HomeMy WebLinkAboutX2019-2766 - Permitsnog
City of Newport Beach - Building Division
Address:
901 BAY AVE W
Record Management:
100 Civic Center Drive, Newport Beach, CA 92660
Phone:
Permit Counter Phone (949)644-3288
-
Inspection Requests Phone (949)644-3255
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Combination Type - MFP
COMB Permit: X2019-2766
x 2 e, 1 9 2 7 6 6 Project No:
Issued Date : 0 910 6/2 01 9
Inspection Area : 1
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
Job Address: 302 E BAY AVE NEI
Description:. MFR- TIO (E) COMP. RPL SHEATHING AS NEEDED. INSTIL 1 LAYER 30# FELT. INSTIL 15 SQ COMP SHINGLES
Legal Desc.: NEWPORT BAY TR SUB OF BILK C LOT 78
Owner:
THURMOND ROBERT SEYMOUR
Address:
901 BAY AVE W
Record Management:
NEWPORT BEACH, CA 92661
Phone:
$0.00
Applicant:
HERBERT JERRY ROOFING INC
Address:
1215311TH STREET
Hazardous Mat
YUCAIPA CA 92399
Phone:
909-790-3644
Code Edit: 2016
Type of Construction: V -B
Occupancy Group: R31U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units: 2
Bldg Height: 0
Bldg Sprinklers:
Flood Zone:
Building Permit Fee: $324.00
Plan Check Fee: $0.00
Overtime Plan Ck
$0.00
Investigation Fee:
$0.00
Record Management:
$0.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
Contractor: HERBERT JERRY ROOFING INC
Address: 1215311TH STREET
YUCAIPA CA 92399
Phone: 909-790-3644
Con State Lie:
407932
Lie Expire:
07131/2020
Bus Lie:
ST30068793
Lie Exp Date:
0913012020
Worker's Compensation Insurance
Carrier:
STATE COMP INS FUND
Policy No:
9068630
Expire:
01/0112020
Building Setbacks
Rear: I
Address:
Front: I
Phone:
Left: I
Designer:
Address:
Right: I
Architect:
$0.00
Address:
ZTOR
Phone:
.State Lic:�S1 E
Engineer:
Demolition Fee
Address:
$0.00
Phone:
State Lia
Designer:
Address:
NOISE
Phone:
NO CONSTRUCTION
Grading Permit Fee:
$0.00
Special Conditions:
Grading PC Fee:
THE WEEKEND
Public Works Department -
ON
Fire Hazard Zone :
N
Excise Tax:
$0.00
Planning Department -
Fire Inspection:
Additional Fee:
$0.00
Plan check Fee
Demolition Fee
Grading Bonds Fee:
$0.00
Fair Share:
General Service
Grading PC Consultant:
$0.00
SJH Trans :
Grading Bond:
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
Grading PC Fee:
$0.00
Public Works Department -
WQ Insp. Fee:
$0.00
Park Dedication:
$0.00
PM Plan Check:
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$0.00
TOTAL FEE: $325.00
PIEONES^EDSY:�
° °
ZONING APPROVAL:
Gi? A(,INPo1APPROVAL:
o
Plan Check Fee: $0.00 Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$325.00
Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
Plan Check Fee: $0.00 Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$325.00
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) 1 have placed next to the applicable items)
(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,%nd
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
improved 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 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
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of per'ury that I am licensed under provisions of Chapte 9 ((commencing with Section 7000) of Division 3 of the Business and Profs Codey ayld rr�y license is in full force
and effect. License Class t ^ 3� License No y 57 q 3 2 Date Contractor Signature, 'W T
WORKERS' 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.
I hereby 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 the
D -e -t rmance of the work for which this permit is issued. Policy No.
SII h ve and will maintain workers' compensation insurance, as -required by Section 3700 of the Labor Code, for the pertormance of the work for which this permit is issued. My workers' workers' compensation
nsura a carrier and policy number are: 2 9
Carrier -i"t Policy NumberExpiration Date
of Agent ^�'�'M1-L Phone # 2 — �.-
291 certify that, in the performance of thework 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 agree
:hat, if I should become subject teyvorkers' cOmp,�nsatiOn p isions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �— 9
Signature of Applicant IV /�JN�/-ti/'r- f DAA_ —�
CLARATION REGAR011w STRUCTION LENDING AGENCY
areby affirm under, I f perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Cade).
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 county to enter the above -identified property for inspection purposes.
Owner or Authorized
PERMIT EXPIRED
PERMIT FINAL
CERTIFICATEOF
OCCUPANCY ISSUED
BY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
LJ I SUBMITTED ASBESTOS NOTIFICATION TO
NOTIFICATION IS NOTAPPLICABLE TO
FOR OFFICE USE ONLY
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