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HomeMy WebLinkAboutX2019-0837 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2019-0837 100 Civic Center Drive Newport Beach, CA 92660 Permit Phone x 2 0 1 9 -. 0 8 3 7 Project No :.. Counter (949)644-3288 Inspection Requests Phone (949)644-3255 _ Combination Type- MFP Issued Date: 03/14/2019 Inspection Area : 5 I 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: 416 ACACIA AVE NIB Description: ' MFR REROOF'T/O COMP SHINGLES AND REPALCE W/ COMP SHINGLES CLASS "B".13 SCIS Legal Desc.c. CORONA 'DEL MAR BLK 329 LOT 18 Owner' - SWANSON RYAN Contractor: COASTAL ROOFING CO INC Architect: Address; :416 ACACIA AVE Address: .: 3303 HARBOR BLVD SUITE G-415. Address:- ,°O•° NEWPORT BEACH, CA 92660 COSTA MESA CA 92926 °veo Phone: Phone: 714-642-2830 Phone: State Lie: Applicant COASTAL ROOFING CO INC Con State Lie: 767366 Engineer: Address:3303 HARBOR BLVD SUITE 6-4/5 Lie Expire: 12131/2019 Address: COSTA MESA CA 92626 Bus Lie. BT20080401 Phone: 714.842-2830 ' Lie Exp Date: 07131/2019 Phone: State Lie. Code Edit: 2016 Worker's Compensation Insurance`. Designer. Type of Construction. V -B Carrier. EMPLOYEE SERVICE' GROUP Address:. Occupancy Group: ,R3 -Policy No, WC018971401 Added /New sq.ft. Bldg: 0 Expire: 1213112019 Phone: Added /New sq; ft. Garage: . 0 No of Stories: 1 Building Setbacks Rear / Special Conditions: wcop No. of Units:. 2: 'Front:. / °e°a '°•°; 'Bldg Height: 0 - Left: / ` Bldg Sprinklers: Right / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation $8.000.00 Building Permit Fee: $324.00 Excise Tax. $0.00 Planning Department- Fire Department Plan Check Fee: $0.00 : Additional Fee 1$0.00 -Plan check Fee: $0.00 Fire Inspection: $0.00 Overtime Plan:Ck: i$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 I. $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 '$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: $325.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $325.00 G PROCESSED BY: l J 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 Lawfor the reason(s) indicated below by the checkmark(s) I have placed next to the applicableitem(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 far the permit to file a signed statement that he or she is licensedpursuant to the provisionsof 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 apermit subjects the applicant to a civil penalty of not more than five hundred dollars ($500): - ❑i. I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) 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 improvesthe: 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). ❑ 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 apply to an owner of property who builds or improves thereon, and who contracts for the projects with 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 signat"A. bgjow I acknowledge that, except for my personal residence in which 1 must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall sell a structure thWhave 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 Profe sions C58e, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. "grure. of PropeRy Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION jfty affirm under penalty of perjury that I am licensed under provisions of Chapter (commencing with Section 70 ) of ivision 3 of the Business and P jessio o , and y license is -force anti Cffect Licenseglass - - License No Date b / Contractor Signat e sense RKERS' COMPENSATION DECLARATION A NG: FAILUY®iOSECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO. CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNG HOUSAND DOLLARS ($700,000), IN ADDITION TO THE WAF OF COMPENSAJTt)$I.OAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'. FEES. pj r"y affirm unijer penalty of perjury one of the following declarations: •I'I`4e. and will m.ylntain 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 e ormtmce of4Ae WON( for which this permit is issued. Policy No. ave and wilt?VirQain 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 ine�r&Rce carriereind policy number are:. Career Policy Number Expiration Date Name of Agent Phone :# 1 certify that, in the perfor ante of the work for which this permit is issued, I shall not employ any person in any manner so as to. become subject to the w/Dat mpensation laws of California, and agre that; if I should become su ect to the ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. --77 ©JSiJnatureof ApplicantD CLARATION Voe'r NSTRUCTION LENDING AGENCY I hereby affirm ajury that there is a construction lending agency for the performance ofthe work for which this permit Is issued (Section 30ode). Lender's Name Lender's Address By my signatureach of the following: I am the proorized to act onthe property owner's behalf. I have read this application and the information I ave provided is correct I agree to comply with all applicable city and co ty ordinances and state laws relating to building construction. I authorize representatives of this city or count to enter the above identified property for inspection purposes. Sicnature of ProOertv Owner or Authorized Agent _ Print Property Owner's or Authorized Agent's Nam Dto d3 Ll R�TLATIONS PART 61 P�RMITFINA' u �I BES CERTIFICATEOF �' I� I \ OPO EF OCCUPANCY ISSUED Sir, WITH CODE OF FEDERAL FOR OFFICE USE ONLY !.40ANDAQMD RULE. to A�Btb I UN Nu I IFICATION TO NO IFICATIOI�II TAPPLICABLE TO 6 I LLQ LITIO /