HomeMy WebLinkAboutX2016-0372 - Permits�nwrna City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 9266
Permit Counter Phone (949)644-3288
u.. Inspection Requests Phone (949)644-3255
Combination Type - SFP
PERMITS EXPIRE 180 DAYS AFTER
INSTALL OR VERIFY SMOKEICARBON MONOXIDE
Job Address: 20451 BAY VIEW AVE NB
Description: SFR REPAIR 1 SQ ASPHALT SHINGLE, CLASS fZ,(,F2Q4tYfi1
Legal Desc.: N TR 1501 LOT 24�""''a/li�r��^
Owner:
BOCKRATHJOS P
Address:
20451 BAY VIEW
Occupancy Group:
NEWPORT BEAC
Phone:
0
Applicant:
BOCK RATH JOSE
Address:
20451 BAY VIEW At
1
NEWPORT BEACH
Phone:
Bldg Sprinklers:
Code Edit :
2013
Type of Construction:
VB
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage: 0
No of Stories:
1
No of Units :
1
Bldg Height:
0
Bldg Sprinklers:
N
Flood Zone:
X
Construction Valuation
Building Permit Fee: $95.00
Plan Check Fee:
$0.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$95.00
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
PROCESSED BY:
AE
CA §dddd'
n -ax'
E l A 960
TOTAL FEE: $191.00
ZONING APPROVAL:
GRADING APPROVAL:
IIIXIIIIIIIIVIIIIID6IIIIII0III3IVI7iIIII II
COMB Permit: X2016-0372
Project No :
Issued Date : 02/04/2016
rea : 3
DLUMBING FIXTRES TO BE UPGRADED
Q% �iUC1d
�Q-� Gantraetor- OWNER/BLDR t Architect: k
Address C{f�FW to A}d�dres�sy.
Pho t'. ,. i4,0?w� �O Phone: State c ^I
e Jt 6[C b Engineer:
� 1% xpire Address:
wit
Bus Lick �t ,
LicpExp lit.}�y V �S Phone: State Li
lker's ens"stZB n6��:y =y Designer:
a'-'arra ' '° (=55- Address:
�AN
xpire: * P o ens rri
Building Setbacks ear:r al
/
dm
R
ett
r - t W Right::
/
Excise Tax:
Additional Fe
1
Grading PC Consultant:
Electrical %:
Mechanical W
Plumbing %:
$0.00
$0.00
$0.00
$0.00
Plan Check Fee:
�cial Conpliti 4P WORK 120„'t�A6
Department- �..r-
Insp.
Plar have 'ca'� $0.00
Fire PlaFire n Rev
se WPI`T ans-: $0.00
Demolition Fee
In -lieu Housing Fee : $0.00
Building Dept Adm
Public Works Department -
General Service
Park Dedication : $0.00
Refund Deposit
PAN Plan Check : $0.00
Grading Bond:
San Dist: $0.00
NMUSD Fee: $0.00
$0.00 Fee Due at Permit Issuance
,mo -
` %UBLIC WORKS APPROVAL:
o s�
m o
o PLAN CHECK BY:
APPROVALTOISSUE
�� vc
0
0 o a o0 0 0
0
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$191.00
OWNER -BUILDER DECLARATION r
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 (_) 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-Builderwill 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 Iegall,,
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 ap li submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent ) Da
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed finder provisions of Chapt 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect. License Class License No Date Contractor Signature
COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, A>EISHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I 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
'ormance of the work for 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' compensal
Trance carrier and policy number are:
Policy Number
Date
Tie of Agent vnone s
certify 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 agre
t, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant Date_
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
Ireby 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 certifyto 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 �11fePfh above -identified property for inspection purposes. ` n� l Da
nature of Property Owner or Authorized Agent'1t! _ Print Property Owner's or Authorized Agent's NamI
A,TWSy D4 7F
py
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