HomeMy WebLinkAboutX2019-3689 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIII�illlllllllllllllllllll COMB Permit: X2019-3689
.:+ 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 3 6 8 9 Project No : 1381-2019
. Permit Counter Phone (949)644-3288
v �.t Inspection Requests Phone (949)644-3255
Combination Type - SFP PLUM Issued Date : 11/1812019
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:
133 VIA JUCAR NB
Type of Construction:
VB
Description:
SFR REROOF WICLS"A" COMP, T/O COMP (30 SQS), REPLACE (2) WATER HEATERS
Legal Desc.:
0
Added /New sq. ft. Garage: 0
No of Stories:
Owner:
LIDO ISLE LP
Contractor:
FABERWEST CONSTRUCTION
Address:
655 BREA CANYON RD
Address:
P.O. BOX 10771
X
WALNUT CA 91789
NEWPORT BEACH CA 92658
Phone:
Phone:
530-277-7502
Applicant:
SERRANO ROLANDO
Con State Lie:
592260
Address:
1041 W 18TH STREET A-208
Lie Expire:
02/29/2020
COSTA MESA CA 92627
Bus Lie:
BT30030099
Phone:
323-508-6127
Lie Exp Date:
1213112019
Code Edit :
2016
Type of Construction:
VB
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage: 0
No of Stories:
2
No of Units:
1
Bldg Height:
0
Bldg Sprinklers:
N
Flood Zone:
X
Construction Valuation: $14,000.00
Building Permit Fee: $324.00
Plan Check Fee: $0.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$0.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $354.16
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Worker's Compensation Insurance
Carrier: STATE FUND
Policy No: 9050853
Expire: 04/01/2020
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: I
Front: I
Left: /
Right: /
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$29.16
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
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Special Conditions: LIQUEFACTION AREA
Planning Department -
Fire Department
Plan check Fee:
Fire Inspection:
Fair Share
Fire Plan Rev
SJH Trans
Demolition Fee
In -lieu Housing Fee:
Building Dept Adm
Public Works Department -
Park Dedication :
$0.00
P/W Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Plan Check Fee : $0.00
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$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Fee Due at Permit Issuance : $354.16
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
-APPROVAL TO ISSUE:
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Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
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$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Fee Due at Permit Issuance : $354.16
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
-APPROVAL TO ISSUE:
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OWNER -BUILDER DECLARATION
I
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
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 L) all of or L) 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).
❑ 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
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 covered 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, Section 7044 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.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 of Div' n 3 of the Busi as nd Professes-Copgpd my license is in full force
and effect. License Class License No Contra or Sig ature �J/
INORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SEOURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL EN LTIE AND VIL FINES UP TO ONE HUNDRED THq SAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF -COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
.berebyaffirm andel penalty of perjury one of the following declarations:.
fte and wiu maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
pence of tqe work for which this permit is issued. Policy No.
lave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensa
9dse carrier and policy number are:
916 . Policy Number Expiration Date
•e of Agent • Phone #
...
;ert�y that, YCIb2 p$rformance of the wor for which this permit is issued, I shall not employ any person in any manner so as to become subject to theADS
ers' compensation laws of California, and a1
�f �:hpyld b .c, mesubject to�he wor mpensation provisions of Section 3700 of the Labor Cade, I shall forthwith comply with those provisions / // �/
attire of AAD I' et • ✓,dvli[7 1��/e r ` �
CLARAILOMREGARDING CO�TRUCTION LENDING AGENCY V
:reby affirm under penalty of p jury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil
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 provided is correct.
I agree to comply with appl' able city and county ordinances d e laws relating to building construction.
I authorize represenjatives this city or county t �g}d�i h -Identified property for inspection purposes. yI �, /� L
nature of Prooertv Owner uthorized ADent F�/�/ Print Prooertv Owner's or Authoriz"d "dent's Name m,19
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ACTION
V DATE
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D?CLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE RNV \ _
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
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