HomeMy WebLinkAboutX2020-0318 - Permitst1'a a City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�III COMB Permit: X2020-0318
- �' 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 0 0 3 1 B Project No
N `; Permit Counter Phone (949)644-3288
it _ y as Inspection Requests Phone (949)644-3255
'r'�+yw.�.a Combination Type - SFP Issued Date: 0210412020
Inspection Area : 2
PROCESSED BY:
ZONING APPROVAL:
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RUQLIV WORKS APPROVAL:
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PLAN CHECK BY:
GRADING APPROVAL:A
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F#rrR,OVAL TO ISSUE:
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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: 1543 SERENADE TER NB
Description: SFR CHANGE OUT (10) WINDOWS, (1) FRENCH DOOR & (1) DOOR TIKE FOR LIKE"
Legal Desc.: TR 1701 LOT 46 FOR OF LOT
Owner: CONOVER CAROL L
Contractor: RENEWAL BY ANDERSEN OF OC
Architect:
Address: 1543 SERENADE TER
Address: 22982 ALCALDE DR #100
Address:
CORONA DEL MAR, CA 92625
LAGUNA HILLS CA 92653
Phone:
Phone: 714-259-6120
Phone:
State Lie:
Applicant: RENEWAL BY ANDERSEN OF OC
Con State Lie: 990416
Engineer:
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co
Address: 22982 ALCALDE DR #100
Lie Expire: 02/29/2020
Address:
LAGUNA HILLS CA 92653
Bus Lie: BT30046925
Phone: 714.259-5120
Lie Exp Date: 04/30/2020
Phone:
State Lie:
Code Edit : 2019
Worker's Compensation Insurance
Designer:
Type of Construction: VB
Carrier: OLD REPUBLIC INS CO
Address:
Occupancy Group: R31U
Policy No: MWC31415B19
Added /New sq.ft. Bldg: 0
Expire: 10/0112020
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 1
Building Setbacks Rear: I
Special Conditions:
No of Units : 1
Front: /
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: I
Flood Zone: X
Use Zone: Parkin S aces: 0
Fire Hazard Zone : N
Construction Valuation: $13.000.00
Building Permit Fee: $280.00
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
PAN 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 : $281.00
A Plan Check Fee : $0.00
Fee Due at Permit Issuance :
$281.00
PROCESSED BY:
ZONING APPROVAL:
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RUQLIV WORKS APPROVAL:
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PLAN CHECK BY:
GRADING APPROVAL:A
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F#rrR,OVAL TO ISSUE:
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OWNER -BUILDER DECLARATION n•
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 itdm(s)r
(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
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 7000) 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).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) 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
improvements 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
im roved 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
apply 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).
❑ 1 am exempt 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 overed by this permit, I cannot legall)
sell a structure that I have 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, ction 70 of the Business and
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent ate
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section, 0 0) of ivi ion 3 of the Business and Prof sen ode, an license is in full force
and effect. License Class License No Date - Contractor Signatu`
WORKERS' COMPENSATION DECLARATION
WARNING: 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
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
111 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
Vha
rmance 0f the work for which this permit is issued. Policy No.
ve and willalptain 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' compensatiol
ance carrier arngt�po7lcy number argue
1 _. 1 /i 1 1 Expiration Date
TIE of Agent !Ll --j�� — - y • [/.11� , ",•""'
certify that, in the perform nce oa�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' compensati n laws of California, and agre
t, if I should becom __ubj to the)ptuor m' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant /� V\\� D 2 1 2
CLARATION REGARDING 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 rovided is correct.
I agree to comply with all applicable city and county or d an P�s and state laws relating to building construction. Fn' ,., y
1 authorize representatives of this City or count 0 e he � oye-identified property for inspection purposes. '� Yv3tN � w
mature of Pronertv Owner or Authorized Agent ��" Print Property Owner's or Authorized Agent's Name ate
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403 • +•• • • +••
PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATIONTO ••• • • ••
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PERMIT EXTENDED OAQMD
PERMITFINAL ITASBESTOS NOTIFATIONI OT APPLICABLE TO
CERTIFICATE OF OPOSED O LII N • • ... • •• • •• • •• ...
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