HomeMy WebLinkAboutX2019-2331 - PermitsCity of Newport Beach - Building Division
a 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - SFP
IIIIIIIIIIIIIIIIIII�IIIIIII�II�IIIIIIIIII IICOMB Permit: X2019-2331
X 2 9 1 9 2 3 3 1 Project No :
Issued Date : 07/25/2019
Inspection Area : 3
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: 1311 GALAXY DR NB
Description: SFR REMOVE (E) 56 SQ REPLACE UNDERLAYMENT, RE -INSTALL (E) TILE, CLASS'B'
Legal Desc.: N TR 4224 LOT 237
Owner: AFSHAR
Contractor:
SOCAL ROOFING COMPANY
Architect:
Address: 1311 GALAXY DR
Address:
13182 ROBERTA PL
Address:
m
NEWPORT BEACH CA 92660
GARDEN GROVE CA 92843
-
Phone:
Phone:
714-936-7851.
Phone:
State Lic:
Applicant: SOCAL ROOFING COMPANY
Con State Lic: 1013621
Engineer:
�Zop�
!9J
Address: 13182 ROBERTA PIL
Lic Expire:
04130/2020
Address:
GARDEN GROVE CA 92843
Phone: 714-936-7851
Bus Lic:
Lic Exp Date:
BT30068264
0713112020
Phone:
State Lic:
Code Edit : 2016
Worker's Compensation Insurance
Designer:
Type of Construction: VB
Carrier:
STATE COMP.INS.
Address:
_1
Occupancy Group:. R3/U
Policy No:
9156840
Added /New sq.ft. Bldg: 0
Expire:
04113/2020
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 0
Building Setbacks
Rear: I
Special Conditions:
No of Units : 1
Front: I
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: I
Flood Zone: X
Use Zone:
Parking Spaces:
0
Fire Hazard Zone: N
Construction Valuation: $21.500.00
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 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
o
Plan Check Fee:
$0.00
Fee Due at Permit Issuance :
$325.00
my m olit
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PROCESSED BY: o _ _ o o®
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PUBLIC WORKS APPROVAL:
ZONING APPROVAL: o
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO ISSUE:
o < oa c o
00 000 0
eo 0 000
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) T
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
is 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
'rofessions 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).
I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or `) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements 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
nproved for the purpose of sale).
1 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
pply 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).
7 I am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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,
ell 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
'rofessions 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
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 ) of Division 3 of the Business and Pr essions Code 'cense is in full force
nd effect. License Class License No Da0'7 - Contractor Signatur
VORKERS' COMPENSATION DECLARATION
,ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (§100,000), IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 9706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations: -
I 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
illwmance 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'
carrier and policy number are:
ne of Agent
certify that, in the performance of the
, if 1 should become subject to the00
Policy Number
Date
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
/ -'I/ ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applican{�V /� „r Date_
DECLARATION REWDINIS CONSTRUCTION LENDING AGENCY
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 ode).
ender's Name Lender's Address
y 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 e¢ter the above -identified property for inspection purposes.
innah Ue of Prnnwrty Owner or Authorized Anent ;k Print Prooertv Owner's or Authorized Acent's Name Jr) A,,,, -�,.e.J .�
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
/REGULATIONS PART 63 OF TITLE 40 AND AQMD RULE
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PERMIT EXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO•
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