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Home My WebLink AboutX2021-2616 - Permit Application„:wrry4, City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIII II11 f`? 100 Civic Center Drive, Newport Beach, CA 9Q660 X 2 0 2 1 2 6 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - MFP ELEC PLUM PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID WSPECTIO ROJECTS MUST BF� I Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. a aturda�7 from 8oti.m. to Job Address: 1000 PARK AVE NB rr��IV, (� Description: MFR SIDING REPAIR, WINDOW REPLACEMENT, WATER HEATER C/ EROOFCOMP�B'kllrl��`LE "STOP Legal Desc.: BALBOA ISLAND SEC 2 BLK 7 LOT 18 a�9 O( / Owner: RICHARDSON JAMES H Address: 1004 PARK AVE NEWPORT BEACH, CA 92662 Phone Applicant: RICHARDSON JAMES H Address: 12674 ROSWELL AVE CHINO, CA 91210 Phone: 626-627-9997 Code Edit : 2016 Type of Construction: V-B Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garag 0 No of Stories: 2 p� No of Units 2®a$' Bldg Height: 0 Bldg Sprinklers: A, Building Permit Fee: ''-.. $ 00 Plan Check Fee: $0.00, Overtime Plan Ck:.$0.0 Investigation Fee: $0.00 Record Management: $0.00 Energy Compliance: $O.ob CA Seismic Safety : $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $0.00 TOTAL FEE: $500.00 PROCESSED BY: ZONING APPROVAL: XAddres OWNERCR� qq�,Oolo CHARDSONsJYKMES��//eo i /f-� Workers Compensation Insurance Carrier Policy No; $wilding Setb.R / F,�{'on I J r ” Aft: I ri`a "'`'.,,k Right: / 7 Planning Dep mxcise itioFee: Plan the Fee 'ng Bonds Fee: 0 Fair are, ing PC Consul Trans rading Permit Q,�Q1Jf� _rp00 In -lieu H si of Grading P e �'k. e 0.00 $0.00 Public or ep rk ication P Ian Check ` ^`0,��. *Menpi,a' 6: \ $ . 0 Dist: l W $0.00 NMUSD Fee: Pmbing %: $0. +tZ a eck Fee : $0.00 Architect: Address: Phone: COMB Permit: X2021-2616 Project No : 2868-2019 Issued Date : 09/28/2021 Inspecti ea : 2 ED Y 0812 12024 OR PERMIT CIDL BE If �P, 6 OR. rk on Sundays or(F jida Z` 119-08 "renew exI0' d permit* ��jjV> viy_ i CRAWFORD ,Y 470 WALD - IRVINE CA 9261 949-453-9893 State-Lic: 001 Address: Phone: Designer: � Address d� Phone / Special State L 0 Fire Department ' $0.00 Fire Inspection: $0.00 ., $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $0.00 lent- General Service $0.00 $0.00 Refund Deposit $0.00 $0.00 Grading Bond: $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $600.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: _ _ APPROVAL TO ISSUE: 20 kCi 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 b e etion 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or it any permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law pter 9 (col fessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Secti 031.5 by any e more than five hundred dollars ($500). l I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) Business and Professions Code: The Contractors' State License Law does not apply to an owner of property improvements are not intended or offered for sale. If, however, the building or improvement is sold withi e improved for the purpose of sale). apply owner of the property, am exclusively contracting with licensed Contractors to construct re project`� IIIaIII��5��5p33333pp,,,ly to an owner of property who builds or improves thereon, and who contracts for the projects with a Iicen exempt from licensure under the Contractors' State License Law for the folloyving reason: y m signature below I acknowledge that, except for my personal residence in " ii I must hav sided for I po ' s of the work, and the throug M` Ooyees' p� year of etion, t�Z# e IM /�>� !� 70 4,6slhess and Pr nor pursuant to i Bese a structure that I have built as an owner -builder if it has not been din its entiret y licensed contractors. Professions Code, is available upon request when t is a plication 1 u I. or at Yle f i ,eb s' I http //wva j Signature of Property Owner or Authorized Agent (s) I have placed next to the applicable items) prior to its issuance, also requires the applicant for with Section 7000) of Division 3 of the Business and k a permit subjects the applicant to a civil penalty of is no tended or offered for sale (Section 7044, )rt, bui or improves the property, provided that the viu�ave a burden of proving that it was not built or Code: The ntractors' State License Law does not *s' State Licen Law). to completion of the improvemen that a copy of the applicable law, Icalaw.html. LICENSED CONTRACTORS DECLARATI I hereby affirm under penalty of perjury that I am license er prov Chapter 9 (commenc ng with Section 7000) of Division 3 of the Business and effect. License Class Li Ili Date Contractor E 7044 of the Business and Code, aV my license is in full force ✓ORKERS' COMPENSATION DECLAR N ®� ARMING: FAILURE TO SECURE WORKERS' COMP , ATION OOVERA S UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES U 1 E H DRED THOUSAND DST OF COMPENSATION DAMAGES AS PRO FOR IN SECTIO 706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES - hereby affirm under penalty of p one ofiFee f wing declarations. I have and will maintain a rtific �r '� onsent to self Insure Or workers' compensation, issued. by the Director of Industrial Relationg-��rovided for b ecty erformance of the work for whit his p mlt is Issued. Policy No )' ki �I ]I have and will maintain worker competnsdllion in, as required by Section 3700 of•the Labor Code, for the perforri lvthe work for w thig �Fk�fant Is isurance carrier and policy nurpger arrier Policy Number Expirati atee e of Agent AV,lo certify that, in the performance o f , hi i udd shall not empl I , if I should beco a subj ct to the ' co Diahon p; visi SofE I ignature of Applicant DECLARATION RE G G CONSTRU 0 El AGENCY hereby affirm under penalty of perjury that tf ' e i construction lendn the ante ender's Name '�4'`.- L s Address y my signature below, I certify to each of the fo t 'owi I am the property owner or authorized to act o the ape s behao I have read this application and the informations , hav rovi i me I agree to comply with all applicable city and cou or . anc a stat I re ' g to buildjper I authorize representatives of this city or co to ter v d ifi p i ignature of Property Owner cr Authorized AD Pr( in any manner so as to cc I shall forthwith co v with of the ACTION DATE BY c DECLARA TJE"COMPLIAN IT DE OF FEDERAL REGU§4710 PART 61 IT AND AQMD RULE 1403 PERMIT EXPIRED Z D/L�� ISUBMITTE 5 OS NOTIFICATIJN TU PERMITCANCELLED EPA PERMIT EXTENDED 0M D PERMITFINAL OASBESTOS NOTIFICATION IS NOTAPPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: Owner's or Authorized AD I FOR OFFICE USE ONLY IN ADDITION TO THE Labor Code, for My workers' DrkerrsCompens�atiioon laws of California, and agree Dat"I'�`".Y is issued (Section 3097, Civil Code).