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X2019-2062 - Permits
City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIII� COMB Permit: X2019-2062 ti 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 2 8 6 2 R ' Permit Counter Phone (949)644-3288 Project No: 1488-2019 'c, Inspection Requests Phone (949)644-3255 ..rd4i�ze�'' Combination Type - MFP Issued Date: 06128/2019 4) Inspection Area : 2 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: 325 COLLINS AVE NB Description: MFR- RIR BOTTOM OF DAMAGED STAIRS Legal Desc.: BALBOA ISLAND RESUB SEC 1 LOT 3 BLK 10 SW 30 FT(AND SW 30 FT LOT 4 BILK Owner: BENDETTI BOB Contractor: OWNERIBLDR Architect WALKER BARRY Address:: 325 COLLINS AV BA 99# ISLAND CA 92662 Phpvq:° c a ° Af Dl4cani WALKgl::PARRY A�IdrRss:° P.b:B X-11658 o m e ... NEW90RT BEACH CA 92658 Pherm oa 949-34$-6085 omo o m o CorPe Edit : ° ° ° 2016 Ty�e.oi ConstrucV&P.. © ° V -B Oc6paAcy Group:- ° ° R31U AJegfl3erw sq.ft. Bldg: 0 Added /New sq. %Gavage: 0 No.of Stories: 0.'..02 No&UnRe': 2 Bldg Height°oo°o.0 Bldg Sprinklers: Flood Zone: _ Construction Valuation: $3.400.00 Building Permit Fee: $136.00 Plan Check Fee: $118.32 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: $295.32 PROCESSED BY: ZONING APPROVAL: Address: P.O. BOX 11658 Phone: Fire Inspection: Con State Lie: OIB Lie Expire: NEWPORT BEACH Bus Lie: $0.00 Lie Exp Date: , General Service Worker's Compensation Insurance Carrier: State Lic:C019637 Policy No: Grading Permit Fee: Expire: In -lieu Housing Fee: Building Setbacks Rear: I $0.00 Front: I Address: Left: / Park Dedication : Right: / Address: P.O. BOX 11658 Planning Department - Fire Inspection: Additional Fee : $0.00 Plan check Fee NEWPORT BEACH CA 92658 $0.00 Fair Share General Service Phone: 949-2464085 State Lic:C019637 Grading Bond: Grading Permit Fee: - Engineer. In -lieu Housing Fee: Grading PC Fee: $0.00 Public Works Department - Address: $0.00 Park Dedication : $0.00 Phone: $0.00 State Lie: $0.00 San Dist: $0.00 Designer: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 Address: Phone:.. y Special Conditions: + � �'� 1 ;r Excise Tax: $0.00 Planning Department - Fire Inspection: Additional Fee : $0.00 Plan check Fee Demolition Fee Grading Bonds Fee: $0.00 Fair Share General Service Grading PC Consultant: $0.00 SJH Trans Grading Bond: Grading Permit Fee: .$0.00 In -lieu Housing Fee: Grading PC Fee: $0.00 Public Works Department - WQ Insp. Fee: $0.00 Park Dedication : $0.00 PAN Plan Check: $0.00 Electrical %: $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 Plan Check Fee: $0.00 ird Zone : N Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $295.32 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: Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $295.32 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(:) (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 U 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). ❑ f, 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 ha been constructed inits entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044D Q�rthe Bus'nesa and Professions Code, is available upon request wherithis a pl llbmitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm]. i Slt Signature of Property Owner or Authorized Age^, �( P tr/111 LICENSED CONTRACTOR'SDECLARA 1M' I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my DLtttiSQ IS in full.force ° and effect. License Class License No Date Contractor Signature WORKERS'COMPENSATIONDECLARATION NARNING: 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 (S'Idb O.Iol,.Ir1ADDITION.T®JtIt COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3766 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I herebyaffirmunder penalty of perjury one of the following declarations: • • . - ', ° o ° ❑ 1 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 Jor tpl performance of the work for which this permit is issued. Policy No. °° ° 131 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. MlIa lliers' comlJ..ensatisr 000 insurance carrier and policy number are: .... • ° C ' r Policy Number Expiration Date ame of Agent Phone # Ilc rtify that, in the performa ce 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 that, f I should become subj t workers' compensation provisions of Section 3700 of the Labor Code, I shall. forthwith comply with those provisions. �,p nature of Applicant • r Dat ©� - l 9 DECLARATION REGA D ONSTRUCTION LENDING AGENCY I hereby affirm under penalt 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). Lender's Name ILender's Address By 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 ordi ances and state laws relating to building construction. m y� I authorize representatives of this city or count en r ve- dentified property for inspection purposes. ��y i Signature of PropertyOwner or Authorized Agent I Print PropertyOwner's or Authorized Agent's Na ate / ACTION DATE BYIARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY R GULATIONS PART 61 OF TITLE 40 AND AQMD RULE NOTIFICATION TO PERMITFINAL UA5BESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF rt X11 PROPOSED DEMOLITION OCCUPANCY ISSUED (/� U SIGNATURE: _ m m ""!'? G1 m- . t: w. D 4. W ,. m •p � '� .c n ... v rs � � ao � .•- n - m w �' SR gra m vi cm W 2 sa N..s;_ J l8 7 7I Q 00 0 60 m `y mUC. Zj m aw�� c49 c @ .0to .. O AG:���3w ". 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