HomeMy WebLinkAboutX2019-1190 - Permits (3)City of Newport Beach - Building Division Illlllllllllllllllllllllllllllllllllllllllilllllu
Building Permit Fee:
COMB Permit: X2019-1190
Plan Check Fee: $90.48
100 Civic Center Drive, Newport Beach; CA 92660.
x 2 0 1 9
1 1 9 9
Project No: 0852-2019
$0.00
a
Permit Counter Phone (949)644-3288
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
-"' rGtion Requests Phone (949)644-3255
$0.00
Hazardous Mat
$0.00
Building Green Fee :
Combination Type - MFP PLUM
Issued Date: 04/1812019
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:
270 CAGNEY LN NB St: 1 FI: 2 Unit: 214
Description:
MFR REPLACE SHOWER W/ TUB
-.
Legal Desc.:
TR 8336 LOT 6 UNIT 101 OF PROJECT LOCATED ON AP 423-011-22 TOGETHER
Owner:
GIDLOF BETTY ANNAIJOSEPH GARAVAGLIA Contractor: OWNER/BLDR
Architect:
STRESHINSKY DAVID
Address:. `
152 VIA SAN NICOLO Address: GIDLOF BETTY ANNA.
Address:
15375 BARRANCA PKWY #A-210
PALM DESERT, CA 92260
IRVINE CA 92618
Phone:
760-625-3708 Phone: 760-625-3708
Phone:
949-788-9223 State Lic:C018642
Applicant:
GIDLOF BETTY ANNA Con State Lia OIB
Engineer:
Address:
270 CAGNEY LN #214 Lic Expire:
Address:
NEWPORT BEACH CA 92663 - Bus Lic:
Phone:
760-625-3708 Lic Exp Date:
Phone:
State Lia
Code Edit: 2016
Type of Construction: VB
Occupancy Group: R21U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units: 1
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation: $1.000.00
Building Permit Fee:
$104.00
Plan Check Fee: $90.48
SJH Trans:
Overtime Plan Ck
$0.00
Investigation Fee:
$0.00
Record Management:
$2.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $246.84
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical W
Plumbing %:
Rear: /
Front: /
Left: I
Right: I
king Spay
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$9.36
Designer:
Address:
Phone:
Special Conditions:
Planning Department -
Plan check Fee
Fire Department
Fair Share
Fire Inspection:.
SJH Trans:
Fire Plan Rev
In -lieu Housing Fee:
Demolition Fee
Public Works Department-
Park Dedication :
$0.00
P/W Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Plan Check Fee:
6 R6N
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$130.48 Fee Due at Permit Issuance :
6 ( O p0
„?UB�ez WORKS APPROVAL:
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PLAN CHECK BY:
"AP?kOVAL TO ISSUE:
o C o C
oca se em o a coo co
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$116.36
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:
$130.48 Fee Due at Permit Issuance :
6 ( O p0
„?UB�ez WORKS APPROVAL:
e e s
PLAN CHECK BY:
"AP?kOVAL TO ISSUE:
o C o C
oca se em o a coo co
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$116.36
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the resson(s) indicated below by the checkmark(s) I have placed next to the applicable item(s)
>ection 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
1e 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 DivisiV-� ` ..he 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,
lusiness 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
ppw,vements 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
ro d for the purpose of sale).
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
ppl o 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).
j718m exempt from licensure under the Contractors' State License Law for the following reason:
ly 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
ell a structure that I have built as an owner -builder if it has not been constructed in its a irety by licensed contractors. I understand that a copy of the applicable law, Section 7044 ofthe Business and
'rofessions Code, is available upon request whe hi ICa' i i ed r th f Ilowing Web site:http://www.leginfo.ca.gov/calaw.html. `— 1 Id 1
signature of Property Owner or Authorized Agent DaReT I O
-ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapt r 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
end effect. License Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
rARNING: 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 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
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, for th
erformance of the work for which this permit is issued. Policy No.
]I 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' compensation
lsurance carrier and policy number are:
Policy Number
Date
of Agent
rtify 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 agre
I should become suject to a workevfds/;compe sa(pon ppy�visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. r J r I
ure of Applicant a L -'F
:reby affirm under pen2lty 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 latin o bu d81g construction.
I authorize representatives of this city or county tq enterA �iove�identifie� rert�r' spection purposes.
of
ACTION
PERMIT CANCELLED
PERMITEXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
BY DECLARATION OF COMPLIANCE
REGULATIONS PART 63 OF TITLE
SUBMITTED
iertv Owner's or
CODE OF FEDERAL I FOR OFFICE USE ONLY
VD AQMD RULE
WION TO s • • •••
• r
• • •• • • •• • • •
❑ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
PROPOSED DEMOLITION •" ••• • • •••
• • • • • • • • • •
SIGNATURE: • • • ! • '_ _•_
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