HomeMy WebLinkAboutX2019-1353 - Permits�axra4 City of Newport Beach - Building Division
{ 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
u +e Inspection Requests Phone (949)644-3255
Combination Type - MFP
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIu II COMB Permit: X2019-1353
x 2 0 1 9 1 3 5 3'I Project No: 0945-2019
Issued Date : 09/23/2019
Inspection Area : 6
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: 2153 VISTA ENTRADA NB
Description: MFR DECK REPAIR 8. NEW GLASS RAILING 520 SF *STOP WORK C2018-0044
Legal Desc.: LOT 38 AND POR LOT 90 TRACT 5878
Owner: PHILLIPS MARK Contractor: OWNERLBLDR
Address: 2153 VISTA ENTRADA Address: PHILLIPS MARK
NEWPORT BEACH CA 92660
Phone
Applicant: TARDIF ANDRES
Address: 21587 LOST RIVER CT
LAKE FOREST CA 92630
Phone: 714-412-6371
Code Edit : 2016
Type of Construction: VB
Occupancy Group: R2/U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 4
Bldg Height: 0
Bldg Sprinklers:
Construction
Building Permit Fee: $312.00
Plan Check Fee: $271.44
Overtime Plan Ck:
$0.00
Investigation Fee:
$312.00
Record Management :
$18.00
Energy Compliance:
$0.00
CA Seismic Safety:
$1.95
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $956.39
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Phone: 949-887-5414
Con State Lie: OLB
Lie Expire:
Bus Lie:
Lie Exp Date:
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 %:
Plumbing %:
Rear: I
Front: I
Left: /
Right: I
'arkino Soaces
$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:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
INSPECTOR
State Lic:
VOLPE ROBERT M
20321 LAKE FOREST DR STE D-6
LAKE FOREST CA 92630
949-305-4700 xt State Lic:C-025116
Special Conditions: 019 AUTH ATTACHED
0 Fire Hazard
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
$40.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$301.00 Fee Due at Permit Issuance : $655.39
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
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 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
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
Pro scions 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 applicar for a permit subjects the applicant to a civil penalty of
re than five hundred dollars ($500).
WWass
owner of the property, or my employees with wages as their sole compensation, will do L) all of or portions of the work, and the structure is not intended or offered for sale (Section 7044,
Wass 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
im 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).
❑ 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 c vered by this permit, 1 cannot legall,
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, Se,:tibp,.7044 of the Business and
Professions Code, is available upon request a Is application j',p,s�bmltte�r at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Aq wit-// vim/t ate
LICENSED CONTRACTOR'S DECLAiVTIdN
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. Lictnse Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
W 1r'.NING: FAILURE Tn 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 COMPENSf.TICN, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hen,by affirm under penalty of perjury one of the following declarations:
' have a1,d 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
1performance of the work for which this permit is issued. Policy No.
' 'i�ve and will mcintain 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
I insurance car,ier and policy number are:
Cori-r _ Policy Number Expiration Date
Nzmc of Agenr Phone #
...p I9
dify 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
if I should becomm."ubject to tt p workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. f
CbEGARDING CONVRUCTW LENDING AGENCY V
reb under penalty of perjddry 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 owners 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 coun t enter th ab ve-identified property for inspection purposes. / m'/'.
nature of Prooerty Owner or Authorized-Avent Print Prooertv Owner's or Authorized Aoentig-Na e ✓�A &,uj101uL1
ACTION DATE 40p8Y DECLARATION 9FCOMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONOK V
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED I LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT EXTENDED QM D
PERMITFINAL f � ESTOS NOTIFICATION IS NOTAPPLICABLE TO
CERTIFICATE OF J' IP PO URIEfv�L I,.
OCCUPANCY ISSUED M� ////
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