HomeMy WebLinkAboutX2019-1217 - Permits.n City of Newport Beach - Building Division
100 Civic Center Drive Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
$ Inspection Requests Phone (949)644-3255
r ,lprib ,; Combination Type- SFP
Illllllll�lllllllllll�llllllllllllllllllllllllllllu II COMB roject DPermit : X2019-1217
Issued Date: 04/17/2019
Inspection Area : 3
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:. 2018 DIANA LN NB
Description:. SFR TIO (E) 34 SQ, INSTALL COMP. SINGLE& 3 SQ OF TORCH DOWN, CLASS'B' MIN.
Legal Desc.: N TR 1763 LOT 43
Building Permit Fee.
$324.00
Owner: WEBB
Contractor: CERTIFIED ROOFING SPECIALISTS
Architect:
Address: 2018 DIANA LN.
Address: .9281 LARKSPUR DR
Address:
- NEWPORT BEACH CA 92660
WESTMINSTER CA 92683
Additional Fee :
Phone:
Phone: 714.323.7481
Phone: State Lie:
Applicant: CERTIFIED ROOFING SPECIALISTS
Con State Lica. 956843
Engineer:
Address:. 9281 LARKSPUR DR
Lie Expire:. 01/31/2021
Address:
WESTMINSTER CA 92683 '.
Bus Lie: BT30053068
$0.00
Phone: 714-323-7481
Lie Exp Date:. 11/3012019
Phone: State Lie:
Code Edit: 2016
Worker's Compensation Insurance
.Designer.
Type of Construction: VB
Carrier: STATE COMP. INS
Address:
Occupancy Group: R31U
Policy No: 1949902
Added /New sq.ft. Bldg: 0
Expire: 1210112019.
Phone:
Added/New sq. ft.. Garage: 0
In -lieu Housing Fee :
$0.00
No of Stories: 1
Building Setbacks Rear: l
Special Conditions:
No of Units : 1
Front: )
-
Bldg Height: 0
Left:
Bldg Sprinklers;
Right:
Flood Zone: X
Use Znne, Parkino Snaces, 0
Fire Ha7anl 7nne N
consrrucnon vaivanon:
a"z.uuu.uu
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
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 Mate
$0.00 -
Electrical %:
$0.00
San Dist: $0.00
Building Green as:
$1.00
Mechanical %:
$0.00.
NMUSD Fee:. $0.00
$0.00
_
Plumbing %:
$0.00
$0.00
TOTAL FEE : $325.00
Plan Check Fps
W0.00 ° m ° ° °, Fee
Due at Permit Issuance :
$325.00
PROCESSED BY:
6 o ° °-PUBLIC° WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK -BY:
GRADING APPROVAL:
Y °
� . ° ` � AVPSPVAS_ LO 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 L) 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
Im roved 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 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, 1 cannot legall)
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:http://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section0 ) of Division 3 of the Business and Prof Si Code, and my license is in full force
and effect. License Class License No Date 1 j Contractor Signature ryunL 1%9r2QUP2
WORKERS' COMPENSATION DECLARATION
NARNING: 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 ($700,000), IN ADDITION TO THE
COST OF COMPENSATION, 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:
:11 have 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
aelformance of the work for which this permit is issued. Policy No.
have and will gt�Intain 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 arkl dolicv number are: r/% . A
Date
ne of Agent 'a No- r —V t v v --y _ vnone s
certify that, in the performance 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 workers' compensation laws of California, and agre
I, if I should become s bject�t the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant /lank Vsii-j.6fP2 D pi -0—I1
CLARATION REG DING CONSTRUCTION IKENDING AGENCY
Ireby-affirm under p natty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 30 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 have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction. -
I authorize representatives of this city or cou t entgr the above-idenjified property for inspection purposes. 1(QZ f� _��,�Q
nature of ProDertv Owner or Authorized ADent VA711 5L t? dez Print Property Owner's or Authorized Agent's Na Frank V Qu�2 _\
ACTION DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
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