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X2019-2105 - Permits
City of Newport Beach - Building Division t' PerrmitCounter Phic Center one one (949)844 -ort Beach 88 h, CA 92660 ' aY .Inspection Requests Phone (949)644-3255 °+� )k Combination Type MFP IIIIIIIXII�II�IIIIII�I�I�II�I�II�II��III�III�I�I�I�IIII COMB Permit: X2019-2105 `r Project No : LOMA CA Phone: 909-229.6130 07/31/2021 - Bus Lic: BT30068016 Address: Issued Date: 07/()8/2019 Job Address: Construction Hours: Monday: 111 CRYSTAL AVE Inspection Area: 2 Friday 7.00 aPm. to 6:30 Description . NB MFR REMOVE EXISTING B.U.R AND REPLACE p.m. and Saturday from 8:00 a.mIto 8,•00 p.m. Na work on Sundays or Holidays Legal Desc : BALBOA ISLAND SEC 5 BLK 2 LOT8 W/ MODIFIED TORCHDOWN B.U.R CLASS B 21 SQS „° c Owner BAKER ROBERT C BA Designer. ,, OB�psc� Address: Phone: CRYSTALR013RT NEWPORT BEACH, CA :Contractor. MC GRAIL TOM ROOFING Address: 8729 BEECHWOOD DRIVE Architect Address: Y oa - ALTA LOMA CA Phone: 909-229-6130 : e Applicant. Address. MC GRAIL TOM ROOFING: 8729 BEECHWOOD DRIVE Phone: Con State Lic:,. g73gg7 - .State Lic: • ° ooe+ - ALTA Lic Expire Engineer San Dist: LOMA CA Phone: 909-229.6130 07/31/2021 - Bus Lic: BT30068016 Address: °+e b • ° - Code Edit: - Lic Exp Date.. 07/30/2020 Phone: ° • 2018 Type of Construction: V Worker's Compensation Insurance - State Lic: „ „° c -S Occupancy Group: R3/U Carrier. CA INS CO Designer. Green Fee : - $1.00 Added /New sq.ft.Bldg. Policy No: 4686315101 Address: - Added /New sq. ft. Garageg Expire: 01/01/2020 $0.00 .Electrical %: $0.00 No of Stories; 2 - Phone: $0.00 San Dist: No Units p Building Setbacks Rear: i $0.00 ° $0.00 Bldg Height: Bldg Height 0 Front / Special Conditions: LIQUEFACTION Bldg Sprinklers: Left Flood Zone: Right: / Construction Valuation: - S9 600 00 Use Zone: Parkin S aces: Fire Hazard Zone : N g Permit Feer $324.00 heck Fee: $0.00 $0.00 $0.00 e Plan Ck: $0.00 igation Fee: $0.00. Management.: $0.00 Compliance: $0.00 ismic Safety : $0.00 d Access :. LLHazardousMat $0.00 ousMat $0:00 Green Fee : - $1.00 TOTAL FEE : $325.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Excise Tax: , Additional Fee: $0.00 Planning Department- $0.00 $0.00 Grading Bonds Fee: $0.00 Plan check Fee: Fire Plan Rev Demolition Fee Grading PC Consultant : .$0.00 $0.00 Fair Share $0.00 Grading Permit Fee: $0.00 SJH Trans Grading PC Fee: $0.00 In -lieu Housing Fee Grading Bond: WQ Insp. Fee: $0.00 Public Works Department - Park Dedication : $0.00 .Electrical %: $0.00 PAN Plan Check: $0,00 Mechanical %: $0.00 San Dist: $0.00 Plumbing %: $0.00 NMUSD Fee: $0.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance n PUBLIC WORKS APPROVAL: - PLAN CHECK BY: APPROVAL TO ISSUE: $0.00 $0.00 $325.00 Fire Department $0.00 $0.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev Demolition Fee $0.00 $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance n PUBLIC WORKS APPROVAL: - PLAN CHECK BY: APPROVAL TO ISSUE: $0.00 $0.00 $325.00 OWNER -BUILDER DECLARATION Licenseel w air he structure, prior to its issuance, also requires the applicant for I hereby affirm under penalty of perjury that I am axecmpofrcounty that requires a permit to co sl uct for improve,ldemol demolish. or rep i they heckmark(s) I have placed next to the applicable items) ction 7031.5, Business and Professions Code: Any Y 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 permit to file a signed statement that he or she is licensed pursuant to the provisions it the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business an fmoreis Code) or that he 11 s provided that the more than five hundred dollars ($500). will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, I, as owner of the property, or employees with wages as their sole compensation, einess 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, p )rness and 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).. art who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 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 ply to an owner of property I am exempt from licensure under the Contractors' State License law for the following reason: of the licable law, Section 7044 of the Business and 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 legal II 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 pp Date ofessions Cotl@,%available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. gnature of�soperly Owner or Authorized Agent I�,� SED&ONTi2ACTOR'S DECLARATION Date Contractor Signature gna ur a0040)Wi penalty of perjury that I am licensed under cense provisions of Chapter 9 (commencing with Section 70 )%f i o of the Business and Profess' s ode, and 'c se} in full force der ideffect. License Class - IN HE ©RKERS' �ONSPENSATION DECLARATION ARMING: FARlf Q JMPEN E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRININ PENALTIES AND CIVIL FINES UP TO ONE HUND D THOUSAND DOLLARS (E'100,0001, IN ADDITION TO T LISTA COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. th hej' affirm 14e; ;penalty of perjury one of the following declarations: L Ylave and wll1 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 Q ance of she w0 for which this permit is issued. Policy No. .••. a and 3✓11 maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance Ezpeationwork Datewhich this permit is issued. My workers' compensa I ee carrier.�nd pplicy number are: Policy Number Phone # • • • . ;awier dame of Agent ensthis ermil o f Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /^ �I certify that, in the pperfan a 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 wo/7ivI rkes' comp nsalion laws of California, an agprovi .hat, if I should becomc o the worker Signature of ApplicanDECLARATION REGG CONSTRUCT ON LENDING AGENCYI hereby affirm underof perjury that there is a construction lending agency for Lt e pert Address of the work for which this permit is issued (Section 3l Code). Lender's Name By my signature below, I certify to each of the following: I am the property owner orauthorized to act on the properly owner's behalf. I have read this application and the information I have provided is correct..cc building ` I agree to comply with all applicable city and conn MI the above ideances and ate a property lrinspect on purposes. C Da I authorize representatives of this city or county C Print Pro art Owner's or Authorized A ant's Name Si nature of Property Owner or Authorized Agent DATE DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY ACTION BY vccl U.ATmNS PART 61 OF TITLE 40 AND AQMD RULE IS NOT APPM*A9LE-TO CERTIFICATE OF nrn IPANfY ISSUED (Dm (D .-�. A N CD (D S (D N i O N O 0 � o a °103" 47 CD (D O j CL N N (n. . k a.�m M W CD G. T.(D. O N O. (D D1 7. (n rt N _ N (D d -°'m 03N c . CO, `< �' O Q0 W_�.� G N to n � N � W v N a N 3 w(D v m Q 3 -� (D ama W N .. O IIi N D1 p1 3 O N D1 (p Qfl.. 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