HomeMy WebLinkAboutX2019-2142 - PermitsCity of Newport Beach - Building Division IIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIII
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COMB Permit: X2019-2142
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Building Permit Fee:
$324.00
Excise Tax:
$0.00
Planning Department-
Fire Department
o ^� 100 Civic Center Drive, Newport Beach, CA 92660
x 2 6 1 9
2 1 4
2
$0.00
Project No
$0.00
Permit Counter Phone (949)644-3288
$0.00
Grading Bonds Fee:
$0.00
Fair Share :.
Inspection Requests Phone (949)644-3255
Fire Plan Rev
$0.00
Investigation Fee:
$0.00
Issued Date :. 0I2019
$0.00
Combination Type - SFP
$0.00
Demolition Fee
Record Management:
Area
Inspection Area : 4
Grading Permit Fee:
$0.00
In -lieu Housing 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
$0.00
Job Address: 3607 SAUSALITO DR NB
$0.00
Public Works Department -
Description: SFR TIO (E) 35 SQ, INSTALL BORAL ESR#1647, 5.7psi, CLASS 'B'
$0.00
CA Seismic Safety:
Legal Desc.: N TR 6229 LOT 4
WQ Insp. Fee:
$0.00
.Park Dedication: $0.00
Owner: STEDMAN ROBERT Contractor: HOYT ROOFS INC -
Architect
$0.00
Address: 3607 SAUSALITO DR Address: 1809 N ORANGETHORPE PK
Address:
NEWPORT BEACH CA 92625 - ANAHEIM CA 92801.
Grading Bond:
$0.00
Phone: Phone: 714-773-1820
Phone:
State Lic:
.�
Applicant: TAKEOIHOYT ROOFING Con State Lic: 606111
Engineer.
-
Address: 1809 N OTANGETHORPE Lic Expire: 12/31/2020
Address:
Building Green Fee :
$1.00.
ANAHEIM CA 92801 Bus Lic: BT30001509
$0.00
NMUSD Fee: $0.00
Phone: 714-773-1800 Lic Exp Date: 11/30/2019
Phone:
State Lic: -
-
Code Edit: 2016 Worker's Compensation. Insurance -
Designer.
$0.00
Type of Construction VB Carrier: REDWOOD
Address:
$0.00
Occupancy Group: R3 Policy No: HOWC910462
Plan Check Fee
: $0.00 Fee
Added /New sq.ft. Bldg: 0 Expire: 07/2412019
Phone:
PROCESSED BY:
Added /New sq If Garage: o
° _ E
° - ° 09UBLIC WORKS APPROVAL:
No of Stories: 0
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Flood Zone: X
Building Setbacks Rear: I
Front: I
Left: I
Right: l
Special Conditions:
UUnscrucnon varuauUn:
aaa."U."
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 Feer
$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
PM 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:
° _ E
° - ° 09UBLIC WORKS APPROVAL:
ZONING APPROVAL:
_ <
` °PLAN CHECK BY:
GRADING APPROVAL:
<�
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APPROVAL TO ISSUE:
c
c
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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
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 `) all of or (_) 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
im 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
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).
❑ 1 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 legall)
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.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 i i n 3 of the Business and P f ton C le, and my lice a is in full force
and effect. License Class License No Dat Contractor Signal
NORKERS' COMPENSATION DECLARATION
NARNING: 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 ($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:
3 1 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
ierformance of the work for which this permit is issued. Policy No.
have 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'
rance carrier 9118loolicy number are;.—
of
res
Date
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
if I should become su ect to the Workers' compen ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
latur-e of Applicant .. .,. ,.,.. ,�,,..,,.....-...,,.,,, ..,,., a
Ireby 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 city or coun n. er Wve-i ntifi rty for inspection purposes.�/
nature of Prooertv Owner or Authorized Aaent Print Property Owner's or Authorized Agent's l l�
DATE I BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO
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