HomeMy WebLinkAboutX2019-1386 - PermitsCity of Newport Beach Building Division Illllllllllllllllllllllllllllllllllllllllllllllllq COMB Permit: X2019-1386
"t 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1. 9 1 3 8 6 Project No:
a - Permit Counter Phone (949)644-3288 - -
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
a.unsuucuou vmuauyn.
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Inspection Requests Phone (949)644-3255
Building Permit Fee: $324.00
K'W
$0.00
Planning Department-
Issued Date : 04/30/2019
Fire Department
Combination Type - SFP
Plan Check Fee: $0.00
,
$0.00
Plan check Fee :
$0.00
Fire Inspection:
Inspection Area : 3
-
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Grading Bonds Fee:
$0.00
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
$0.00
Job Address: 2021 DEBORAH LN NB .
$0.00
Investigation Fee:
$0.00
Grading PC Consultant:
Description:. SFR REROOF T10 COMP SHINGLES AND
REPLACE W/ COMP. CLASS "B" 22 SOS
$0.00
Demolition Fee
Legal Desc.: N TR 1805 LOT 14
_
$0.00
......
$0.00
In -lieu Housing Fee:
$0.00
Building Dept Adm
aeon
Owner: BASHORE TODD
Contractor:
MC CORMACK ROOFING ENERGY.
Architect:
° • • •
^ • • • °
°
Address: 2021 DEBORAH LN
Address:
1260 N HANCOCK#108
Address:
.00.
WQ Insp. Fee:
NEWPORT BEACH, CA 92660
Park Dedication:
ANAHEIM CA 92807
m
• m o °
Phone:
Phone:
- 714-777-4040
Phone:
State Lie: e
PM Plan Check:
Applicant: MC CORMACK ROOFING ENERGY
Con State Lie:
643700
Engineer..
Hazardous Mat
.Address: 1260 N HANCOCK #108 -.
Lie Expire:
08/30/2020
.Address:
m°O.O•
-...0°
ANAHEIM CA 92807
Bus Lie:
BT30064748
Building Green Pee ;
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e -
.Phone: 714.777.4040
Lie Exp Date:
10/31/2019
Phone:
State tic:
OBmDD
Plumbing %:
$0.00
Code Edit: 2015
Worker's Compensation Insurance
Designer.
om••o.
o o
Type of Construction: V -B
Carrier:
EMPLOYEE SVC GRP
Address:
$0.00
Fee Due at Permit Issuance :
Occupancy Group: R31U
Policy No:
WC900085109
Added /New sq.ft. Bldg:. 0
Expire:
1213112019
Phone:
ppO°
Added /New sq. ft. Garage:. 0�
No of Stories: 1
Building Setbacks
Rear: 1
Special Conditions:
No of Units : 1
Front: /
i
si �
(
i 1 a
Bldg Height: D
Left: /
a
Bldg Sprinklers:
Right:. /
Flond 7nnR'
Ilse Zone: Parking Soares' n
Fire Hazard Zone, N
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
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_
Building Permit Fee: $324.00
Excise Tax:
$0.00
Planning Department-
Fire Department
Plan Check Fee: $0.00
Additional Fee i
$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 Feer
$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
PM Plan Check:
$0.00
Grading Bond:
$0.00
Hazardous Mat
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Building Green Pee ;
$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
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
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
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 (_) 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 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 jtte.Rroperty, 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).
4, wrp exempt fjom licensure under the Contractors' State License Law for the following reason:
By my signature ME' 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 legal)
sell a structure lhatl Mile 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
PfofB,jydns Code, % available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html.
Siggnature of Property ®wner or Authorized Agent Date
LdCEWSED CdNtRAbTOR'S DECLARATION
I hereby affirm un4aopenally of ger ury hat I am licensed under provisions of Ch p r comma ting with Section 000 f Division of the Business and 4 fes ' s ode, and my Iice,r, " 'S in f II f
ah6'effAgt. LicdhbgpJdss (M License No %UCJ Dat Contractor Sign ufa
�E}eW•ERS' CONIPENSATION DECLARATION fs//
11MIM�:FAILURE TO SECt&RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRI )NAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRE USAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF OOMPENSA010R,OAMAGES AS PROVIDED FOR IN SECTION 3100 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
PRdve and Otij 4illtain 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
p ormance of the work for which this permit is issued. Policy No.
ave 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' compensatio
insurance ca ier and policy number are: ' I�/� ,F ,q
Carrier Policy Number l4L10dd ��I Expiration Date
Name of gent Phone #
I certify that, in(th nce ofthe work for which this rmit is sued, I shall not employ any person in any manner so as to become subject t0 the workersompensation laws of California; and agrethat, if I should bee s je th workers' compensaf pr v' i sof S 3700 of the Labor Code, I shall forthwith comply with those provisions.211 G7Signature of Appht D te� oc�
DECLARATION RE ING CO S RRUCTION LENDING AGENCY
I hereby affirm under p Ity of p rjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section X097, 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 an o finances and �Iaws�tbuildlngI authorize representatives of this city or c unty to a ove-ids./Si natureof Pro ertOwner or Authorized Agen ner's or Authorized Agent's Na lei D e
ACTION DATE BY /(DECLA TION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGU TIONS PART 61 OF TITLE 40 AND AC MD RULE
PERMIT EXPIRED I SUB MIT TED ASBESTOS NOTIFICATION TO
PERMITCANCELLED EPA
PERMIT EXTENDED qMD
PERMIT FINAL 6. 77-)17 STO IFICATION IS NOTAP AS TO
CERTIFICATE OF RO E ION
OCCUPANCYISSUED SIC.NATDRE: L/
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