HomeMy WebLinkAboutX2019-1736 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
r''+cxsw3u*�c� Combination Type -MFP VIA, W
PERMITS EXPIRE 180 DAYS AFTEI
Construction Hours: Monday - Friday 7:00 a.m, to 6:30 p.m. an
Job Address: 323 CRYSTAL AVE NB
Description: MFR -RESTORE TO ORIGINAL CONDITION, MOVE ALL & DOOR TO AL
Legal Desc.: TR 1049 LOT 1 IRREG LOT IN NLY COR(AND NLY 32.66 FT LO
Owner: LEONARD K>CA92660
actor PDC
Address: 323 CRYSTAAddress S HATH
NEWPORT BSANTA ,
Phone' Q ,I Ph n 14 -0Applicant: CASKEY BILCon Stat ic: 9685Address: 630 CAMEO, Lic Shire_ -1118412
Phone: 714-624-7 6
Code Edit: 2
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Gara%e:
No gPStoPies: . . No o*u Unitsd
Bldg Height: - °oneo0
Bldb,5%dipl�lers: .
Flood Zone: o
tluildift,permit Ftiq, o $232.00
Pt9n Clack Feee MUM
Qv irtim°e Plan Ck ° ° 0
$0.00
Investigation Fee: °
$232.00
Record Manag(tmenY °
$0.00
°
tr`idrg§EompliantL,
$0.00
CA Seismic Safetp:° c
$0.00
Disabled Access° ° ° °
$0.00
Hazardous Mat
$0.00
Building Green Fee :.
$1.00
TOTALFEE:
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
III IX2I�II0IIII�III3III�6�'III
COMB Permit: X2019-1736
Project No : 1245-2019
. Issued Date: 06/03/2019
Inspection Area : 2
uovniv i UAOI vHuu nvJreVl lum
d S ay from((,,at8te:pt, to 6;00p.
:00 JC.r1 P40
CONK IfflD0'PER25tj26t1 OPWORK"
$Qo'0 Or
Architect: ASKEY BILL
92 SOTUNIT C O�fl s: 630 CAMEO Hh
CORONA DELI
t0 IP Phone:714-624-7086
Engineer:
Address:
SIR 1% Phone:
IPPS CO Addre
Spa I
mo �0
Rf `
a es: 0 - Fire H rd 7n
g v00
�lyn�p_
Eddi IT6e $0.00
spa
ading�_gq ea. $0.00
rading onsultant : $0.
Grading Permit Fee: .00
Grading PC Fee: $0.00
WQ Jn
{�('sp. F
1 `Elleectrical %:
,_�PISn check
Fair Share,;
$0.00
$0.00
Plan Check Fee:
-�In-I' using Fee:
is Works Department -
Park Dedication : $0.00
PAN Plan Check : $0.00
San Dist: $0.00
NMUSD Fee: $0.00
on Sundays or Holidays
S DR
92625
its Lic:C017746
.0� Fire Department
40.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee -
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
$241.84 Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$465.00
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' ance, 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 w' Ion 00) of Division 3 of the Business and
'rofessions 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 appl' r a permit subj is the applicant to a civil penalty of
iot more than five hundred dollars ($500).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the d the structure is not intended or o red for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, thro ployees' or gQy�s�ggnnal effort, builds or im�pp�ve the property, provided that the
mprovements are not intended or offered for sale. If, however, the building or improvement is sold within on completion th@',��?SBUildI�OIODgoe(f�(ylki'lrSh 0 roving that it was not built or
m roved for the purpose of sale). `` 11
I, as owner of the property, am exclusively contracting with licensed Contractors to co a project (Section 7044, usiness ��aqqd p�pfsg 'lo s Code: The Contractors State License Law does not
apply to an owner of property who builds or improves thereon, and who contracts projects with a license ntractor p�§ul®H►Rh�Contractors' State Lice w).
❑ 1 am exempt from licensure under the Contractors' State License L e following reason: vv
By my signature below I acknowledge that, except for my pars si enc in which I mus resided for one year prior to co ti a improvements covere y this permit, I cannot legally
sell a structure that I have built as an owner-builder if of been c d in Irety by license cto I under�tld�l�lopy of the applicable law, Section 7 4 of the Business and
Professions Code, is available upon request w sap t n s u at the folio ing e. gi c v calaw.html. _
Signature of Property Owner or Authori gent Date
LICENSED CONTRACTOR'S DEC RAJ�O
I hereby affirm under penalty of perjury t t I a sed under ro of Er nc Section 7000 'vision 3 of the Business and Professi a an license is in full force
and effect. License Class Licen o Da I Contractor Sign
WORKERS' COMPENSATION DEC RAT
NARNING: FAILURE TO SECURE WORKERS' COMPE RATIO COVERAG UNLA D SHALL SUBJECT E R T RI PEN ND CIVIL FINES UP TO ONE HUNDRED TH U S 157 '0001, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED R IN CTION 570 THE LABOR CODE, INTER
I hereby affirm under penalty of perjury one o the f rations: r`�
❑ ave and will maintain a certificate of nsent to self-i re fib or s' c n 'on, iss ed by the Director of Indt'�I �gleti ns IBJvi ed by Sectio 00 of the Labor Code, for the
p ormance of the work for which this permit 'ssued '�„,,��aa(k0
ave and will maintain workers' compensa n in a quir action 3700 of the
or Code, fort pe a of t,!hp5T c fe1"%ch: 's r 1 i u r rs' compensat°iol
ur nce carrier and policy number are:
Carr r - er "OExpir atl on Date ��• • ° °°
°
Name of Agent Phone # � • • • ° ° ° °
❑I certify that, in the performance of the work for w 'ch this a tis ' s t m y�Q y person in any manner so as to b e subject,{}ppy,�thwo rs' ation law: of �aflifornia„ 9HYl°dt&
that, if I should become u -jec othe sati pro ion o 70 f,1.66or Code, I shall forthwith y with those pro 'Ions. - , . . • ° ° ° °
Signature of Applicant . "'��— '• °”
DECLARATION REGARDI STRUCTION LEN G ENCY V.
I hereby affirm under penalt IF er'u that there is a c struction lending agency for the perf nce of the work f Ich t It is issued (Section 3097, Civil Code). • , ° °
Lender's Name r s.Address °
By my signature below, I certify to each of the following: }}oo • ' ' • ° ° ° ° °
A>=YS shelf.
I am the property owner or authorized to act on the pr a ,,,
I have read this application and the information I have ovided is correct. • '
•••ae
I agree to comply with all applicable city and county ordl ces a e la Ing to building construction.
1 authorize representatives of this city or county to ante - v property for inspection purposes. /-�,1. A \yi, ��?j•{�
ignature of Property Owner or Authorized Agen Print PropertOwner's or Authorized Agent's Name
ACTION DATE BY D F COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
GULATIONS PART 61 OFTITLE ]RULE
1403
PFRMITFXPIRFO L 17w I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITFINAL ❑ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF PROPOSED DEMOLITION
OCCUPANCY ISSUED SIGNATURE: