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Home My WebLink AboutX2020-2436 - Permits1,p , City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2020-2436 ;k. - 6 100 Civic Center Drive, Newport Beach, CA 92660 x 2 e 2 e 2 4 3 6 Project No: h `':, M. Permit Counter Phone (949)644-3288 $ Inspection Requests Phone (949)644-3255 �''�rr,inr,9 Combination Type - MFP Issued Date : 1012312020 Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 10/24/2023 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: 209 DAHLIA AVE NB Description: MFR REPLACE (18) WINDOWS (SAME SIZE, SAME LOCATION) Legal Desc.: PM 250-42 PARCEL 1 OF PROJECT LOCATED ON AP 52-031-22 TOGETHER INSPECTOR RESSNER RONALD Contractor: AMERICAN VISION Vy��oOwner: Architect: Address: 1104 WATERWHEEL PL Address: 2125 N MADERA ROAD#A Address: WESTLAKE VILLAGE, CA 92626 SIMI VALLEY CA 93065 Phone: Phone: 888-563-0008 Phone: State Lic: Applicant: AMERICAN VISION Con State Lic: 778326 Engineer: Address: 2125 N MADERA ROAD#A Lic Expire: 05/31/2022 Address: SIMI VALLEY CA 93065 Bus Lic: Phone: 888-563-0008 Lic Exp Date: BT30020889 1013112020 N(� f� 1 Phone':"" C®NSTRU071bN lJ , Code Edit : 2019 Workers Compensation Insurance Designer: WO ' , Type of Construction: VB Carrier: CLEAR SPRING Address: Occupancy Group: R3I1.1 Policy No: 000001159 Added/New sq.ft. Bldg: 0 Expire: 01101/2021 Phone: �� Added /New sq. ft. Garage: 0 SA �j Ri®DAYS ; No of Stories: 3 Building Setbacks Rear: I Special Conditions: No of Units : 2 Front: / " Bldg Height: 0 Left: / _ _ •... Bldg Sprinklers: Right: I Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zane : N Construction Valuation: $9,000.00 Building Permit Fee: $229.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $0.00 Additional Fee: $0.00 Plan check Fee : $0.00 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: $0.00 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 Woo Disabled Access : $0.00 P/W Plan Check: $0.0o 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 : $230.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $230.00 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: 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 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 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). ❑ 1, 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 ap ly 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 legalh 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:hftp://ww .leginfo.ca.gov/calaw.html. Signature of Property 0vner or Authorized Agent Date LIC�!M ED CONTRACTOR'S DECLARATION I hereby affirm and=r penalty of perjury that I am licensed under provisions yf f.,h7pt>3T cpmmencing with Sec 1 700 Ivisio 3 Qf the Bu I s and Profe sio s Code, and y A ense is in fWl force and effect. License Class License No ////�L 7755 J Ci Dat 'y` Contract r ignature v— WORKERS' COMPEcNSATION DECLARATION N,'4RNINU; FAILURE TQSrECORE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDR THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE COST Or COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNETS FEES. `IrEb; affirm dndrr penalty of Perjury one of the following declarations: I (lave and 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 38JU ,i,:le of the work for which this permit is issued. Policy No. �yaannd 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' compensatio il,eurancv carrier and policy number are: 3 of Agent ertify that, in the performance of the work if 1 should become-sdbjet"O the workers' Policy Number Date this permit is issued, 1 shall not employ any person in any manner so as to become subject to the ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of 1 nt —o-I,-r� IECLARATI N R ARDI CONSTRUCTION LENDING AGENCY hereby affirm and r pena of perjury that there is a construction lending agency for the performance of the work for which this permit is issued Ender's Name Lender's Address ly 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 county ordinances and state construction. I authorize representatives of t Is c y or county to enter th e I I entifi p operty 1br inspection p es. rtv >ionature of Prop(Owner or ed Agent / viYY riot Property Own or Authorized gem ACTION PERMIT EXPIRED PERMITCANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATEOF OCCUPANCYISSUED DATE - DEC ION OF COMPLIANCE WITH CODE OF FEDERAL FOR O FICE USE ONLY REG TIONS PART61 OFTITLE 40 AND AQMD RULE 1 SUBMITTED TO TO .rs' compensation laws of California, and Civil Code).