HomeMy WebLinkAboutX2020-0593 - PermitsL v City of Newfport Beach - Building Division *X2020-0593* COMB Permit: X2020-0593
' r � 100 Civic Center Drive, Newport o>-_atT,_'A 92660 Project No:
w Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
a'�xr�numry'. Combination Type - SFP
Issued Date : 03/05/2020
0
Inspection Area : 1
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY OR PERMIT WILL BE INVALID
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: 1718 E OCEAN FRONT NB
Description: SFR - C/O (6) WINDOWS INTO EXTG
Legal Desc.: N TR 518 BLK C LOT 5
Owner: KOZBERG ROGER & J Contractor: RENEWAL BY ANDERSEN OF OC Architect:
Address: 1718 E OCEAN FRONT Address: 22982 ALCALDE DR #100 Address: tq��•
NEWPORT BEACH CA 92661 LAGUNA HILLS CA 92653 ��d'�,/�, • ®°
Phone: Phone: 714.259.5120 Phone: State Lic: C(�, •(°°° °
Applicant: RENEWAL BY ANDERSEN OF OC Con State Lic: 990416 Engineer: S+ o • • O°
Address: 22982 ALCALDE DR #100 Lic Expire: 02/28/2022 Address: ,� O ° ° • °
LAGUNA HILLS CA 92653 Bus Lic: BT30046925 IVO • �° O0 °
Phone: 714-259-5120 Lic Exp Date: 04/3012020 Phone: to ° • ° • • • ® o
Code Edit: 2019 Worker's Compensation Insurance Designer:
gg,, o• o
Type of Construction: VB Carrier: OLD REPUBLIC INS CO Address: �fy. ° ° ° • ° • ® °
Occupancy Group: R3IU Policy No: MWC31415819 ®®®° ° ® ......
Added /New sq.ft. Bldg: 0 Expire: 10/0112020 Phone: ®
Added /New sq. ft. Garage: 0 n
No of Stories: 2 Building Setbacks Rear: I Special Conditions:;q 'z.®®��Y.6
° ° ° ® �, • ° o
No of Units : 1 Front: I
Bldg Height: 0 Left: I 'T®�^ ••••O° ®mmo"
Bldg Sprinklers: Right: I
Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N
Construction Valuation: $6.600.00
Building Permit Fee: $184.00 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 : $185.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $185.00
PROCESSED BY: PUBLIC WORKS APPROVAL:
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(%)
(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❑ 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,
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
improved for the purpose of sale).
1:11, 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).
❑ I 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 covered by this permit, 1 cannot legally
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, Section 7044 of the Business and
Professions CoOls'aawilable upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.htmi.
$ignatuW of Prop'bTtf Owner or Authorized Agent ate
CIC@ro,$ED CQN,TF%CTOR'S DECLARATION
I Herebyy affirm under penalty of perN�Y that I am licensed under provisions oj, F�pt r 9 (commencing with Section 7000) of Sion 3 of the Business and Profession de and my license is in full force
anbeffeet. License Class 1S License No 01�(H II� Date Contractor Signature
..
WORKERS' COMPEN'DECLARATION
I�faAF*NING!FAILURE \OaBCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IE AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE
COSTW COMPEN§P.TJON.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I'Ik421y affirm Ilndbi g4nalty of perjury one of the following declarations:
...
�� I�ave 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 the
rmance of the word for which this permit is issued. Policy No.
0
and wiR fnailin 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' compensatior
camer leln�drpolicynumber are: _
i ttf6Pvyi1(� Policy Number Irlt L�L� (75* Expiration Date la
le of Agent
certify that, in the p
, if I should become
of
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 agrer
I&workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Date_ 5' 2,6
CLARATION REGARQING CONSTRUCTION LENDING AGENCY
rreby 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
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 onthave
p party owner's behalf.
I have read this application and the information provided is correct.
I agree to comply with all applicable city and co o inances and state laws relating to building construction.
I authorize representatives of this city or county -the above -identified property for inspection purposes.
nature of Prooertv Owner or Authorized AGent Print Property Owner's or Authorized Agent's Name
ACTION DATE BY r! DECLARATION OF II REGULATIONS PARTOMPLIANCE WITH CODE OF 1 OF TITLE 40 AND AQMD RULE FOR OFFICE USE ONLY
PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED EPA
PERMIT EXTENDED
)RAJMD
PERMITFINAL BE TOS I KATION IS NOTAPPLICABLE TO
CERTIFICATEOF q�" PROPOSED DE LI N IV—V
OCCUPANCY ISSUED /w /�Jw7 //// SIGNATURE:
Civil Code).
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