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Home My WebLink AboutX2019-3611 - PermitsCity of Newport Beach - Building Division IIIIIIIII�IIIIIIIIIIIIII II COMB Permit: X2019-361 �wwt•rwT x 2 0 1 9 3 6 1 1 100 Civic Center Drive, Newport Beach, CA 92660 Project No Permit Counter Phone (949)644-3288 v ' •.� Inspection Requests Phone (949)644-3255 Issued Date :11/1212019 Combination Type - SFP Inspection Area : 5 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: 4511 CAMDEN DR NB /� Description: SFR - T/O BUR, INST 3-PLY BUR CAP 9 SOS CLASS "A" (FLAT AREA ONLY) Legal Desc.: N TR 3357 LOT 139 INSPECTOR Owner: CUBAS ARTIE Contractor: FONTAINE WEATHERPRFG INC Architect: Address: 4511 CAMDEN DR Address: 586 N. BATAVIA ST Address: CORONA DEL MAR CA 92625 ORANGE, CA 92868 Phone: 949-293-0971 Phone: 949-598-8360 Phone: State Lic: Applicant: MEDINA BEN Con State Lie:, 875099 Engineer: Address: 31225 LA BAYA DR Lie Expire: N v03/31/2020 Address: WESTLAKE VILLAGE CA 91362 Bus Lic: BT30069701 Phone: 818.735-7876 Lie Exp Date: 11/30/2020 Phone: State Lie: Code Edit : 2016 Worker's Compensation Insurance Designer: , Type of Construction: VB Carrier: CALIF INS CO Address: Occupancy Group: R31U Policy No: 828218120110 - Added /New sq.ft. Bldg: 0 Expire: 01101/2020 Phone: , Added /New sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: I Special Conditions: - No of Units : 1 Front: I , Bldg Height: 0 Left: I Bldg Sprinklers: Right: I Flood Zone: Use Zone: Parkin S aces: 0 Fire Hazard Zone : N Construction Valuation: $6,500.00 Building Permit Fee: $324.00 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 WO Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 PIN Plan Check : $0.00 Grading Bond: $0.00 Hazardous DAat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $1.9 Mechanical %: $0.00 NMUSD Fee: $0.00 - $0.00 Plumbing %: $0.00 $0.00 TO Al_ FEE : $325.00 Plan Check Fee: $0.00 Fee D t Issuance : $325.00 PROCESSED BY: PUBLIC WORKS APP 'OVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: �� OWNER -BUILDER 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 ie 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 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 of more than five hundred dollars ($500). I, 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 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). 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). 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 legally ell 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 '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 t .ICENSED CONTRACTOR'S DECLARATION hereby affirm under oenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 D 1 io 3 of the Business and Pr fes i n e, and my license is in full force nd effect. License Class License No Date Contractor Signature V'CR{tcRS' COMPENSATION DECLARATION IARNING: FAILURE TO SECJRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (S100,00D), IN ADDITION TO THE OST W COMPENSAT'ON, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNETS FEES. hereby affirm under penalty of perjury one of the following declarations: ha,.e and will ma„ltain 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 IN gqt,mance oft" wcr!: for which this permit is issued. Policy No. and will Inaimain 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 a;.d policy number are: Policy Number 1e of Agent Date ;cri(y that, in ante of the work for which this 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 that, if I should ecome Is bjec s' co Ion visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applican Date DECLARATION REG NG UCTION LENDING AGENCY I hereby affirm under enalty 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). Lender's Name Lender's Address By 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 'County and St lating to building construction. I authorize representatives of this city or cou inspection purposes. t y Signature of Property Owner or Authorized Agen- y to ent o - e y or Print Property Owner's or Authorized Agent's Name Da ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE 1403 PERMIT EXPIRED 11 Ll I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT C4NCELLEO 91 UEPA PERMIT EXTENDED 114 fqQM D PERMITFINAL �C /7� (2.,4, ASBE ICATION IS NOTAPPLICABLE TO CERTIFICATE OF J l ROPOS OLITION OCCUPANCY ISSUED IIGNATI