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Home My WebLink AboutX2019-2723 - Permitsa City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2019-2723 100 Civic Center Drive, New ort Beach, CA 92660 X 2 0 1 9 2 7 2 3 p Project No : 1940-2019 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - BLDG Issued Date : 09/26/2019 Inspection Area : 7 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: 2300 FORD RD NB Description: COMM INSTALLATION OF GLASS WIND SCREEN @ OUTDOOR (E) PAVILION 1,060 SF, REPLACE (E) FABRIC CURTAIN Legal Desc.: P BK 302 PG 11 PAR 1 Owner: CHURCH OF ST MATTHEW-BY-THE-SEA Contractor: OWNER/BLDR Architect: HILL JOHN STEVEN Address: 2300 FORD RD Address: AUTH AGENT: Address: 3195-B AIRPORT LOOP DR .. NEWPORT BEACH, CA 92660 JOHN CREWS COSTA MESA CA 92626 Phone: Phone: Phone: 714-825-8888 State Lic:CO23553 , Applicant: HILL JOHN STEVEN Con State Lic: O/B Engineer: „ Address: 3195-B AIRPORT LOOP DR Lic Expire: Address: COSTA MESA CA 92626 Bus Lic: ' Phone: 714-825-8888 Lic Exp Date: Phone: State Lic: , • . Code Edit: 2016 Worker's Compensation Insurance Designer: Type of Construction: Carrier: Address: Occupancy Group: U Added /New sq.ft. Bldg: 0 Policy No: Expire: Phone: l� [� Added /New sq. ft. Garage: 0 � V No of Stories: 0 Building Setbacks Rear: / Special Conditions: No of Units: 0 Front: I Bldg Height: 0 Left: / Bldg Sprinklers: Right: / Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $5,000.00 Building Permit Fee: $152.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $132.24 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 : $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. Foe: $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: $325.24 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Plan Check Fee $172.24 Fee Due at Permit Issuance : $153.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: IWO 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). ❑ 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 iIm rove ments 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 rroved for the purpose of sale). s 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 poly to an owner rf property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 am exempt `.rcr.i licensure under the Contractors' State License Law for the following reason: Py mI , s-gnature below I acknowledge that, except for 4a,�b sidence in ich I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal[) sell a structure toot I have built as an owner -builder if' hn construc in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 70Q�'of the Business and PrJfes.,ions Code, is available upon request when th' a ubmi d at the folio g Web site:http://www.leginfo.ca.gov/calaw.html. ignrt:re of Property Owner or Authorized Agent Date LICEPSED CONTRF.CTOR'S DECLARATI f hereby affirm under penalty of perjury that I am li d under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions C de, and my license is in full force and effect. Licei,sa Class License No Date Contractor Signature WOPKERS' COMPENSATION DECLARATION WARNING FAILURE To SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE rOST OF ^OMPENSPTION, CAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: LJ I hpbe and w& 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 performance of tlTs v.•crk for which this permit is issued. Policy No. have 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' rance carrier and policy number are: Policy Number Date to of Agent 13 Phone # certify that, in the perfo anc th work for which �tyrje permit is issued, I shall not employ any person in any manner so as to become subject to the if I should become su ie o the o*ers' compenSa4Dn provisiqDs_of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant CLARATION REGA DIN ON RUCTION LENDING AGENCY Ireby affirm under p na of perjury that there is a construction lending agency for the performance of the work for which this permit is issued 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 orpe9d is correct. I agree to comply with all applicable city and cou y opeinapfes and s4 laws relating to building construction. I authorize representatives of this city or county o ter bove= ified r inspection purposes. of Property Owner ACTION PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED or Authorized Agent Print Property Owners or Authorized Ag DATE BY ECAARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGJiLATIONS PART 61 OF TITLE 40 AND AQMD RULE SUBMITTED ASBESTOS NOTIFICATION TO IS NOTAPFCABLE TO compensation laws of California, and agre q/2�6/q 3097, Civil Code).