HomeMy WebLinkAboutX2020-2997 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIII'IIIIIIIIIIIIIIIIIIIII II COMB Permit: X2020-2997
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 0 2 9 9 7 Project No : 2385-2020
F
' Permit Counter Phone (949)644-3288
it: •. `. Inspection Requests Phone (949)644-3255
":As Issued Date: 03/0212021
"9au�r,y�x' , " Combination Type - SFP
Inspection Area : 1
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0310212024 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: 246 WALNUT ST NB
Description: SFR EXTERIOR ENTRYWAY BEAM REPAIR
Legal Desc.: TR 772LOT 18 BLK 4 ALL (EX NELY 10 FT) THEREOF AND NELY
11 FT LOT 19'""
Owner: ROGGENBUCK JUDY
Contractor:
BREAKWATER BUILDERS, INC
Architect:;
Address: 246 WALNUT ST
Address:
239 PROSPECT ST
Address:
$
NEWPORT BEACH, CA 92663
NEWPORT BEACH CA 92663
ri
Phone:
Phone:
714-342-7579
Phone:
State Lie:
Applicant: HIGGS TOM
Con State Lie:
968041
Engineer:
STOVNER ERIC
Address: 239 PROSPECT ST
Lie Expire:
1213112021
Address:
1852 LOMITA BLVD #210!
..�.,.�
NEWPORT BEACH, CA 92663
Bus Lic:
BT30038396
LOMITA CA 90717
Phone: 714-342-7579
Lie Exp Date:
12/3112021
Phone:
310-530-3050 State Lic:S-004204
Code Edit: 2019
Worker's Compensation Insurance
Designer:
^'
Type of Construction: V -B
Carrier:
WC EXEMPT
Address:
Occupancy Group: R3IU
Policy No:
(NO EMPLOYEES)
.. _...,. .
Added /New sq.ft. Bldg: 0
Expire:
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 2
Building Setbacks
Rear: I
Special Conditions: LIQUEFACTION AREA
No of Units : 1
Front: I
Bldg Height: 0
Left: I
Bldg Sprinklers: N
Right: I
Flood Zone: X
Use Zone: Parking Spaces: 0
Fire Hazard Zone : N
Construction Valuation: $22.000.00
Building Permit Fee: $450.00
Excise Tax:
$0.00 Planning Department
-
Fire Department
Plan Check Fee: $391.50
Additional Fee :
$0.00 Plan check Fee :
$46.25 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: $6.00
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
WO 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 W
$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: $894.75
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan Check Fee
d
$437.75 Fee Due at Permit Issuance : $457.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
Colo
cc
so
$437.75 Fee Due at Permit Issuance : $457.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
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 the applicant for
he 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
Irofessions 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
lot 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,
3usiness 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
mprovements 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
mproved 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
Ipply 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:
3y 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 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
Irofessions Code, is available upon request when this application is submitted or at the following Web site:hltp://wm,leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 00 ) of Divisi n 3 of the Business and Prof ssions Code and my I'nense. is in full force
Ind effect. License Class License No Date Contractor Signature
YORKERS' COMPENSATION DECLARATION R cam_
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL 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:
7 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 the
erformance 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'
rance carrier and policy number are:
Policy Number
of Agent
Date
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 agree
t, if I should become subject
-to the
eworkers'
"compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. r�
nature of Applicarlh( A
CLARATION REgrA ING CONSTRUCTIO -E-NU NG AG CY-' -
areby 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 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 couty o_enteP4ha,-ebn�-��-�' D+_pe L perty for inspection purposes.
—
na}ure of Prnnedv Owner nr Authnri�ed Anenf Y - _� ""'' PrinfFTr`DrSartv Owner's or Authorized ADent'6 Name Y ) fl u'✓� �1 I � � � Da[e l } Z �.1
ACTION DATE BY t DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND ACIMD RULE
1403
PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
EPA : • •. : • • . • • : • r ..
PERMIT EXTENDED QMD • • • • • : • : • `•
PERMIT FINAL`2 AS ESTOS NOTI ICATION IS NOT AP_Q&UE TO • • • •.
CERTIFICATEOF `�" ' PR SEDIDEMIXITIO
OCCUPANCYISSUED ATUR :r::✓"-"�' ..-�""M