HomeMy WebLinkAboutX2018-3307 - Permits�g ob"67% City of Newport Beach - Building Division X2018�3307" COMB Permit: X2018-3307
.4 r� 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 2579-2018
Permit Counter Phone (949)644-3288
ci 2 Inspection Requests bone (949)644-3255
Combination T e - MFP
Issued Date: 1110512018
Inspection Area : 8
PERMITS EXPIRE 160 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: 4203 COLONY PLZ NB
Description: MFR DRYWALL REPAIR IN CLOSET 40 SF
Legal Desc.: 0 .
Owner: IRVINE CO Contractor: NATIONAL RENOVATION INC Architect: RANIER] RANDY INV � � III
Address: 550 NEWPORT CENTER DR Address: PO BOX 78810 Address: 2061/2 ABALONE AVE
NEWPORT BEACH, CA 92660 CORONA CA 92877 NEWPORT BEACH CA 92662
Phone: 714-296-5502 Phone: 909-923-2077 Phone: 714-296-6502 State Lic:CO24225
Applicant: RANIERI RANDY Can State Lie: 956793 Engineer:
Address: 206 112 ABALONE AVE Lie Expire: 01131/2019 Address:
NEWPORT BEACH CA 92662 Bus Lie: BT30062023 - >
Phone: 714-296-5502 Lie Exp Date: 0113112019 Phone: State Lie:
Code Edit: 2016 Worker's Compensation Insurance Designer:
Type of Construction: V-A- SPR Carrier: ARCH INSURANCE CO Address:
Occupancy Group: R21U Policy No: ZAWC12536801
Added /New sq.ft. Bldg: 0 Expire: 09101/2019 Phone:
Added /New sq. ft. Garage: 0
No of Stories: 4 Building Setbacks Rear: / Special Conditions:
No of Units, 1 Front: /
Bldg Height: 0 Left: I
Bldg Sprinklers: Y Right: I
Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N _
Construction Valuation: $3,200.00
Building Permit Fee: $136.00 Excise Tax: $0.00 Planning Department- Fire Department
Plan Check Fee: $118.32 Additional Fee : $0.00 Plan check Fee : $40.00 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 : $0.00 SJH Trans: $0.00 Demolition Fee
Record Management : $8.00 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: $0.00 Park Dedication: $0.00 Refund Deposit $0.00
Disabled Access: $0.00 PAN 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 %: $0.00 NMUSD Fee: $0.00 $0.00
Plumbing %: $0.00 $0.00
TOTAL FEE : $303.32 Plan Check Fee : $158.32 Fee Due at Permit Issuance : $145.00
PROCESSED BY: - PUBLIC WORKS APPROVAL:
ZONING APPROVAL: PLAN CHECK BY: '
GRADING APPROVAL: APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION
1 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
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 icensure 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).
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
Iusiness 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).
1 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).
7 I 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 legall,
ell a structure that 1 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 perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) o Div' ion 3 of the Busi s ,and Professio license is in full force
nd effect. License CIDss License No �� Contractignature
VORK4RS' COMPENSATION DECLARATION
'ARNING- FAILURF',D SECJRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (M0,000), IN ADDITION TO THE
DST OF COMPENSATION, PARADES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
herby affirm under penalty of perjury one of the following declarations:
1 have and wil. ,naintain 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
er.ormance of V:E -irk for which this permit is issued. Policy No.
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'
carrier and policy number are:
Policy Number
cf Agent _ _ _ _
Date
3( Oenify that, in the performance of for ich this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
,ot, i" I should becom subject to pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignatureof Appt � �V
DECLARATION RE ARDIN R NG AGENCY
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).
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 owner's behalf.
I have read this application and the information I have provided is c
I agree to comply with all applicable city and county ordina s la relating to building construction.
1 authorize representatives of this city or county to ent a n' d property for inspection purposes.
signature of Property Owner or Aut ed Agei
ACTION DATE BY
PERMITEXPIRED
PERMIT CANCELLED
PERMITFINAL yfoy i S
CERTIFICATE OF rI
OCCUPANCYISSUED
DECLARATION OF COMPLIANCE_IdLITH CODE OF FEDERAL
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
I SUBMITTED
ASBESTOS
SIGNATURE:
TO
or
FOR OFFICE USE ONLY
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