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HomeMy WebLinkAboutX2019-2645 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIillll�lllllllllllllllllllllllllllll COMB Permit: X2019-2645 a. 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 2 6 4 5 Project No : 0118-2017 h.. *. Permit Counter Phone (949)644-3288 ) Inspection Requests Phone (949)644-3255 Combination Type - MFP Issued Date: Inspection Arearea :2019 5 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: 212 FERNLEAF AVE NB Description: MFR -RENEW EXPIRED PERMIT- CANTILEVERED ROOF DECK EXTENSION 69 SF (X2017-0163) Legal Desc.: RESUB OF CORONA DEL MAR LOT 14 BLK 133(AND NELY112LOT 12 BILK 133 NO CONSTRUCTION NIDISE Owner: NOWLIN ERIC &JACKIE Contractor.. OWNERIBLDR Architect .°.• Address: 212 FERNLEAF AV#1 Address: NOWLIN JACKIE Address: CORONA DEL MAR CA 92625 Phone: 949-842-4694 Phone: Phone: State Lie: • • • ° ° Applicant: LAO RAUL Con State Lie: O/B Engineer: MANSNAUATHE V EEKENPO °m Address: 19922 GRIDLEY.RD Lie Expire: Address: 1800 E 16TH ST UNIT B $0.00 CERRITOS CA 90703 Bus Lic: $0.00 SANTA ANA CA 92701 m m Phone: 562-673.2716 _ Lie Exp Dater Phone: 714-835-2800 State Lic:C-036840 ...... Code Edit: Type of Construction: Occupancy Group: Added /New sq.ft. Bldg:. Added /New sq. ft. Garage: No of Stories: 2 .No of Units : 2 Bldg Height: 0 Bldg Sprinklers: Valuation: 2016 Worker's Compensation Insurance Designer: LAO ERIC ° VIB Carrier: Address: 19922 GRIDLEY RD oemmom R31U Policy No: CERRITOS CA 90703 ° 0 Expire: Phone: 562-673-2716 m mb 0 om o moon Building Setbacks .Building Permit Fee: $0.00 Excise Tax: Plan Check Fee: $0.00. Fair Share : Additional Fee Overtime Plan Ck: $0.00 Grading Bonds Fee: Investigation Fee: $0.00 Grading PC Consultant Record Management: $0.00 Grading Permit Fee: Energy Compliance: $0.00 Grading PC Fee: CA Seismic Safety: $0.00 WQ Insp. Fee: Disabled Access : $0.00 $0.00 Hazardous Mat $0.00 Electrical %m: Building Green Fee : $0.00 Mechanical %: Plumbing %: TOTAL FEE/` $359.00 I PROCESSED BY: ZONING APPROVAL: Rear: I Front: I Left: I Right: I $0.00 $359.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 e•moo m mmmoo 00000° o c om0000 o n ommo Special Conditions: NOISE FORM RECEIVED INSPE®� CT Planning Department - Fire Department Plan check Fee $0.00 Fair Share : $0.00 SJH Trans : Fire Plan Rev In -lieu Housing Fee: $0.00 Public Works Department - Park Dedication : $0.00 PAN Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Plan Check Fee : $359.00 PUBLIC WORKS APPROVAL: PLAN GRADING APPROVAL: 1/ 4 APPROVAL TO Issuance $0.00 $0.00 $0.00 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 PUBLIC WORKS APPROVAL: PLAN GRADING APPROVAL: 1/ 4 APPROVAL TO Issuance $0.00 $0.00 $0.00 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 items) 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 fessions 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, ;iness 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 ro ed for the purpose of sale). 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 ply to an owner ofrJroperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 0* . I am exempt from litensure under the Contractors' State License Law for the following reason: my signature Mow 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 Iegallt VdIocture trsl,l*fte 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 fessions Coda 09vailable upon request when�this�Pplic ' n is su mlt1a j'the fol ing Web site:http://www.leginfo.ca.gov/calaw.htmi. nature of Propeldy Owner or Authorized Agent i`-' 4h1 / Date IEWSED CONTRACTOR'S DECLARATION^ Tre4offirm Ailer'psulalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force eff@ct. License Gass License No Date Contractor Signature RKERS' M$]AAPENSATION DECLARATION JOIIOG: FAILURE TOp4ECURE 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 5 Gr.QOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Aeby affirm unser penalty of perjury one of the following declarations: PM4 and wijl,maiptain a c6rtificate 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 the onn ance of the wbir ofor 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' compensatiol Trance carrier and policy number are: Policy Number Expiration Date Agent 3Cce Ify 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 agree iat, ' I should become subject he wor ers' DorDpensatio'� n pr sons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ,ignature of Applicant �G�/%/ K/d IECLARATION REG RV9w CONSTRUCTION LENDING AGENCY hereby affirm under perfflty 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 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 ordinances and state laws relating to building construction. I authorize representatives of this city or county to a the ab%o�ve-i I d property for inspection purposes. ;ionah He of Pmnnrty Owner or Authnrized Anent � PAi.✓.f'_! Print Pronertv Owner's or Authorized ADent's Name ACTION - DATE BY / DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 EXPIRED 1 /I, V1 I LI I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT EXTENDED UAQMD PERMITFINAL ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF^ ��� ,IALi PROPOSED DEMOLITION OCCUPANCYISSUED L,'�'� vl V SIGNATURE: lI7 nntR 5<r--> > a) O U -C C W v v D /0L a) �_ C "2 O O Z COC 0 o U U C a) pLU CU om3.sa> LU -0 O .0 O C O � a m Q pj Q- CO () O V W OC: C L Q 1 .C- Z Z C N c > Q O O W U) p as r- o U) F- "O�' a) dC a= ChSQ o 0 °ate z a 2:13:o �m Or m =m mac.°�0 U po O Z UM o m C:cZ �C\ LL. 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