HomeMy WebLinkAboutX2019-2722 - Permitsrx,rk City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
N Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - BLDG
IIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIII II COMB Permit: X2019-2722
Project No : 1940-2019
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 2,039 SF, REPLACE (E) FABRIC CURTAIN
Legal Desc.: P BK 302 PG 11 PAR 1
Owner: CHURCH OF ST MATTHEW-BY-THE-SEA
Address: 2300 FORD RD
NEWPORT BEACH, CA 92660
Phone
Applicant:
HILL JOHN STEVEN
Address:
3195-B AIRPORT LOOP DR
COSTA MESA CA 92626
Phone:
714-825-8888
Code Edit : 2016
Type of Construction:
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units : 0
Bldg Height: 0
Bldg Sprinklers:
Flood Zone: X
11 Construction Valuation: $
Building Permit Fee: $152.00
Plan Check Fee: $132.24
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$16.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $341.24
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor: OW NER/BLDR
Address: AUTH AGENT:
JOHN CREWS
Phone:
Con State Lic: O/B
Lic Expire:
Bus Lic:
Lic Exp Date:
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: /
Front: /
Left: /
Right: /
king Spa
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
HILL JOHN STEVEN ;
3195-B AIRPORT LOOP DR '
COSTA MESA CA 92626
714-825.8888 State Lic:CO23553
Special Conditions:
0
Planning Department -
Plan check Fee
Fair Share :
SJH Trans :
In -lieu Housing Fee
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check :
$0.00
San Dist :
$0.00
NMUSD Fee:
$0.00
State Lic
INSPECTOR
Fire Department
$40.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
Plan Check Fee: $172.24 Fee Due at Permit Issuance : $169.00
PUBLIC WORKS APPROVAL:
_ PLAN CHECK BY:
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
;he 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 (_) all of or L) 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
m oved for the purpose of sale).
19��p�r1, 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' plyvto 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).
D 1 3m exempt from linensure under the Contractors' State Licens w for the following reason:
by my signature below,. acknowledge that, except for m perso re ' Since in which I rplust have resided for at least one year prior to completion of the improvements coveredAy this permit, I cannot legally
se;l a structure that I have built as an owner -builder if i as bee constructed in it irety by licensed contractors. I understand that a copy of the applicable law, Sectio
rrofc>;ions Code, is available upon request when thi ap Cello s itted or a e ollowing Web ttp://www.leginfo.ca.gov/calaw.htmi. n 44 of the Business and
s
Signablre of Propertv::wner or Authorized Agent Da /
i.l(.FNSED COi TRi,CTOR'S DECLARATI
I hereby affirm um. a: penalty of perjury that am can d under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions ode, and my license is in full force
and effact. License r`lass License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
,VANNING. FAILURE -0 SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,000J, IN ADDITION TO THE
COST OF COMPENdw i IUN, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
❑ I have and OP raintain 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 the work 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
ne of Agent I Phone #
certify that, in the perfor ante Jeor for which thi ermit is issued, I shall not employ any person in any manner so as to become subject to the workers' ompensation laws of California, and agre
I, if I should become su Jett the compens 1rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.nature of Applicant � 9 te_
��zbll�,
CLARATION REGA ING CON LENDING AGENCY
Ireby affirm under p alty o rjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
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 h e prove Sid is correct.
I agree to comply with all applicable city and cou or as and state s relating to building construction.
I authorize representatives of this city or county Sir t�aatXve-idenfj 1 pr spection purposes. 4 �
[Signature of Property Owner or Authorized Agent Print Pro erty Owner's or Authorized Agent's Nam O n TLe, SA Da 1 I e /"
ACTION DATE BY / ATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
( GULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED L1 I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED UEPA
PERMIT EXTENDED QMD
PERMITFINAL BESTO 1N TIFICA SNOTA LI ABLE TO
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