HomeMy WebLinkAboutX2016-1507 - Permits1 City of Newport Beach-uu,Jing Divisic. IIi7 r r + III! I'jII) IIIc C MB Perrr It : X2016,•1507
� - 100 Civic Center Drive, Newport Beach, CA 92660 IIIIIIIIIiI6IIIIII�III IIIII6dIIIIIII9�1 5 Oi„ I7 I CP
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Permit Counter Phone (949)644-3288 �-
`$:.. " Inspection Requests Phone (949)644-3255
Combination Type - MFP j Issued Date : 05/05/2016
j Inspection Area : 1
TOTAL FEE: $96.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan check Fee:
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
INSTALL OR VERIFY SMOKE/CARBONj MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED
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Job Address: 1200 W BALBOA BLVD NB
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Description: SFR CHANGE OUT GARAGE WINDOW (NON -EGRESS)
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Legal Desc.: N TR 234 BLK 112 LOT 1
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Owner: FRANCISCO DOUGLS/RICHARD Contractor:
AMERICAN VISION WINDOWS INC
Architect:
Address: 6016 VICTORIA AVE
Address:
2125 N MADERA ROAD#A
Address:
RVERSIDE CA 92506
SIMI VALLEY CA 93065
Phone:
Phone:
880-563-0008
Phone:
State Lic:
Applicant: GONZALEZ ARTURO
Con State Lie:
778326
Engineer:
Address: 2125 N MADERA ROAD#A
Lie Expire:
05(31/2018
Address:
SIMI VALLEY CA 93065
Bus Lie:
BT30020889
'--
Phone: 888-563-0008
Lie Exp Date:
10/131/2016
Phone:
State Lic.
Code Edit : 2013
Worker's Compensation Insurance
Designer:
Type of Construction: VB
Carrier:
EMPLOYEE SERVICE GRP
Address:
-
Occupancy Group: R3/U
Policy No:
WLRC48776371
Added /New sq.ft. Bldg: 0
Expire:
03/01/2017
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 0
Building Setbacks
Rear I
Special Conditions:
No of Units : 3
Front:- I
Bldg Height: 0
Left: /
Bldg Sprinklers:
Right: /
Flood Zone: X
Use Zone: Parking Spaces: 0
Fire Hazard Zone : N
Construction Valuation: $798.00
Building Permit Fee: $95.00
Excise Tax:
$0.06 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 :
$8.00 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:
$6.00 Park Dedication :
$0.00
Refund Deposit
$0.00 j
Disabled Access: $0.00
, P/W 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 W
$0.00 NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00:
TOTAL FEE: $96.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan check Fee:
$0.00 Fee Due at Permit Issuance : $96.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
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$0.00 Fee Due at Permit Issuance : $96.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
OWN
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 applica¢le 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
is 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).
7 I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U 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
nprovements 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
nproved 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
pply 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:
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 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 when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of plory that I am licensed under provisions Chapter 9 (commencing with Section 700p) of Division of the Business and Pro nddeand y li e is in fu}� fDrr�
Ind effect. License Class l � License No =?I rte Date Contractor Signature "iCf / 1ze37 /L fl� LC'" C
VORKERS',COMPENSATION DECLARATION
DARNING: 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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I 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 IN
erformance of the work for which this permit is issued. Policy No.
have andIntain 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'
ranee carri and policy number gre:
is of Agarit_ JJ`
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certify that, in the pi
if I should become
Iature of Abolicant
Date
for which this per t 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
compensatio rOVl Ions of Se tion 3700 of the Labor Code, I shall forthwith comply with those provisions.
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, Civil Code)
Ender's Name Lender's Address
y 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 in ces ands aws relating to building construction.
I authorize representatives of this city or county nt r e above= entifiedpr perty for inspection purposes. /J
ignature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name\Za4
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