HomeMy WebLinkAboutX2019-0175 - PermitsCity- of Newport Beach -- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
v. Inspection Requests Phone (949)644-3255
4 x�rx* Combination Type - SFP
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COMB Permit: X2019-0175
Project No : 0139-2019
Issued Date : 01125/2019,
Inspection Area 3
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Construction Hours: MondayFriday 7:00 a.m. to 6:30 m. and Saturday from 8:00 a.m. to 6:00 m. No work on Sundays or Holida s � Y P• Y A• Y Y
Job Address: 369 SAN7A ISABEL AVE NB -
Description: SFR - DECK EXPANSION 134 SF, FACADE REMODEL
Legal Desc.:. TR 300 LOT 106 POR OF LOT ```"`'�y, ;•'
Owner WORLEYADRIENNE Contractor, WF. Srpu
Address: 369 SANTA ISABEL AVE= r ss 620 RRO HIGHWAY Address:.
NEWPORTBEACH C A92660 A 50 ,_
Phone. a a P e ?/?_0 -4 6 t� q�3iadel'�Ni �' State Lie:
Applicant: LOCKETT VICTOR dol
n State Lie: 572359 F�? lSA�k
Address: 2844 E3RD ST #204 ,.�;wL�ic F t,�. 07Fp1/ A'd'dr�s'sr�' '1'atg17 q/CN"fdESS AVE
LONG BEACH CA 90 14 �;0 xtus I�ic � � B�0 1 � 81 4 � GARDENA CA 90249......
Phone: 562-252-2715 d � wM Lieu(pDate i ,-'-0�31 19 "� y Phone 562-235-4572 State Lio:C-042881 ....
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Code Edit: VB _9 , r' ompe a17on InSArance Designer.
Type of cy Group: Construction: R2 Carder BENCHMARK INSURANCE - Address: • . °
Occupancy Group:. R2 4
Added /News ft. Bid ° ° • o a
q' 9 �: y xpi�$ buf 4�JIg1/ 20. v x tM. Phone:
Added /New sq. ft. Garage: 0 ' `.r 4 s `! "`r.`� n' • • ° °
No of Stories. 2 l; S 'tz ul bH� sl Rea j / ��v �� '���
k i� {§8t C�k� �� ���. N,s..,3 Special Conditions: ,
No of Units: 1 ,;>- Front: / a®' a °•90'
Bldg Height: 0 ��, Left: /
Bldg Sprinklers: Right: I
Flood Zone: n oA4°e°
�a Use Zone: Parking Spaces: 0 a FireHaza Z
Construction Valuation:. 80 00.00 • '�_za a s _ - ° ° ••..
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Building Permit Fee: $973.00 ax: s $0.00 Planning Department-
Fire Department
Plan Check Fee: $846.61 Ad Up aa5' it ;)$0.00 Plan check el xSvK Sido) Fire Inspection §0.00
Overtime Plan Ck: $0.00 Grading
o
onds 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 F
Record Management: $28 00 , r,. E.-,S,"• Grading Permit Fee:. $0.00 In -lieu HgE,4,mg Fea � e dm
Energy Compliance: $0.00 ee: 0.00 Public Works Department - $0.00
CA Seismic Safety $10 40 x WQ Insp. Fee: $0.00 ' Park Dedication : $4M.P. jai i Qia sit-- $0.00
Disabled Access : $0.00 an e-CF-cTc--$0.00 _ Gradin Bond: $0.00
Hazardous Mat $0.00
Building Green Fee : $4.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00
Plumbing %:. $0.00 $0.00
TOTAL FEE: $1,901.91 Plan Check Fee : $1,901.91 Fee Due at Permit Issuance $0.00
PROCESSED BY: AA �11.. PUBLIC WORKS APPROVAL:
ZONING APPROVAL: W8W PLAN CHECK BY:
GRADING APPROVAL: 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 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).
❑ 1, 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,
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). - -
❑ I, as owner of the property, am exclusively contractin 't P -te�emsttE'c-Pt )ec ection 7044, Business and Professions Code The Contractors' State License Law does not
apply to an owner of property who build sthereon, and w o c r for ds with a licensed Contractor pursuant tq.the_Copt�actors State License Law);
❑ 1 am exempt from licensure under tie Contractors' State Lice
By my signature below 1 acknowledge ttat, e>�c �1 erso esl a or at least one year prior to completri-on� oft�e,!'rr��lpprovements Srovered by this permit, I cannot legal
sell a structure that I have built as an o ner-bull er if it has not b n constmcted in its entirety by licensed contractors. I and�55tta�16�attgg4pr� tt�Qa`pjlTiGHdl�hatd,IS�ctidn 7044 of the Business and
Professions Code, is available upon re est when this application' ubmitt or at fors si .leginfo!ca'.g�v7celawhtml. 4
Signature of Property Owner or Authors d A - Dater
LICENSED CONTRACTOR'S DECV ION
I hereby affirm under penalty of perjury tttlat I licens nde ovi t ( m . it ` - n f si `lhe-Business and Profess' de; and my license is in full force
and effect. Lig2�s2' Mass )+ _ Lice Date ! Contractor Signature
WORKERS' CMIPENSATION DE RATION
"AMO: FAILUFATJ EiURE WORKERS' c0 ENS GE IS L D PE IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DO�a�LARS ($100,000), IN ADDITION TO TH'.
COST OF COMPENSATIONMAMAGES AS PROVI D FO 7060 BO , IN ES Illn'
' S _ dnereby affirm under penalty of perjury o e of a wi decl-13 I(lave and.&II4$ntain a certificat of cIf-in er pensa Issue by the Director of Industrial Relations as provided for by Section 3700'of the Labor Code, for tl
rmence of the wotk for which this pe_ It is (icy No. b
yve and vrilinaiatain workers' cc ensation insurance, as required by Section 3700 of the Labor Code, for the erf$rmance of the work or whic It isiss ed. My workers' compensati(
�n� yral1Ee carri8r adH*Policy number are:
1�3�4r • Poldt#FeP°a P o to P
this
Of
.reby affirm under penalty of perjurytha ttfefe its a con=
ider's Name
my signature below, I certify to each of a follow% g
I am the property owner or authorized sang t
I have read this application and the information I have
I agree to comply with all applicable city and county or
I authorize representatives of this city or county to en
(nature of Prooertv Owner or Authorized Agent
employ any person in any mannef § Yas to3ecome subject to the
I of the Labor Code, I shall forthwith comply with those provisions.
)nding agency for the performance of the work for which this perm jtis"le4[
Lender's Address
i
is correct.
and state laws relating to building construction.
eve -identified property for inspection purposes.
Print PmDerty Owner's or Authorized ADent's Name
ACTION DATE I BY _I REGULATIONS PART 1 OF TITLE 40 AND AQMD RULE
DECLARATION OF COMPLIANCE WITH CODE OF �L FOR OFFICE USE ONLY
PERMIT EXPIRED
Y/i/•
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U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED
DEPA
PERMIT EXTENDED
QMD
PERMITFINAL
CERTIFICATE OF
OCCUPANCYISSUED
BESTOS NOTIFI IS NOT APPLICABLE TO
POSED DFIMOLI
SIGNATURE: \ .
IN
and