HomeMy WebLinkAboutX2018-3663 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIII�
COMB Permit: X2018-3663
100 Civic Center Drive, Newport. Beach,
CA 92660
X 2 0 1 8
3 6 6 3
Construction Valuation: $5,800.00
Project No
Permit u Phone
Building Permit Fee: $324.00
Inspection Req Requests Phonnter
e (949)6443255
$0.00
Planning Department-
Combination Type- SFP
Plan Check Fee: $0.00
Additional Fee:
Issued Date : 2018
Plan check Fee:
$0.00
Fire Inspection:
$0.00
Area
Inspection Area ; 2
Grading Bonds Fee:
$0.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
$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
Investigation Fee: $0.00
Job Address: .226 AMETHYST AVE NB
$0.00
SJH Trans :
$0.00
Demolition Fee
Description: SFR REROOF T/O FLAT ROOF AND REPLACE W/ TORCH DOWN SYSTEM CLASS "B" 9 SOS
Record Management: $0.00
Grading Permit Fee:.
$0.00
Legal Desc.: BALBOA ISLAND SEC 3BLK 20 LOT 14
$0.00
Building Dept Adm
$0.00
Energy Compliance: $0.00
Owner: ;,' VAUTRIN DAVID -
Contractor:
JH ROOFING
Architect:
General Service
$0.00
Address:. 226 AMETHYST AVE
Address:
190 B COSTA MESA ST
Address:
$0.00
NEWPORT BEACH, CA 92660
$0.00
COSTA MESA CA 92627
,A
PNV Plan Check:
Phone:
Phone:
714-402-6481
Phone:
State Lie:
Electrical %:
$0.00
San Dist:
$0.00.
Applicant: JH ROOFING
Con State Lie:
1008577
Engineer:
e e
Address: 190 B COSTA MESA ST
Lie Expire:
1013112019
Address:
- ° • ° ° °
COSTA MESA CA 92627
Bus Lie:
BT30060846
$0.00
TOTAL FEE : $325.00
• °
Phone: 714402-6481
Lie Exp Date:
10/31/2019
Phone:
State Lie: o
Code Edit : 2016
Worker's Compensation Insurance
Designer
o e
Type of Construction: V-B
Carrier:
STATE COMP
Address:
Occupancy Group: R3/U
Policy No:
9145801
i�n,.
;:,'V"
Added /New sq.ft. Bldg: 0
Expire:.
10/29/2019
Phone:
,.,
,
-Added /New sq. ft. Garage:. 0_
No of Stories: - 2
Building Setbacks
Rear: /
Special Conditions: AE FLOODZONE "�
No of Units: 1.
Front: l
Bldg Height: 0
Left: 1
0..060
Bldg Sprinklers:
Right: I
Flood Zone
Use Zone: Parkina S aces: 0
Fire Hazard Zone : N
00ooe°
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
_PUBLIC. WORKS APPROVAL:._.
PLAN CHECK BY:
APPROVAL TO ISSUE:
Construction Valuation: $5,800.00
Building Permit Fee: $324.00
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
PNV 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 : $325.00
Plan Check Fee:
$0.00
Fee Due at Permit Issuance:
$325.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
_PUBLIC. WORKS APPROVAL:._.
PLAN CHECK BY:
APPROVAL TO ISSUE:
OWN
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) 1 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
is 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
'rofessions 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
of more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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.
nprovements 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
nproved for the purpose of sale).
1 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 doeii not
pply 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:
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 legall)
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.govtcalaw.htm].
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm urldonpenalty of per that that I am licensed under provisions of Chapter 9 (commencing with Section 70 0) of ivisi n 3 of the Business and Prof ssions Co �, and my f e ee is in full force
jid effect. License Cl?ss C h ( License No j L'X>S Date / Z / Contractor Signatur
MIRVIRS' COIF RUSATION DECLARATION
�ARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PENALTIES AND CIVIL FINES UP TO ONE HUN RED THOUSA DOLLARS ($700,000), IN ADDITION TO THE
OSY OFeOOMPENSATION, 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:
rbave and wit Alintain 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
9rgVnce of tbg%trk forwhich this permit is issued. Policy No.
Bve 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
"jaFop carrier an'd policy number are:
arner -,A✓ — :rm Policy Number 1115-9-0) Expiration Date
'rarRe.of.Agent - Phone #
JI b9itify that, Iih tlie. g�rf rmance o. 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' ompensation laws of California; and agre
sat, if I should become bject tot a workers' com s tion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignalureof Applicant D e_ 5 7v
DECLARATION REG RDING STRUCTION LEND AGENCY
hereby affirm under enalty of perj ry that there is a construction lending agency for the performance of the work for which this permit is issued (Section 30 7, Civil Code).
ender's Name Lender's Address
my signature below, I certi to a ch of the following:
I am the property owner or a rized to act on the
I have read this application and the information I by
I agree to comply with all applicable city and couW�//y
I authorize representatives of this city or county e
DATE I BY
EXPIRED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY ISSUED
Ier's behalf.
is correct. /�
and state I yrelating to building construction..
ve-idept!fi roperty for inspection purposes.
I OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
PART 61 OF TITLE 40 AND AQMD RULE
SUBMITTED ASBESTOS NOTIFICATION TO
NOT
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