HomeMy WebLinkAboutX2019-2100 - Permitsw City of Newport Beach -Building Division
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OMB Permit :X2019-2100
100 Civic Center Drive, Newport Beach, CA 92660
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''. Permit Counter Phone (949)644-3288
Project NO
ei Inspection Requests Phone (949)644-3255.
Combination Type - SFP
-
Issued Date : 07/05/2019
Inspection Area : 5
' 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 am. to 6:00 p.m- No
work on Sundays or Holidays
Job Address: 2615 COVE ST NB
Description: SFR REMOVE (E) 18 OFB.U.R, INSTALL MODIFIED BITUMEN,
CLASS'B'MIN
Legal Desc.: CORONA DELMAR LOT 4 BLK B32(AND LOT 12 BLK B32
Owner BEDARSKI Contractor
GUARDIAN ROOFS Architect:
Address: 71 SUMMERSTONE Address.
1010 N. BATAVIA #F Address:
IRVINE CA 92625
ORANGE CA 92867
tryy
Phone, Phone:
951-264-0008
Phone:
State Lie:
�A1 �
Applicant GUARDIAN ROOFS Con State Lie
847279
Engineer.
Address: 1010 Nr BATAVIA #F Lie Expire:
09/30/2020
Address:
ORANGE CA 92867 Bus Lie:
BT30054609
Phone 951-264.0008... Lie Exp Date:
05131/2020
Phone:
State Lie
Code Edit: 2016 Worker's Compensation Insurance
Designer:.
'g t
rtJ
Type of Construction: VB Carrier:.-
STATE FUND
Address:
-
Occupancy Group: R3/1.1 Policy No:
9077388
Added /New sq.ft. Bldg: 0 Expire:
03101/2020.
Phone:
-.. Added /New sq. ft. Garage: 0
No of Stories: 0 Building Setbacks
No of Units: 1 -
Rear: /
Special Conditions: LIQUEFACTION AREA
Bldg Height: 0
Front: /
Left:
Bldg Sprinklers:
Right: I
Flood Zone: X Use Zone: Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: 55.600.00
Building Permit Fee: $324.00 Excise Tax:
$0.00
Planning Department-
Fire Department
Plan Check Fee: $0.00 Additional Fee :
Overtime Plan Ck: $0.00
$0.00
Plan check Fee: $0.00
Fire Inspection: $0.00
Grading Bonds Fee:
Investigation Fee $0.00 Grading PC Consultant:
$0.00
$0.00
Fair Share :: $0.00
SJH Trans`.. $0.00
Fire Plan Rev $0.00
Record Management: $0.00 Grading Permit Fee:
$0.00
-
In -lieu Housing Fee: $0.00
Demolition Fee
Building Dept Adm $0.00
Energy Compliance: $0.00 Grading PC Fee:
$0.00
Public Warks Department -
General Service $0.00
CA Seismic Safety: $0.00 WO Insp. Fee:
Disabled Access : $0.00
$0.00
Park Dedication : $0.00
Refund Deposit $0.00
Hazardous Mat $0.00 Electrical %L:
$0.00
PAN Plan Check: $0.00
San Dist: $0.00
Grading Bond: $0.00
-
Building Green Fee :. $1.00 Mechanical %L:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00.
$0.00
-
TOTAL PEE : $325.00 Plan
Check Fee:
$0.00 Fee Due at Permit Issuance : $325.00
PROCESSED BY:
PUI8LI[C,W0RKS APPROVAL:
..ZONING APPROVAL:
PLAN CHECK eG: ` P
GRADING APPROVAL:
., APPROVAL TSO ISSUE:
_
UV's Ci cC .V U(i
OWNER -BUILDER DECLARATION
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)
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
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
2rofessions 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
iot more than five hundred dollars ($500).
1, 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,
3usiness 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
mprovements 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
m roved for the purpose of sale).
1, 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
ap 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).
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 legal
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.govicalaw.htmi. Date
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section Business and Profs ode, and my of Division 3 of the BusiI' t 'saa1ul14n.�e
and effect. License Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRD THOUSAND D LLARS ($700,000), IN ADDITION TO TH
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:
111 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 t
pe)formance of the work for which this permit is issued. Policy No.
have and will ma
rance carrier and
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
Inumber are:
,xr.,,,,,.,,,,L1.,,.,(1 Expiration Date
ne of Agent
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
I, if I should become sub' ct iq the workers' compengation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. i� �
nature of Applicant /� Dat �' -5^-
CLARATION REGA I�ONSTRU ION LENDING AGENCY ��
areby affirm under penalty of perjury that there is a construction lending 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 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 county � r�r the abov ntified property for inspection purposes. �/ r(\ � /
P,...,...__- _. a n..e.,.V 'A� ke.. � — Print Propertv Owner's or Authorized Agent's Name ag 6 v —
ACTION DATE BY DECLA ATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED (SUBMITTED ASBEST S NOTIF•II!ATIQ9 W
PERMIT CANCELLED EPA `°+ : • +•• • • ` °
PERMIT EXTENDED S"'" • ++ • • • • • • • �
PERMITFINAL AS EST NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATEOF PRO ED E OUTION / .+,_... •.•
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