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Home My WebLink AboutX2020-0477 - Permitsv10 City of Newport Beach - Building Division IIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2020-0477 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 0 0 4 7 7 Project No: 2088-2019 �'` Permit Counter Phone (949)644-3288 G Inspection Requests Phone (949)644-3255 �'cr>ou�,% Combination Type - SFP Issued Date: 02121/2020 0 Inspection Area : 3 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: 14 BIG DIPPER CT NB Description: DELTA 1 - RIR 3 WINDOWS, ADD 2 NEW WINDOWS (REV20-0309) Legal Desc.: TR 8835 LOT 6 UNIT 11 P-11 G-11 CP -11 OF PROJECTLOCATED ON AP Owner: WHEELERMOLDEN Contractor: PYXIS WATER SYSTEMS INC Architect: Address: 9104 HIGH OAK CT Address: 8544 HAMILTON AVENUE Address: FAIR OAKS, CA 95628 HUNTINGTON BEACH CA Phone: Phone: Phone: State Lic: Applicant: HOLDEN KELLY Con State Lic: 896753 Engineer: Address: 9104 HIGH OAK CT Lic Expire: 05/31/2021 Address: FAIR OAKS, CA 95628 Bus Lic: BT30069113 Phone: 916-579-4707 Lic Exp Date: 09130/2020 Phone: State Lic: Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: V -B Carrier: SECURITY NATIONAL INS CO Address: Occupancy Group: R3/U Policy No: SWC1148349. "^ Added /New sq.ft. Bldg: 0 Expire: 05/04/2020 Phone: Added /New sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: I Special Conditions: } No of Units : 1 (Bldg Front: I®^ Height: 0 Left: I {1.I Bldg Sprinklers: Right: I Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N INS Construction Valuation: $3.000.00 Building Permit Fee: $120.00 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 PNV 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 : $121.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $121.00 ;E PROCESSED BY: ' - _ ` `gym Q PUBLIC WORKS APPROVAL: ZONING APPROVAL: ` - r PLAN CHECK BY: 1 GRADING APPROVAL: APPROVAL TO ISSUE: rim oc` �`o n c, occ o c c o „ oc au �• 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 items) (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 -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 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 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 Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0) of Division 3 of the Business and �si n ode, and licens full force and effect. License Class License No Date °' Z-� o Contractor Signat fG� INORKERS' COMPENSATION DECLARATION z NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINER UP TO ONE HUNOR THOUSAND 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. hereby affirm under penalty of perjury one of the following declarations: 3�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 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' rance carrier and policy number are: ier I Policy Number Expiration Date of 31 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 iat, if I should become fs�u/ple�t ty�-tjk`-�workers///' cyyym ensa Ion rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of Applicant ! I .S --- �"Z IECLARATION REGA�IG CONSTRUCTION LENDING AGENCY hereby 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, Ivil Code). ender's Name Lender's Address ly 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 countytwo en�rjhe above-identifiedproperty for inspection purposes. ^' 'im. + i of orn 4w n -nor nr A„Ihnrin A„o� / S�r� � �.� Print Prooertv Owner's or Authorized ADent's Nam' e1/Date d,? -2 /.-4D DATE BY VAI REGULATIONS PART DECLARATION OF CO ATO 1 OF IITLE 40 AND QMD RU ECE WITH CODE OF RAL FOR OFFICE USE ONLY PERMIT EXPIRED ❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO • • • : "' • • • .. PERMIT CANCELLED LIEPA i : • • • • • • ` •� PERMIT EXTENDED qMD • • • • • • •: PERMITFINAL I�'I�✓ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF Li] PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: •'• +•• •• • ••+