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Home My WebLink AboutX2018-3611 - Permits��gi'V1y City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII� COMB Permit: X2018-3611 '. 100 Civic Center Drive, Newport Beach, CA 92660 _ X 2 0 1 8 3 6 1 1 Project No: Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 '`w �y,.> Combination Type - CIP Issued Date : 11/29/2018 94s a Inspection Area : 7 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: 4101 BIRCH ST NB Description: COMM T/O (E) 32 SQ @ MANSARD, INSTALL METAL ROOFING, CLASS'B' MIN. Legal Desc.: Owner: IRVINE FOUR LLC Contractor: SAN MARINO ROOF CO INC Architect: Address: 11766 WILSHIRE BLVD #820 Address: 2187 N BATAVIA Address: LOS ANGLES CA 90025 ORANGE CA 92665 Phone: Phone: 714.9743070 Phone: State Lic: ° Applicant: MEDINA BEN Con State Lic: 249559 Engineer: .10 Address: 2187 N BATAVIA Lic Expire:; 07131/2020 Address: FMr11 ORANGE CA 92665 Bus Lic:BT30068923 Phone: 818-735-7876 Lic Exp Date: 04/3012019 Phone: State Lic: Code Edit : 2016 Workers Compensation Insurance Designer: Type of Construction: Carrier: REDWOOD FIRE Address: - Occupancy Group: B Policy No: SAWC827135 Added /New sq.ft. Bldg: 0 Expire: 0 710112 01 9 Phone: Added /New sq. ft. Garage: 0� No of Stories: 2 Building Setbacks Rear: I Special Conditions: - No of Units : 0 Front: I Bldg Height: 0 Left: I Bldg Sprinklers: Right: I Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $87.500.00 Building Permit Fee: \ $1,0Y9.00 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 PAN Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $4.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE: $1,033.00 Plan Check Fee: s emo 000 PROCESSED BY: C 4 = Ce o6 P G ZONING APPROVAL: 0 0 GRADING APPROVAL: oc C G L m V C c <c G Geo cos ssc o c. moc me $0.00 Fee Due at Permit Issuance : $1,033.00 PLfBLIV WOPKS°APPROIAL'."o .° oe oo a o 0 o s< soo PLAN CHEt:K BV: @.PPR9VAL°TO ISSUE: oa a ° O p oceos- ms G •°o ccs 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) ction 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 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 fessions 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 more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, dness 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 rovements 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 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 ,ly 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). J 1 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 affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 )G� �(o 4rof the_Busin an Profession n my license is in full force nd effect. License Class License No Date ` Lrt Contractor Signa UORKERS' COMPENSATION DECLARATION IARNING: 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 15100,0001, IN ADDITION TO THE OST 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: I 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 erformance of the work for which this permit is issued. Policy No. I have andtain 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 Isurance carr�and olicy number a ,arrier icy um r Expiration Date lame of Agen Phone # ]I certify that, in the performance of the work this permit is issue o on in any manner so as to become subject to the workers' compensation laws of California, and agre tat, if I should become subject to the w compensatio ns of Section a Labor Code, I shall forthwith comply with those provisions. �n ignature of Applicant icrl AOArinra eer_n I _ rrrnnnl I CKLPMTn Ar ry �- �reby affirm under penalty of perjury tha is a co�ugtion-Wfiding 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 owners behalf. I have read this application and the information I have provided is correcctt. -®�� 1 agree to comply with all applicable city and county ordina at ri-la�.rel g to building construction. I authorize representatives of this city or county .e d d property for inspection purposes. d nature of Prooertv Owner or Authorized ADen Print Propertv Owner's or Authorized Agent's Nam x kill ACTION DATE BY - RATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMITEXPIRED I UISUBMITt !P QI�Ip ASBESTOSKATION ASBES,t5Ni)TI;ICATIONTO • • • • a • • • � � • • IS NO ABLE TO • -:- • • e•• • •. • • • •• • : • � • PERMIT CANCELLED PERMIT EXTENDED PERMITFINAL '1 .`Sy.et0 CERTIFICATE OF 71 �ca•w P POSED DE OL,I ON OCCUPANCYISSUED SIGNAT • .0• • ••• ••• •�• ••e e•e •• • a