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Home My WebLink AboutX2019-2088 - Permitse11tr1 City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIII II COMB Permit: X2019-2088 100 Civic Center Drive, Newport Beach, CA 92660. X 2 0 1 9 2 0 a 6 Project No: Permit Counter Phone (949)644-3288 - Inspection Requests Phone (949)644-3255 Combination Type - SFP Issued Date: 12019 Area : +r+r¢nR 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. to 6:00 p.m. No work on Sundays or Holidays Job Address: 109 VIA VENEZIA NB " Description: SFR - TIO TILE, APPLY 30# FELT WIBORAL SAXONY 600 TILE CLASS "A" ESR -1647 43 SOS 5.9 LBS 1� Legal Desc.: TR 907 LOT 280(AND NELY1/2 LOT 281 Ns+PL�r ®� Owner: ZANDERHOLM STEVEN Contractor: SCHMIDT ERIC CONSTRUCTION Architect: Address: 109 VIA VENEZIA Address: 448 PROSPECT ST Address: NEWPORT BEACH, CA 92663 NEWPORT BEACH CA 92663 Phone: 714403-4141 Phone: 949-335-2380 Phone: State Lie: Applicant: SCHMIDT ERIC CONSTRUCTION Con State Lie: 695406 Engineer Address: 448 PROSPECT ST Lie Expire: 08/31/2020 Address: NEWPORT BEACH CA 92663 Bus Lic: BT30023771 Phone: 949-335.2380 Lie Exp Date: 06/3012020 Phone: State Lie: Code Edit: 2016 Worker's Compensation Insurance Designer Type of Construction: VB Carrier: EXEMPT. Address: Occupancy Group: R31U Policy No: Added /New sq.ft. Bldg: 0 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: I Special Conditions: No of Units : 1 Front` I ° Bldg Height: 0 Left: I Bldg Sprinklers: Right: I Flood Zone: Use Zone: Parkin S aces: 0 Fire Hazard Zone : N Construction Valuation: $37,000.00 o ®°`° `°°•°° Building Permit Fee: $324.00 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 $ I Building"Green Fee :$ Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00. .. $0.00 TOT L FEE : $326.0 Plan Check Fee : $0.00 F Due at P it Issuance : $326.00 PROCESSED BY: PUBLIC WORKS A PROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: 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 Me 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 Section 7000) 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 iot 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 U 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 n 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 only 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 legall) ell 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, Section 7044 of the Business and 'rofessions 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 at .ICENSED CONTRACTOR'S DECLARATION hereby affirm ugde;enalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 of D'visi 3 of the Business and Professi ns on i in full force nd effect. License Class License No Da Contractor Signature YORKERS' CON*PANSATION DECLARATION 'ARNING! FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO GRIM AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE (aST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. helgt),yaffirm under penalty of perjury one of the fallowing declarations: •1R• I have and will matntain 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 •Y•• --e�7r"'P_�o'�">�:'ro��3nce of the work for which this permit is issued. Policy No. f 9 and roll l'Vosiin 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 r7E 1R a carrier and policy number are: gre1Ml• Roliry Number Expiration Date Went•••••• Phone# hat, ir►tile p=perjurya r hich is p rmit is issued,' hall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre uld 9gcy sation provisions of Sec. on 3700 of the Labor Code, I shall forthwith comply with those provisions. % Signature of Applic nt Date 7- L � 9 DECLARATION RE .LENDIN I hereby affirm under pIs a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the Br w If. I have read this application and the information I € e pro ' d is co ct. I agree to comply with all applicable city an oun y ordi nc a ws rel t'to building construction. I authorize representatives of this city or unty t ant Ove-ide i r rty for inspection purposes. _` / Signature of Property Owner or Authorized A Tit Print Property Owner's or Authorized Agent's Name dSI-'�c_ ..,.5 LA Da w ACTION DATE BY=REGULAATTIOr N OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY S PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIREDI LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT EXTENDED PERMITFINAL jj�� ASBESTOS NOTIF I SN TA PLI BLE TO CERTIFICATEOF % Z ZO +b K'A^ ROPOSEDD OCCUPANCY ISSUED SIGNATU - _