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Home My WebLink AboutX2019-2733 - PermitsCity of Newport Beach - Building Division COMB Permit: X2019-2733 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII� II } 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 2 7 3 3 Project NO i. rte., Permit Counter Phone (949)644-3288 ®..° Inspection Requests Phone (949)644-3255 ° r''t1n,uTM� Combination Type -MFP Issued Date 0910412019 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 +m Job Address: 1421 SUPERIOR AVE NB `Description: MFR - T/O COMP SHINGLES: RPLC SHEATHING AS NEEDED: INSTIL 51 SQ COMP SHINGLES ° e Legal Desc.?. TR 10297 LOT 1 UNIT 4 OF PROJECT LOCATED ON AP 424.021-26 TOGETHER .... ° °. o ° Owner PALMER MICHAEL CHARLES Contractor CERTIFIED ROOFING SPECIALISTS Architect + • e °f �.° o.. 'Address: 1701 KINGS RD.. -.Address: -. 9281 LARKSPUR DR 'Address: NEWPORT BEACH, CA 92663 WESTMINSTER CA 92683 se. •'"�«•° Phone: Phone 714-323.7481 Phone: State Lie: °. r e, • ° ° •.e °'. Applicant:. CERTIFIED ROOFING SPECIALISTS. - Con State Lie: 956843. Engineer Address:. 9281 LARKSPUR DR Lie Expire: -01/3112021 Address: - WESTMINSTER CA 92683 Bus Lie: BT30053068 Phone: .714-323-7481 Lie Exp Date: .1113012019 " Phone: State Lie: Code Edit: 2016 :. Worker's Compensation Insurance Designer. ' Type of Construction: V-B Carrier: STATE COMP. INS Address: Occupancy Group: R2 - Policy No: 1949902 Added /New sq.ft. Bldg: 0 Expire:. :1210112019 Phone: Added /New sq. ft. Garage:. - 0 - No of Stories: - 3 Building Setbacks Rear: / Special Conditions: No of Units : 5 Front: / Bldg Height 0 Left: / Bldg Sprinklers: Right. / ` IN Q Flood Zone Use Zone: Parkin Spaces: 0 Fire Hazard Zone :N Construction Valuation:' $23.000.00. - 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 P/W 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: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: - - APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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 7031.6,-15%Iness 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 fidsigned 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 Plgfp1sions Cgdp) osthat 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 thaltfjve 4Adred dollars ($500). 0 h ps owner cif the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Prgfgcsions 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 a of 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 impjg0ed for the purpose of sale). QJ,as owner of Ne property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not aap )y1tH an owner ofproperty who builds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the. Contractors' State License Law). J aln exempt fromalicensure under the Contractors' State License Law for the following reason: Bymy�ignatugeayelovt 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 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 Prb4t tions Coder is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. 9igrhature of Propog)i 8wner 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 ) of ivi on 3 of the Business and'ro essiops Cod e�an y liy se is in full force and effect. License Class License No Dat Q Contras tor Sign tr AfORKERS' 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.-ft- ereby 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 thi Drmance of the work for which this permit is issued. Policy No. 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' carripr and nnlicv numhpr nm Policy Number A4 9q 02 of Agent Date 12—1 - k q I 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 that, if I should become subject to o� the workers' compensation of Section 3700 of the Labor Code, I shall. forthwith comply with those provisions. �t} Signature of Applicant vy Ot4h9! 1 -1 DECLARATION REG NG CONSTRUCTION LENDING AGENCY I hereby 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). Lender's Name Lender's Address By 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 county to enter the above -identified property for inspection purposes. �1 Isignature of Property Owner or Authorized A e� Print Property Owners or Authorized Agent's Name L Date ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED OEPA PERMIT EXTENDED qMD PERMIT FINAL S13ESTOS NOTIFICATION IS NOTAPPLICABLE TO CERTIFICATEOF PROPOSEDDE OUTI N OCCUPANCYISSUED SIGNATURE: