HomeMy WebLinkAboutX2018-0344 - Permits,•�,� City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
p, Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - MFP
�e GQe INIIOuINI�IWIell�3lllll4lll4l�ll
0 0 0 0 0 0 0 0
c o e o o
0*
co o 0
ooe o o e oo no
f O G OAO e e
COMB Permit: X2018-0344
Project No :
Issued Date : 02/05/2018
Inspection Area : 2
- - PERMITS EXPIRE 180 PAVS VT8P ($,%UAWCeE OR CAS;V#LID INSPECTION.
Construction Hours: Monday - Friday 7:00 a.m. to 6:5Q73.rgle and Sgthrely frorg:%00 p!m. to 6:00 p.m. No work on Sundays or lo�yg
Job Address: 121 CRYSTAL AVE NB
Description: MFR- RE -ROOF 13 SQ. TIO COMPIWOOD SHAKE, RE -SHEET AS NEEDED. INSTALL COMP SHINGLES x
Legal Desc.: BALBOA ISLAND SEC 5 BLK 2 LOT 13To R
p�
Owner: HAMILTON JACK Contractor: D & J ROOFING INC Architect:
Address: 121 CRYSTAL AV Address: P.O. BOX 8788 Address:
BALBOA ISLAND CA 92661
Phone
Applicant: D & J ROOFING INC
Address: P.O. BOX 8788
MAMMOTH LAKES CA 93546
Phone: 760-937-5636
Code Edit: 2016
Type of Construction: V -B
Occupancy Group: R31U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 2
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation: $11.000.00
Building Permit Fee:
$304.00
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: $305.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
MAMMOTH LAKES CA 93546
Phone: 760-937-5636
Con State Lic:
886300
Lic Expire:
10/3112018
Bus Lic:
BT30038799
Lic Exp Date:
03131/2018
Worker's Compensation Insurance
Carrier: ESG
Policy No: WC018974900
Expire: 12131/2018
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: I
Front: I
Left: /
Right: /
'king Spa
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee:
0
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
State Lic:
State Lic:
Special Conditions: < SUBSTANTIAL
IMPROVEMENT
FORM ATTACHED
Planning Department -
Fire Department
Plan check Fee
$0.00
Fair Share
$0.00
SJH Trans
Fire Plan Rev
In -lieu Housing Fee:
$0.00
Public Works Department -
Park Dedication :
$0.00
P/W Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
$0.00 Fee Due at Permit Issuance : $305.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
Fire Department
$0.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $305.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION •• ••• • • •• 00 •"
1 hereby affirm under penalty of perjury that I am exempt from the Contractors' 6tate Litonaea Law for thgYeasop(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 93 mnstr1t,oalter, 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 provisldnslMhe Contrabtors' Statl 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 compe%jc tion:*ill Vo (,)'allObf pr 0 portioljs 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 ofprop arty what 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 imTiAearlIat is sNowitt one yeaCof 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 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 legaill
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
I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Pr, fe sions dex and my li n is'In full force
and effect. License Class License No Da� Contractor Signature ff
WORKERS'COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TC ONE HUND THOUSAND DOLLARS ($700,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
I heyerand 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
pert "mance of the work for which this permit is issued. Policy No.
I h ve 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' compensatiol
insur hce carrier and policy number are:
'er Policy Number Expiration Date
me of Agent
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 agre
t, if I should become ubject to th kers' compens visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
D S C♦"
nature of Applicant —
CLARATION REG R NG S RUCTIO ENDING AG CY
areby affirm under pena f perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, C i1 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 cit or coup enterove-identified property for ins ction purposes.
mature of Pro ee y r'drtv Owner or Authorized AGent '- ->.'-� i��t Property Owner's or Authorized Agent's Nam'J �^ �ar.�-��P Date
DATE BY 1EG3ULATIONS PPARTOMPLIANCE 61 O TIIT E 40 AND AQMD RULEWITH CODE OF
FOR OFFICE USE ONLY
EXPIRED I I I I U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITFINAL 7--1S Lrm 7 L td -ASBESTOS NOTIFICATION S NOTAPP1,IGABLE TO
CERTIFICATE OF PROPOSE EMOLITION
OCCUPANCYISSUED SIGNATU
W
O
U
Z
U
N
z
O
U
c
M
p
LUM
Q
o
0
o
LU
U)
z
v
m
3
7
�
1
o
Q
ww
Q
M
Z
0�
LU
a
Q
U
J
¢
U
¢
OV
W
O
U
Z
U
N
z
O
U
0
0
r
0
a
CL
U
d
W
Pn
o
M
p
09
0
o
m
7
.0
^
J
0
M
V
•0
O
E
o F-
U ti
av
¢¢
v
E
�
Fccsyyt
va
sir
Q
v
Q
Q
0
0
r
0
a
CL
U
d
W
Pn
o
M
p
9
es
C
O
m
7
d
^
J
N
M
V
N
0
a
19
VI
o
N
p
9
es
C
O
N
0
a
19
VI
o
N
Al
N
C
O
m
7
d
^
J
n
�
•0
O
E
o F-
U ti
av
¢¢
v
E
x a oa
a' •�' al O
a 0 a 0 u m 0 a
U p C 0 N .o N C o N
Q C m
CO o c N 6 E 0 a@ m o
.._ CL 0 L U co w tiN+ O N N a3 L E O
U N Q a1 a) r. O
M Q a a7 : O
Ia1 m N y a O C a) .f. 3 N V= O N �,
� co N �' L N Q m O L C
F -i Q co
Q w "O'' Z N '� O Y N E G a 'O
N ~/ a 3 al 7 00 L U O U N o E W C
p� rti �} O 'O 00 U z N '> O N Ncu
U O Z N N Z O C 0 O O N NP CL} >
W Qi O ` O '0 O U O. .. N C a. O
U M N
r O U) (O
N W a� o m E v m t c a ami v_
Azo ° [—+ � v � t � � >1 0) Cc � 'CL
o N
O O w F o m N `o N Q r •o .6 N
W z 3 W '1 •� c _ 0 a) 0 o p 0 N 0 0 c
Co
z) 0. " Q a ; C C C l6 L o' E C a L Q
-r—o W N 0 c a) 3 m rn a 4 N m
q ao m �„� y5 o f> 0 0 E .@ c
c a N m Z y N C.)r(a cn o m
L ca
U m
W �Am° C c6 @-0 2 m E 3 m o a� J�
O o W �l o o c �voi ¢ o' oo cL c aZi E o) N c °� a°i
q a Q V H Q° 0 C 0 L 0 > o w aNi 0 'N a 'E 0 D
O � a) ro F� a Mn y 'm o. o E 3 Y o a�
0 > a p Z p p `o_ as a 0 Z 0 m
a a o0 0 m c a o U E 0 0 c a o
L O N
E �i F O p OC N N E
a F-1 a E o o c N aoi o o o w w > Q
O m Q C N .N. 3 o
O O O N 0 \ E
U O U 0 m O CO " N U C C m
w
C L N In a7 (0 C C N> O. a) 7 N n
0 3 > M o o$ 0 0 E m E CL .� N
p a 3 0 o = p N o o E 0
> aL .c 0 E E E E a° 'a ° p 0
EACR a m p o m E c E C N o C U o
o E = as c Z E 0 —m 0 o m 0 0
0 � �: U O N L o N C Q U N a) N
o N
a c a a 0 m
N 0 g 0 c N@ a � a m E 0 E 3
y "`off d U m .n 3 IL— E� 3 Co
> U w a0 F LL
I
h
N
F a0
�z to
O o
Q U M
w m�
Azc--
F 0 nM
w Z
1 A
to rn
Oc7��
x
�QmCca
w .. 0
m
F > ZSZC
� 5
w
O
U 5
0
0
M
U
J
^JOR
F O`
U
O 3 O
v
Z D
Y
m
O N O U
IL d d
-j
C
7
O)
3
m
L
O
N
U
m
a)
C
O
a
C
m
cu
d
m
O)
C
Q
N
N
L
U
m
a)
N y N
m E E
Nm
C
m m
f0 0 Y
V%
Ea)
m N �
O
m
c
m -oco Y
a) - > U
L xO W-
0
3CL
(n o a
0)EmN
C N
0
m
,O -2 N 7
7
Y
ON E w
E
m m E
m
N a)
ocoo o
. i .
m
7 N
CL
N N
r-
-0 O_� -
-0 U
'a N
o m E
a) _ N
C m U
0.- L 'j
am..�Ya
OO C > L
-
O fl. H
a
E_
°) o
U L
O 'gLO
o_y2
I�
w
m
O
�i
7
N
c
m
m
m fLd
.m+ 0.-C
"OO
Y
y
YO
m
N'00-0
CL U)
.N.
o
CL"O
.=
N
N
O
N
N
U >+
Y
D
N X
mm 0
3 N
O
E'
'OY
CO
_O
O L O
7
O.
a)
N E
a) L ro
0)
D
N
U m
C
C
6 C
42 ca
m N
m
O
�O
M i
O C O
m
m
U
N
o
U
S o m
o
Q c o
U m
L
O o�
ami
m
U
N U
O O
C7 '
N
O
00
E
O
Y
O U
m O 3
CY
E
N;-
O N
C .0 = N
O
a)
Y
0Em
C
a)
C
O r
m
N N
3M
,+em
U
a)
Qa> a
a)
.m.
amC�
U
c
'O E m 'O
C
m
`=
M
W
.-,E U
U)
(D,C
O U
d
O U
E
C
ULm
2c'o0)
Q
C(
� M
O m m
°)
)
O '(O
N V
0
3
N
0
m N
UQ00
o@o
H%:1
m C
m -00 'UN
a) a
6 a)
'` 01U
N ..L. Q
❑
N U
a)Y
H.0 U
(x)U
IM
C
7
O)
3
m
L
O
N
U
m
a)
C
O
a
C
m
cu
d
m
O)
C
Q
N
N
L
U
m
a)
N y N
m E E
Nm
C
m m
f0 0 Y
V%
Ea)
m N �
O
m
c
m -oco Y
a) - > U
L xO W-
0
3CL
(n o a
0)EmN
C N
0
m
,O -2 N 7
7
Y
ON E w
E
m m E
m
N a)
ocoo o
. i .
m
7 N
CL
N N
r-
-0 O_� -
-0 U
'a N
o m E
a) _ N
C m U
0.- L 'j
am..�Ya
OO C > L
-
O fl. H
a
E_
°) o
U L
O 'gLO
o_y2
I�
w
m
O
�i
7
N
c
m
m