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Home My WebLink AboutX2019-1205 - Permits,. City of Newport Beach - Building Division IIIIIIillllllllllll�lllllllllllllllllllllllllllll COMB Permit: X2019-1205 $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 Fire Department as 100 Civic Center Drive, Newport Beach CA 92660 X 2 0 1 9. 1 2 0 5 $0.00 Project No : 2355-2018 ) N =, Permit Counter Phone (949)644-3288 Fair Share : =s Inspection Requests Phone (949)6443255 - $0.00 - r'x yob', �.lerrri Combination Type -CIP. - $0.00. Issued. Date :04/11612019 0 $0.00 In -lieu Housing Fee : Inspection Area ; 7 $0.00 Building Dept Adm $0.00 $0.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. General Service $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 Job Address: 2920 NEWPORT BLVD NB Refund Deposit Description: COMM REMOVEIREPLACE (E).4 SQ OF B.U.R, CLASS B, CRRC#0628-0002 PAN Plan Check.: $0.00 Legal Desc.: LANCASTERS ADD LOT 23 BLK230(AND ALL -EX POR TO ST- LOT 24 BLK 230 $0.00 $0.00 Owner: FEUERSTEIN ARNOLDIELLIOTT Contractor:: PREMIER ROOFINGIBLDG CO INC Architect: Address: 8294 MIRA MESA BLVD Address: 17501 NORWOOD PARK PLACE Address: $0.00 SAN DIEGO CA 92126 TUSTIN CA 92780 $0.00 J Phone: Phone: 714-573.0155 Phone: State LI $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : Applicant. PREMIER ROOFING/BLDG CO INC Con State Lic: 634404 Engineer. a y Address: 17501 NORWOOD PARK PLACE Lic Expire: 12/31/2019 Address:.- 'TUSTIN CA 92780 Bus Lic: BT30058009 Phone: 714.573.0155 Lic Exp Date: 01131/2020 Phone: State Lic: m m Code Edit: 2016 Type of Construction: V -8 -SPR Occupancy Group: A2/13 Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Flood Zone:. Construction Valuation: $6.1 Building Permit Fee: $168.00 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 Workers Compensation Insurance Carrier: REDWOOD FIRE Policy No: PRWC918371 Expire: 1 012 8/201 9 Building Setbacks Rear:. / m ° mo 0 Front: / 00000 0 Left: / oc000 Right: / TOTAL FEE: $169.00 PROCESSED BY: ZONING APPROVAL: Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Designer: Address: Phone: Special Conditions: A01 FLOODZONE mmo o momo m000cr • r ® o 0 • ommmmm ® o ° a 00000 m ° mo 0 m ° 0o m 00000 0 m oc000 000 0 � cco moo0oo 0 u 0 PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: eooc omoo $0.00 Planning Department - Fire Department $0.00 Plan check Fee: $0.00 Fire Inspection:. $0.00 $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 $0.00 SJH Trans: $0.00. Demolition. Fee $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 $0.00 Public Works Department - General Service $0.00 $0.00 Park Dedication: $0.00 Refund Deposit $0.00 PAN Plan Check.: $0.00 Grading Bond: $0.00 $0.00 San Dist: $0.00 $0.00 NMUSD Fee: $0.00 $0.00 $0.00 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $169.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that 1 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 Coder 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 L) 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). ❑ I 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 legally sell a structure that I have built as an owner -builder if it has not been constructed in its entirely 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:hftp:l/www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affigg under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 ) of !via! n 3 of the Business and Prof od my license is in full force and effect.- � icgUSE Class License No Date < Contractor Sign QRKERP.r.OMPENSATION DECLARATION ARCING: FAILUPATQSECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNO RED THOUSAND DOL RS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 1 have an; VIr Laintain 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 rf2fmance of thgyvork for which this permit is issued. Policy No. ave an4w11maintain 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 ln;ayr1hce carrier pnd policy number are: CS3rver• Policy Number Expiration Date �iTIE of Agent' • • • • Phone # 0ee4y that, iR th8 perfor ante 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 fhaq 1f•1 should b®eor Te su ject to the s' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant Dat _ 41//4 DECLARATION IN CONST UCTION LENDING AGENCY I hereby affirm under p nalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309/Civil 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 cojmty ordinances and state laws relating to building construction. I authorize representatives of this city or cou to tified property for inspection purposes. 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