HomeMy WebLinkAboutX2019-1700 - PermitsCity of Newport Beach - Building Division
Planning Department-
COMB Permit: X2019-1700
Plan Check Fee: $0.00
IIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIII
Additional Fee
Overtime Plan Ck
$0.00
Grading Bands Fee:
Investigation Fee:
$0.00
Grading PC Consultant:
Record Management:
$0.00
Grading Permit Fee:
II
$0.00
Grading PC Fee:
100 Civic Center Drive, Newport Beach, CA 92660
X 2 0 1 9
1 7 9 6
Disabled Access :
Project No
$0.00
Permit Counter Phone (949)644-3288Inspection
a
$0.00
Electrical %:.
Building Green Fee :
Requests Phone (949)644-3255
Mechanical %:. -
Park Dedication :
$0.00
Combination Type - SFP
TOTAL
Issued Date : 05129/2019
P/W Plan Check :
$0.00
Inspection Area : 4
$0.00
- PERMITS EXPIRE 980 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION..
$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: 1016 SANDPIPER DR NB
$0.00
Description: SFR REROOF TIO ROCK ROOFING AND REPLACE W/ COMP SHINGLES CLASS B 35 SOS
Legal Desc.: N TR 3660 LOT 29
Plan Check Fee:
$0.00
Fee Due at Permit Issuance
,
N.Owner.
WEIG ROBERT W Contractor: UNDER COVER HOME IMPROVEMT
Architect:
Address: 1016 SANDPIPER DR Address. 19562 DITMAR LANE
Address:
-,
CORONA DEL MAR, CA 92625 HUNTINGTON BEACH CA 92646
Phone. Phone: 714.593-9840
Phone:
State Lie:
Applicant: UNDER COVER HOME. IMPROVEMT Con State Lie: 687961
-
Engineer.
-
Address: 19562 DITMAR LANE Lie Expire: 02128/2021
Address:
HUNTINGTON BEACH CA 92646 Bus Lie: BT30062506
-
Phone: 714-593-9840 Lie Exp Date: 03/31/2020
Phone:
State Lie:
• a
Code Edit: 2016 Worker's Compensation Insurance
Designer:
Type of Construction: V-B Carrier: STATE FUND -
Address:
Occupancy Group: R31U Policy No: 9040625
Added /New sq.ft. Bldg: b - Expire: 01/01/2020
Phone:
.Added /Newsq. ft. Garage: 0
No of Stories: I Building Setbacks Rear: I
Special Conditions:
No of Units: 1 Front: I
Bldg Height: 0 - Left: /
° a.
,•°
Bldg Sprinklers: Right: /
Flood Zone: Use Zone: Parkina Spaces: 0
Fire Hazard Zone: N
Building Permit Fee: '$324.00
Planning Department-
Excise Tax:
Plan Check Fee: $0.00
Fire Department
Additional Fee
Overtime Plan Ck
$0.00
Grading Bands Fee:
Investigation Fee:
$0.00
Grading PC Consultant:
Record Management:
$0.00
Grading Permit Fee:
Energy Compliance:
$0.00
Grading PC Fee:
CA Seismic Safety:
$0.00
WQ Insp. Fee:
Disabled Access :
$0.00.
$0.00
Hazardous Mat
$0.00
Electrical %:.
Building Green Fee :
$1.00
Mechanical %:. -
Park Dedication :
$0.00
Plumbing %:
TOTAL
FEE ` $325.00
P/W Plan Check :
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
$0.00
Planning Department-
Fire Department
$0.00
Plan check Fee:
$0.00
Fire Inspection:
$0.00
Fair Share:
$0.00
Fire Plan Rev
$0.00
SJH Trans :
-
$0.00
Demolition Fee
$0.00
In -lieu Housing Fee:
$0.00
Building. Dept Adm
$0.00
Public Works Department -
General Service
$0.00
Park Dedication :
$0.00
Refund Deposit
P/W Plan Check :
$0.00
Grading Bond:
$0.00
San Dist:
$0.00
$0.00
NMUSD Fee:
$0.00
$0.00
Plan Check Fee:
$0.00
Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
°$9�O1► ° e a ° u
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$325.00
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 items)
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
is 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
'rofessions 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
of more than five hundred dollars ($500).
1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements 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
nproved 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
pply 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:
ly 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, 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 the Business and
'rofessions 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
.ICENSED CONTRACTOR'S DECLARATION
hereby aHinn under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 f iv jgry 3 of the Business and Pro ssi s Code and my license is in full force
nd effect. License Class License No Date / `9 Contractor Signa
VORKERS',GOMPENSATION DECLARATION
IARNING: FAIL j'Q SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNO ED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
OSTJOF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
tLATiby affirm°under penalty of perjury one of the following declarations:
..
i have and yvill 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 Cade, for th
i fDrmance of the�%ork for which this permit is issued. Policy No.
LI hive and willmaintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for whic this is issued. My workers' compensatiol
n Barri ya�(�1�,polic number are: //��
;arrierrr l\'( _Ja.n.y� Policy Number 6)V V06)-5 Expiration Date
lame of Agent <E A) Phone #
3lceRify that 1"-r1QiVJ)erfo ance 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' co Zalon ws of California, and agre
let, if1 shoul� become su act t the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. p,
i %etre of Appllcen Dat
i CLARATION'129CA DIN C ST UCTION LENDING AGENCY
hereby affirm under p nalty of pe that there is a construction lending agency for the performance of the work for which this permit is issued (Section 30 , Civil Code).
ender's Name Lender's Address
ly my signature below, I certify to each of the following: c x
W
I am the property owner or authorized to act on the property owner's behalf. --�J`
^ n �k �r�
I have read this application and the information I have pr vided is correct.
I agree to comply with all applicable city -an ou y ordijilOnces and state laws relating to building construction.
I authorize representatives of this city or county 7t�ntaft above -identified property for inspection purposes.
ianature of Prooertv Owner or Authorized AGent I __% Print Property Owner's or Authorized A ent's Name . ate
ACTION DATEI BY C ( DECLARRMN OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
i REGWTIONS PART 61 OF TITLE 40 AND ACIMD RULE
PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED OEPA
PERMITEXTENDED qMD _
PERMITFINALp� ASBESTOS OTIFICATION IS NOT APPLICABLE TO
CERTIFICATEOF b SDI G, �7 OPOSEDMOLITIO
OCCUPANCYISSUED V� SIGNATUR,
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