HomeMy WebLinkAboutX2020-1425 - Permitse, City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
E~ Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - MFP
COMB Permit: X2020-1425 IIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIII�II II
Project No :
Issued Date: 0612212020
Inspection Area : 8
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 06/23/2023 OR PERMIT WILL BE INVALID
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: 419 VISTA FLORA NB
Description: MFR DRYWALL REPAIR IN LAUNDRY RM
Legal Desc.: TR 5740 LOT 7 & POR OF LOT 76
Owner:
CROSS JOHNISARAH
Address:
419 VISTA FLORA
NEWPORT BEACH, CA 92660
Phone:
Applicant:
JOHNINEWPORT COAST ELITE
Address:
20701 BEACH BLVD #52
HUNTINGTON BEACH CA 92648
Phone:
949-873.3255
Code Edit: 2019
Type of Construction: VB
Occupancy Group: R21U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units : 4
Bldg Height: 0
Bldg Sprinklers:
Flood Zone: X
Construction Valuation: $1,000.00
Building Permit Fee: $107.00
Plan Check Fee: $0.00
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: $108.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor:
NEWPORT COAST ELITE
Address:
20701 BEACH BLVD #52
HUNTINGTON BEACH CA 92648
Phone:
949-873-3255
Con State Lie:
1018682
Lie Expire:
0913012020
Bus Lie:
BT30071152
Lie Exp Date:
0212812021
Worker's Compensation Insurance
Carrier: NO EMPLOYEES
Policy No:
Expire:
Building Setbacks
Use Zone:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: I
Front: I
Left: /
Right: /
Parkino Spaces
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee :
Architect
Address:
Phone: State Lie:
Engineer:
Address:
Phone: State Lie:
Designer:
Address:
Phone:
Special Conditions:
Planning Department -
Plan check Fee
Fair Share:
SJH Trans :
In -lieu Housing Fee:
Public Works Department -
Park Dedication :
$0.00
PNV Plan Check :
$0.00.
San Dist:
$0.00
NMUSD Fee:
$0.00
Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
pope
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $108.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
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0 0
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0 0 0
00 0
0 0
0 0
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0
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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
:he 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
lot 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 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
mprovements 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
m roved 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
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).
J 1 am exempt from icensure 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
Bell 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
Drofessions 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 1�
I herebyaffirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 f Div! on 3 of the Business and Profes Ion Rse-I in full force
P Y P J rY P P ( 9 fI)
arW effect. Licenst"Sss License No Date fb r 6� Contractor Signature �_
Nt)1V9AS' COIVIPE1tLSAT10N DECLARATION
VARIHNGyFAILUREAO SEME 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
:CUT OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
herebyffirm under penalty of perjury one of the following declarations:
1 hate and wi1rifiain[ain 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
rejfpr g%nce of thpV✓ glt for which this permit is issued. Policy No.
:1I.hews 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' compensatiol
nsgraruecarrier and policy number are:
Barrier : ': Policy Number Expiration Date
V m0 oiAgent Phone #
1�4RRy that, i ftr� pip Forman a of the Workfor hich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' co pensation laws of California, and agre
t, if I should become subjec to the wor rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. j
31gnalure of Applicant Date
DECLARATION REGAR G ING AGENCY I�
hereby affirm under pen Ity of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, ivil Code).
_ender's Name Lenders Address
3y my signature below, I certify to each of the following: I/
I am the property owner or authorized to act on the property owner's behalf.f f,�' t'[✓7
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and cclating to building construction.
I authorize representatives of this city or countarty for inspection purposes. _
31nature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Na a Da
ACTION DATE BY ATION CIS COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGIAATIONS PART 61 OF TITLE 40 AND, RULE
PERMIT EXPIRED
PERMIT CANCELLED
I SUBMITTED ASBESTOS
PERMITFINAL Mfl.>. ASBESTOS
CERTIFICATEOF (( fOA IRPOSED DE
OCCUPANCYISSUED it- (I IGNATURE:.
TO