HomeMy WebLinkAboutX2019-1520 - Permits�r City of Newport Beach - Building Division *X2019-1520* COMB Permit: X2019-1520
100 Civic Center Drive, Newport Beach, CA 92660 Project No
%. Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
' ftarm1>iF Combination Type - SFP Issued Date : 0511412019
9
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: 332 PROSPECT ST NI3
Description: SFR -APPLY 1-LYR.30# FELT W/COMP OVER EXTG COMP 20 SCIS
-
Legal Desc.: TR 772 LOT 18 BLK 18 ALL -EX
NLY 5 FT- THEREOF(ANDNLY 6 FT LOT 19 BLK
Owner: GNEGY BRAD C -
Address: 332 PROSPECT ST
Contractor: JSL ROOFING INC Architect:"'F
Address: 2415 MARGARET ST Address:
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NEWPORT BEACH, CA 92663
NEWPORT BEACH CA 92663
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Phone: 714-299.9251
Phone: 949-646-3571
Phone:
State Lit.1 ` A
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Applicant: JSL ROOFING INC
Con State Lie: 747706
Engineer:
•�O•
Address: 2415 MARGARET ST.
Lie Expire: 04/3012020
Address:
. • • • a •. • o
NEWPORT BEACH CA 92663
Bus Lie: BT98036946
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Phone: 949.646-3571
Lie Exp Date: 08/31/2019
Phone:
State Lic:
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Code Edit: 2016
Worker's Compensation Insurance
Designer:
u
Type of Construction: VB
Carrier: STATE COMP
INS FUND Address:
Occupancy Group: R31U
Policy No: 1913758
Added /New sq.ft. Bldg: 0
Expire: 06/1812019
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 1
Building Setbacks Rear: I
Special Conditions:
NO TEAR OFF -PRE-INSP
No of Units: 1
Front: /
REQUIRED
Bldg Height: 0
Left: /
IN9TAT-1.OR VEI1,IFY y'DI`F ANOJW,0-C CN
Bldg Sprinklers:
Right: /
MONGSJDED4F@TORS AREg.-i{i�ict,
Flood Zone;
Use Zone: Parking Spaces:
0 Fire Hazard Zone :
N REB CBM b14.1 & 315.2
Construction Valuation: $7.000.00
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
P/W Plan Check: $0.00
Grading Bond: $0.00
Hazardous Mat$0.
Electrical %: $0.00
San. Dist: $0.00
Building Green as : $1 0
Mechanical %: $0.00
NMUSD Fee: $0.00=.
$0.00
Plumbing %: $0.00
$0.00
TOTAL F
Plan Check Fee :
$0.00 Fee Due at
Permit Issuance : $325.00
PROCESSED BY:
PUBLIC WORKS APPROVAL,
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION
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)
:tion 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
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
'essions Coda) 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
more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do C_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
iness 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
rovements 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
roved for the purpose of sale).
1, 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
ly 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).
J I am exempt from licensure under the Contractors' State License Law for the following reason:
3y 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 rmit, I cannot legally
;ell 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 Business and
Irofessions 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 Properittt Owner or Authorized Agent Dat
_ICENSED COWIRA'CTOR'S DECLARATION
Plpgk�YAfflrm L41ger penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 1 .— i the Business and Prfes ' y li n is in full force
and effeet. License License No Dat I Contractor Signature
VQJ?KFRS' COPJPENSATION DECLARATION
JARNIMG: FAILURE TD SEC RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T ANVOLARS 0,0001, IN ADDITION TO THE
;WT Or6COMPENBpl1p91, J$IMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
} erlepi; tifirm under penalty of perjury one of the following declarations:
3-I•Mfte and will.rftiptain 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 the
alfa nce of the work for which this permit is issued. Policy No.
' 'and will,maigtpin 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' compensatior
ur ceu era�r j
**!Mm yt8? Policy Number
Expiration Date
lahMdfAgent" ' ' Phone#
71 certify that, in the performance rk for whit s 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 agree
iat, if I should become subjec a ars' com ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ,[— ✓ ,/�
tignature of Applicant Ile Dae_
hereby affirm under peva ter f per''" there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
_ender's Name Lender's Address
3y my signature below, 1 certify to each of the following:
I am the property owner or authorized to act on the property ow is behalf.
I have read this application and the information I hav$pro' Is correct.I agree to comply with all applicable city and county oand state I s relating to ding construction.
I authorize representatives of this city or count t eb v -ide 'f' propert r inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized A ant's Name
ACTION DATE BY NLON OM I CE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
U TIO ART 6I OFTITLE40ANDAQMD RULE
PERMITEXPIRED LJISUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED EPA
PERMITFINAL^ UASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
CERTIFICATE OF ^2'0 -4 ^ 1"L-'/"'-'- PROPOSED DEMOLITION
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