HomeMy WebLinkAboutX2017-2839 - PermitsCity of Newport Beach - Building DivisionIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2017-2839
t4 100 Civic Center Drive: Newport Beach, CA 92660 X 2 0 1 7 2 8 3 9 PfOJBCt NO
Permit Counter Phone (949)644-3288
cs Inspection Requests Phone (949)644-3255
�r4arrtu'� Combination Type - MFP Issued Date : 09/01/2017
Inspection Area : 2
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 6:00 a.m. to 6:00 p.m. No work on Sundays or Holidays
Job Address: 3245 BROAD ST NB
Description: MFR T/O (E) 24 SQ, INSTALL COMP. SHINGLE, CLASS B (3245 & 3247 BROAD ST)
Legal Desc.: PM 254-30 PAR. 2 OF PROJECT 937-35 LOCATED ON AP 425-283-34
Owner: DONAHUEIDOFELMIER
Contractor:
HOYT ROOFS INC Architect:
"
Address: 3245 BROAD ST
Address:
1809 N ORANGETHORPE PK Address:
NEWPORT BEACH, CA 92663
ANAHEIM CA
92801
Phone:
Phone:
714-773-1820
Phone:
State Lie:
Applicant: HOYT ROOFS INC
Con State Lie:
606111
Engineer:
Address: 1809 N ORANGETHORPE PK
Lie Expire:
12/31/2018
Address:
ANAHEIM CA 92801
Bus Lie:
BT30001509
a...,
Phone: 714-773-1820
Lie Exp Date: 10/31/2017
Phone:
State Lie:
Code Edit: 2016
Worker's Compensation
Insurance
Designer:
-�
,
Type of Construction: VB
Carrier:
REDWOOD
Address:
Occupancy Group: R3/U
Policy No:
HOWC807664
Added /New sq.ft. Bldg: 0
Expire:
0712412018
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 2
Building Setbacks
Rear: /
Special Conditions:
No of Units : 2
Front: /
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: /
Flood Zone: X
Use Zone:
Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $12.000.00
Building Permit Fee: $304.00
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 $0.00
Electrical %:
$0.00
San Dist: $0.00
Building Green Fee : $1.00
Mechanical %:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $305.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$305.00
PROCESSED BY:
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Pul1BLIC WORKS APPROVAL:
ZONING APPROVAL:
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L ` Y UN CHECK BY:
GRADING APPROVAL:
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APPROVAL TO ISSUE:
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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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) 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).
❑ 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
for the with a licensed Contractor pursuant to the Contractors' State License Law).
apply to an owner of property who builds or improves thereon, and who contracts projects
❑ 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.ieginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION i� f ull force
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 00) of Division 3 of the Business and Prof s �i s ode, and my licen sin\
and effect. License Class License No Dat Contractor Signatur,
ORKERS' COMPENSATION DECLARATION
WARNING: 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 ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORN EV'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
111 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
performance of the work for which this permit is issued. Policy No.
I have eand I alntain 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
in rance came an policy number
Carrier P3h�4DF er Expiration Date
-R
Name of Ag nt �� xx Phone #
I certify that, in the performance of a 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
that, if I should become su 'act to the Ike 'compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signatureof Applicant e g�;i '
DECLARATION REG DING CONST ION LENDI AGE
I hereby 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).
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 and county ordinances and state Is s relating to building construction.
I authorize representatives of this city or county o me e a ove-i tifi r party for inspection purposes. ' �
Signature of Property Owner or Authorized Agent Print Pro erty Owners or Authorized Agent's Name I Dat
ACTION DATE BY DECLAR ION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED (SUBMITTED ASBESTOS NOTIFICATION V ••• •
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PERMIT EXTENDED QMD
PERMITFINAL ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
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