HomeMy WebLinkAboutX2022-0750 - Permits¢r+tr City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, -CA 9266-0
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - CIP
COMB Permit: X2022-0750 IIIIXIIIIIIIilllll�llllllllllllllllllllll� II
Project No : 0660-2022
Issued Date : 04/01/2022
Inspection Area : 2
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0410112025 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: 701 VIA LIDO SOUD NB
Description: COMM REPLACE WINDOW W/ SLIDING GLASS WALL
Legal Desc.: TR 907 LOT 20 AND LOTS 21 TO 25 INCLUSIVE AND POR ABAND STR
Owner:
LIDO ISLE COMMUNITY ASSN
Contractor:
ROBERT FERNANDEZ CONSTRUCTION INC
Address:
701 VIA LIDO SOUD
Address:
923 EVERGREEN PLACE
Address:
NEWPORT BEACH, CA 92663
COSTA MESA CA 92627
Phone:
Phone:
949.981-9169
Phone:
Applicant:
FERNANDEZ ROBERT
Con State Lie:
677390
Engineer:
Address:
701 VIA LIDO SOLD
Lie Expire:
04/30/2022
Address:
NEWPORT BEACH, CA 92663
Bus Lie:
BT30046730
Phone:
949-623-6170
Lie Exp Date:
03/31/2023
Phone:
Code Edit, 2019
Type of Construction: V-B
Occupancy Group: A3
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 1
No of Units : 0
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation:
Building Permit Fee: $570.00
Plan Check Fee: $495.90
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$18.00
Energy Compliance:
$61.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat -
$0.00
Building Green Fee :
$2.00
TOTAL FEE: $1,198.90
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Workers Compensation Insurance
Carrier: WIC EXEMPT
Policy No: (NO EMPLOYEES)
Expire:
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: /
Front: /
Left: /
Right: /
3arking 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:
State Lie:
SOMA JR PHILIP GEORGE
252 SOUTH BRENTWOOD
ANAHEIM CA 92804
949-252-7660 State Lic:C-046231
Designer:
FERNANDEZ ROBERT
Address:
923 EVERGREEN PL
COSTA MESA, CA 92627
Phone:
949-981-9169
Special Conditions
Planning Department -
Plan check Fee
Fair Share
SJH Trans
In -lieu Housing Fee
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check :
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Fire Department
$52.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
•
0000
0
•UJOOo
•
.•
•
•
°
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$547.90 Fee Due at Permit Issuance : $651.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
•
000000
ao 0
0
°°••
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
3rofessions 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
iot more than five hundred dollars ($500).
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,
3usiness 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
mproved 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).
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 lega111
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.htmi.
Signature of PropejV.Ow'ner or Authorized Agent ate
LICENSED CLyyWCTOR'S DECLARATION
tq %r2g4affirm Vgjlej penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 ) Div i0rr3 f the Business and Pr Cod , and m li rise is in full force
and effect. License Glass License No Date contractor Signatu
PQRKfRS' C0911PENSATION DECLARATION
NARNVM: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUB.IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TH USAND DOLLARS ($100,000), IN ADDITION TO THE
CAST q COMPEN§)M&M QAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNETS FEES.
;hc?%Vaffirm ur%%? penalty of perjury one of the following declarations:
••44mve and a all 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
aerWraance of the wort for which this permit is issued. Policy No.
• •I IMC and will malr(jain 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' compensatioi
insurance carrier and policy number are:
garner• .. Policy Number Expiration Date
Ndineof Agent• • • Phone#
I certify that, in the pe ocefrthe work for ich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia, and agre
I should beco e b cw compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.JJ�'�7Signature of Applican Date �PDECLARATION REG GTRUCTION LENDING AGENCY
I hereby affirm under a o that there is a construction lending agency forthe performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Name i Lender's Address
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 my finance nd state laws relating to building construction. ��,�
1 authorize representatives of this city or count t r the ov ndentified property for inspection purposes. /` _ _ 67
Signature of Prooertv Owner or Authorized Aqent I Print Property Owner's or Authorized Agent's Name �VIC. 7i 5 � Da y - l
ACTION DATE BY V I EC9RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED
I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
EPA
PERMITEXTENDED
AQMD
PERMITFINAL
CERTIFICATE OF
OCCUPANCYISSUED
'
ASBESTOS TIFI TIO N�]CABLE TO
ROPOSED DE OL
SIGNATURE: