HomeMy WebLinkAboutX2011-0446 - 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
Combination Type -MFP PLUM
I 1111111111111111 lllll 111111111111111111111111111111 IIII IIII COMB Permit : X2011-0446
Project No:
Issued Date : 02/24/2011
Inspection Area : 1
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Job Address: 3711 W BALBOA BLVD NB St: 1 Fl: 1/2
Description: BATH 1 REMODEL "WORK IN PROGRESS"
Legal Desc.: N TR 15935 LOT 69
Owner: SCHROEDER CHRIS
Address: 37111/2 W BALBOA BLVD
NEWPORT BEACH CA 92663
Phone: 714-747-7878
Applicant: SCHROEDER CHRIS
Address: 3711 1/2 W BALBOA BLVD
NEWPORT BEACH, CA 92663
Phone: 714-747-7878
Code Edit:
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
2010
V-B
R3/U
0
0
No of Stories: 2
No of Units : 2
Bldg Height: 0
Bldg Sprinklers:
Flood Zone:
Construction Valuation: $2,000.00
Building Permit Fee:
Plan Check Fee:
Overtime Plan Ck:
Investigation Fee:
Record Management :
Energy Compliance:
CA Seismic Safety :
Disabled Access :
Hazardous Mat
Building Green Fee :
$93.00
$0.00
$0.00
$93.00
$1.05
$0.00
$0.00
$0.00
$0.00
$1.00
TOTAL FEE: $197.35
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor: OWNER/BLDR
Address:
Phone:
Con State Lie: O/B
Lie Expire:
Bus Lie:
Lie Exp Date:
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
Building Setbacks Rear:
Front:
Left:
Right:
Use Zone: Parkino S2_aces:
Excise Tax:
Additional Fee :
Grading PC Consultant :
Grading Permit Fee:
Grading PC Fee:
WQ lnsp. Fee :
Electrical %:
Mechanical %:
Plumbing%:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$9.30
Plan Check Fee :
.lft✓ ,~,~~'1\
~~<"-+
'-()),. Architect:
Address:
Phone: State Lie:
Engineer:
Address:
Phone: State Lie:
Designer:
Address:
Phone:
Special Conditions: NON STRUCTURAL. O/B AUTH
FORM ATTD TO X2010-2764.
C2010-0396
0 Fire Hazard Zone : N
Planning Department -
Plan check Fee :
Fair Share:
SJH Trans:
In-lieu Housing Fee :
Public Works Department -
Park Dedication : $0.00
P/W Plan Check : $0.00
San Dist : $0.00
NMUSD Fee: $0.00
$0.00
$0.00
$0.00
$0.00
Fire Department
Fire Inspection:
Fire Plan Rev
Demolition Fee
Building Dept Adm
General Service
Refund Deposit
$197.35 Fee Due at Permit Issuance:
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE: ~ 77
'O.A ,.,,,,
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
;
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 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).
D 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,
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).
D 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
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).
D I 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 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
Professions 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 __________ _
LICENSED CONTRACTOR'S DECLARATION
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 license is in full force
and effect. License Class ____________ License No ______________ Date_______ Contractor Signature ________________ _
WORKERS' COMPENSATION DECLARATION
WARNING: 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
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
ID 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 the
performance of the work for which this permit is issued. Policy No. ____________ _
fD1 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' compensatior
insurance carrier and policy number are:
Carrier _________________ Policy Number ________________________ Expiration Date ___________________ _
Name of Agent ___________________________________________ Phone# ______________________ _
ID1 certify 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 agree
that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant __________________________________________ Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY
I 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).
Lender's Name _________________________ Lender's Address -----------------------------------------ll
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 ordinances and state laws relating to building construction.
I authorize representatives of this city or county to enter the above-identified property for inspection purposes.
Signature of Property Owner or Authorized Agent ________________ Print Property Owner's or Authorized Agent's Name ______________ Date ____ _
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