HomeMy WebLinkAboutX2019-3249 - Permits1, City of Newport Beach - Building Division Ililllllllllllllllllllllllllllllllllllllllilllllll COMB Permit: X2019-3249
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 _.3 2 a 9 Project No:
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
a xn� Combination Type- MFP Issued Date'. 1 0/1112 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:.3322 VIA LIDO NB
Description:MFR - TIO TILE, APPLY2-LYR FELT WICLASS "A" 30 YR COMP 24 SQS
Legal Desc : - -
Owner: STUPIN ANDREW - Contractor ( TRC ROOFING Architect:
Address: -3322 VIA LIDO ` Address: 3553 ATLANTIC AVE #322 Address:
NEWPORT BEACH CA 92663 LONG BEACH CA 90807
Phone: 714402-1185 Phone: 562-682-9027 Phone: State Lic:
Applicant: TRC ROOFING Con State Lic 712184 Engineer:. "gID
Address: 3553 ATLANTIC AVE #322 Lic Expire. 1113012020 Address:
LONG BEACH GA 90807 Bus Lic BT30064946
Phone 562-682-9027 Lic Exp Date: 1013112019 Phone: .State Lic
Code Edit: 2016 Worker's: Compensation Insurance Designer:
Type of Construction VB Carrier: STATE COMP INS FUND Address10
Occupancy Group: R31U Policy No: 1830086
Added /New sq.ft. Bldg: 0 Expire 06/01/2020 Phone:
Added /New sq. ft. Garage:, 0
No of Stories: 2 Building Setbacks Rear / ` Special Conditions: HIGH DENSITY AREA
No of Units.:: 2 Front:. /::.
Bldg Height: 0 Left
Bldg Sprinklers: Right
Flood Zone. Use Zone: Parking Spaces: 0 Fire Hazard Zone : N
Construction Valuation: $10.500.00. -
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 Feer $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 IND Insp. Fee $0.00 - Park Dedication $0.00 Refund Deposit - $0.00
Disabled Access: $0.00 PAN 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 %o`.. $0.00 $0.00
TOTAL FEE : $325.00 Plan Check Fee : $325.00 Fee Due at Permit Issuance : $0.00
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 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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do U 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).
1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, BusinessandProfessions Code: The Contractors' State License Law doesn0t.
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 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 Cade, 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 perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
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 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 th
performance of the work for which this permit is issued.. Policy No.
1:11 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' compensatio
insurance carrier and policy number are:
Carrier Policy Number Expiration Date
Name of Agent Phone he
❑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 agree
that, if I should become subject. to the workers' compensation provisions of Section 3700 of the Labor Code, I shall. forthwith comply with those provisions.
Signature of Applicant Date_
DECLARATION REGARDING 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.
Signature of Property Owner or Authorized Agent - Print Property Owner's or Authorized Agent's Name 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 LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED DEPA
PERMIT EXTENDED QMD
PERMIT FINALVit)-LZ/q. ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF l 1 PROPOSED DEMOLITION
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