HomeMy WebLinkAboutX2021-1232 - PermitsCity of Newport Beach - Building Division
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COMB Permit: X2021-1232
100 Civic Center Drive, Newport Beach, CA 92660.
X 2 0 2 1 1 2 3 2
Project No: 0050-2021
Permit Counter Phone(949)644-3288
NO
CONSTRUCTION NOISE
Inspection Requests Phone (949)644-3255
Issued
Dat
+z .zck Combination Type - SFF
AX2021
tion
Inspection Area : 1
Area
BY
PERMIT EXPRES 180 DAYConstrul A6/30 76
051712024 R PERMIT WILL BE INVA
LID
ction Hours.SMonday s Friday 7.00 a.m.
t p.m. anld
Satu a�y�hb�ifB:bO"a'n .m.
No/work on Sundays or Holidays
Job Address: 201 07TH ST NB
Description: SFR REMOVEIREPLACE (17) (E) WINDOWS
p
Legal Desc.: EAST NEWPORT BLK 5 LOTS
Owner: SACCHIALBERTJ Contractor:
OWNERIBLDR
Architect:
Address: 760 S MAPLE AVE Address:
AUTH AGENT:
Address:
,„ s
MONTEBELLO, CA 90604
FISH TRACY
Phone: .323-728-7983 Phone:
562-941-4177
Phone:
State Lic:
Applicant: FISH TRACY Con State Lic: O/B
Engineer:
PS"�
M
Address: 11127 GERBER AVE Lic Expire:
Address:
WHITTER CA 90604 Bus Lic:
` a
Phone: 562-941-4177 Lic Exp Date:
Phone:
State Lic:
Code Edit : 2019 Worker's Compensation
Insurance
Designer:
Type of Construction: VB Carrier:
Address:
Occupancy Group: R3/U Policy No:
Added lNew sq.ft. Bldg: 0 Expire:
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 2 Building Setbacks
Rear: /
Special Conditions:
HIGH DENSITY AREA
,
No of Units : 1
Front: I
`
Bldg Height: 0
Left: I
Bldg Sprinklers: N
Right: I
Flood Zone: X-0.2 Use Zone:
Parking Spaces:
0 Fire Hazard Zone :
N
Construction Valuation: $9.789.00
Building Permit Fee: $246.00 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
PAN 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 : $247.00
Plan Check Fee:
$0.00 Fee Due at
Permit Issuance : $247.00
PROCESSED BY:
ZONING APPROVAL:
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
. O
!O
bGC AV (U - u ciVO Off.
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
ie 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
'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 applicant for a permit subjects the applicant to a civil penalty of
of 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,
Iusiness 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
r r Tments 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
(proved for the purpose of sale).
fgl I, ) 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
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).
I am exempt from licensure under the Contractors' State License L w for the following reason:
ly my signature below I acknowledge that, except for myJpersonal resj pence in which must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally
ell a structure that I have built as an owner -builder if it has not been,dnstructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
'rofessions Code, is available upon request whettJJ�xis pplication is g mitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
signature of Property Owner or Authorized Agenty „iv''✓ ;� Daterr,,( -7
.ICENSED CONTRACTOR'S DECLARAT16N
hereby affirm under penalty of perjury that I amQic'ensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
nd effect. License Class License No Date Contractor Signature
COMPENSATION DECLARATION
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
:OMPENSATION, 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:
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
amance 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' compensa'
rance carrier and policy number are:
1eofAgent A
i
certify that, in the perforrrgi ce of the
if I should become $ubie. t to the wo
lature of Applicant 1j
Policy Number Expiration Date
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
npensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
CLARATION REG,4RDING CONSTRUCTION LENDING AGENCY
:reby affirm under en6lty 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 prop 6rt 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'ptate laws relating to building construction.
11
I authorize representatives of this city or cou�tyrf,7a ter the above -entified property for inspection purposes.
nature of Prooerty Owner or Authorized AGent rX`'" Print Property Owner's or Authorized Agent's NamNC
ACTION
DATE BYY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
'403
PERMIT EXPIRED
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