,OM0o) of Division 3 of the Business and
'rofessions 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
of more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements 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
nproved for the purpose of sale)..
1, 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
pply 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:
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 legally
ell a structure that I have built as an owner -builder if it has not been constructed in its entirely by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
'rofessions Code, is available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw.html.
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of peryyry that I am licensed under provisions 6,pa er 9 (commencing with Section 7 ) o Div Sion 3 of the Business and Profession de, d y license is in full force
nd effect. License Class ''SS License No ``'��u (1 \1., Dat "� Contractor Signa_DdkE\"
IIORKERS' COMPENSATION DECLARATION
'ARNING: 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
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 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 IN
erformance of the work for which this permit is issued. Policy No.
;Khave and will main ain orkers' 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' compensatiol
nsurance carrier and po' y n tuber are: �7
3arrier_UJOP�DOstt Nurr I rP Expiration Date
Vame of Agent ry0 �7 Phone #
:1I certify that, in the perfor once ff t,>` he 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 agree
hat, if I should become su ct to thk�(w\or�kers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
g
�� � �
)ECL ure of Applicant Va
IECLARATION REGARIDINGICONSTRUCTION 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
3y 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 haveovided is correct.
I agree to comply with all applicable city and county or d noes an state laws relating to building construction.
I authorize representatives of this city or coty " ente th above- e fi (property for inspection purposes.��`�
"f!
3i nature of Property Owner or Authorized A ent Print Property Owner's or Authorized Agent's Na 't)
ACTION
DATE
BY L
DECLARAYION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
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