HomeMy WebLinkAboutX2019-1740 - Permits1r� City of Newport Beach - Building Division IIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIII COMB Permit: X2019-1740
t)4 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 1 7 4 0 Project No
aj Permit Counter Phone (949)644-3288
n Inspection Requests Phone (949)644-3255
Combination Type - SFP Issued Date:
Inspection Arearea :2019
4
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: 3500 SEABREEZE LN NB
Description: SFR - T/O SHAKE ROOF. INSTL OSB PLYWOOD AS NECESSARY. INSTL 1 LAYER 30# FELT. INSTL 40 SQ BORAL SAXONY 600 PSF TILE. ESR# 1647
Legal Desc.: N TR 6228 LOT 20 -
Owner: CHRISTMAN SHARON
Address: 3500 SEABREEZE LN
CORONA DEL MAR, CA 92625
Phone:
° o °
0
e'A°pplwant 98 CLAIN ROOFING INC
®Attar°e°ss: °13VJXZALLEY VIEW ST#33
® ° G'ARDE`N GROVE CA 92845
0
®14611'a. 714-897.1760
,Codegdit: o°°� 2016
`rype°o°f Constructio�:V-B
Ocaupaecy Gr%$° ° ° R31U
Added°/New sq.fr BPd°g: ' 0
Addptl7ldew sq. ft Garage: 0
11o•of glories: ° °° ° m 1
Np of Units:
Bldg Sprinklers:
Construction Valuation: $17.000.00
Building Permit Fee:
$324.00
Plan Check Fee: $0.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$0.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access ;
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $325.00
PROCESSED BY:
ZONING APPROVAL:
Contractor:
MCCLAIN ROOFING INC
Architect::
Address:
12812 VALLEY VIEW ST #33
Address:
GARDEN GROVE CA 92845
Phone:
714-897-1780.
Phone:
State Lie:
Con State Lie:
625013
Engineer:
Lie Expire:
08131/2019
Address:
Bus Lie
BT30056478
Lie Exp Dater
06130/2020
Phone:
State Lie:
Worker's Compensation Insurance
Designer:
Carrier:
STATE COMP
INS
Address:
Policy No:
1713760
Ir/
Expire:
0611812019
Phone: P
Building Setbacks
Rear: I
Spe 31`Ggnditiq s ,
Front: I
Left: I
Right:
Use Zone: Parking Spaces:
0
Fire Hazard Zone : N
Excise Tax:
$0.00
Planning Department -
Fire Department
Additional Fee :
$0.00
Plan check Fee :
$0.00
Fire Inspection:
$0.00
Grading Bonds Fee:
$0.00
Fair Share :
$0.00
Fire Plan Rev
$0.00
Grading PC Consultant:
$0.00
SJH Trans:
$0.00
Demolition Fee
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
$0.00
Building Dept Adm
$0.00
Grading PC Fee:
$0.00
Public Works Department -
General Service
$0.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
PM Plan Check:
$0.00
Grading Bond:
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00.
Plumbing %:
$0.00
$0.00
Plan Check Fee : $0.00 Fee Due at Permit Issuance ; $325.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
OWNER -BUILDER
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 U 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
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 a licensed Contractor pursuant to the Contractors' State License Law).
❑ 1 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, I 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.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION •• ,
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) iv' ' 3 of the Business and Professiggs„Cde, in full fo&-,
and effect. License Class License No Date ? Contractor Signature\I/vf%Jr/Y
NORKERS' 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 (E100,s00)r IN AUDITION TTOPTHS
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
• , 000(
hereby affirm under penalty of perjury one of the following declarations: ,• 00
arI 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-kii Codelofori�
r�o rmance of the work for which this permit is issued. Policy No.
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,v"Ike4
.__ carr/:�r and olicy nu berare: ''7 // . i , ..:.a
:7(°, li Policy Number l /� )�G7� Expiration Date
of Agent Phone # _
•
•eeoo
I 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 agree
I, if I should become subject
�ttoo� t�h/e/� o s' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /�
:nature of Applicant PSL hY/,�I Ci ,lo//Li _ Dat .(� ,� Q
CLARATION REGARDING CONSTRUCTION LENDING AGENCY - ” ` r
Dreby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, 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 county to entghye/a ove ntified property for inspection purposes.
nature of Prooertv Owner or Authorized Aqent r�. "//// "/ _ 7z,/,1 Print Property Owner's or Authorized Aqent's Nam R x2 v�.T
ACTION DATE BY DECLARATION OF III REGULATIONS PART0610 TIITLE 40 AND AQMD RULE CE WITH CODE OF AL FOR OFFICE USE ONLY
PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED OEPA
PERMIT EXTENDED LJAQMD
PERMITFINAL PASBESTOS NOTIFICATION ISSN�%TAPPLICABLE TO
CERTIFIGITEOFl7 /G PROPOSED DEMOUT(QJVq(
OCCUPANCY ISSUED / SIGNATIIRF,1
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