HomeMy WebLinkAboutX2019-3291 - PermitsRrj City of Newport Beach - Building Division
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COMB Permit: X2019-3291
100 Civic Center Drive, Newport Beach, CA 92660
X 2 0 1 9 3 2 9 1
Project No
' Permit Counter Phone (949)644-3288
t Inspection Requests Phone (949)644-3255
0
'���xsriwc� " Combination Type -SFP
Issued Date : 10117/2019
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: 2006 GALAXY DR NB
Description:. SFR REROOF W/ CLS"A" COMP,
TIO COMP (25 SOS), APPLY ADO'L LAYER OF
SINGLE PLY TPO (21 SO$), APPLY SINGLE PLY TPO, T/O ROCK (12 SQS)
Legal Desc.: N TR 4224 LOT 14
-
Owner. BRADFORD GEORGE
Contractor FAIRWEATHER ROOFING INC Architects
-
Address: 239 OCEAN VIEW AVE
NEWPORT BEACH, CA 92663
Address: 1212 E ASH AVE Address:
CA 92831
FULLERPhone:
'^\I
P Fl/. 1,T
OR
Phone..
714-997-94490
Phone:
StI9
LC:S
• `w •
Applicant FAIRWEATHER ROOFING INC
Con State Lie: 770565
Engineer.
Address. - 1212 E ASH AVE
- Lie Expire: 10131/2021
Address:
FULLERTON CA 92031 -
Bus Lie:' BT30063244
Phone: 714-997-9449 ''
Lie Exp Date: < 05/31/2020
- Phone:
State Lie:
Code Edit: 2016
Worker's Compensation Insurance
Designer.
Type of Construction: VI3
Carrier CALIF INS CO
Address:
° o.
Occupancy Group: R31U
Policy No: WC018971701°POGO
Added /New sq.ft. Bldg:. 0
Expire: 12/31/2019
Phone:
°
Added /New sq: ft. Garage; 0
.....
No of Stories: 1
Building Setbacks Rear: I
.Special Conditions:
- No of Units: 1
Front: L
Bldg Height: 0
Left: 1.
Bldg Sprinklers
- Right: I
Flood Zone
Use Zone: Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $30.000.00
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
Overtime Plan Ck .$0.00
Grading Bonds Fee: $0.00
Fair Share:. $0.00
Fire Plan Rev '$0.0Q
Investigation Fee. $0.00
Grading PC Consultant : $0.00
SJH Trans : $0.00
Demolition Fee. 19 0
Record Management: $0.00
Grading Permit Fee: $0.00
In -lieu Housing Fee ,. $0.00
Building Dept Adm so.W °°°
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 : $2.00
Mechanical %: $0.00
NMUSD Fee: $0.00
$0.00
Plumbing%: $0.00
-
'$0.00
TOTALFEE : $326.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance : $326A0
PROCESSED BY:
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO ISSUE:
1
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 cneckmark(s) I haveplaced 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 L) all of or L) 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 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 Code, is available uponrequeist 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
1 hereby affirm under penalty of perjuryry that I am licensed under provisions of Chaptz JErnmencing with Sec n 7000) of Division 3 of the B -siness and Professio d m li s is e
and effect. License Class C. "� License No ` 17E� D ' tm T i—/� Co ractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FIN UP TO ONE HUNDRED. THOUSAND DOLLARS ($700,000(, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirpi Vader penalty of perjury one of the following declarations:
El I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for IN
.•.
rmarP-d1he work for which this permit is issued. Policy No.
` ave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatib
••, i sante artier and policy number are:
• Carrier zw"d aA Policy Number Expiration Date
•' Ame of Agent Phone #
•j certify t1'in the performance wor a which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
�• tha ,(,•if I should pecome sub Be
w s' n n slo of Section 3700 of thqjahor Code, I shall forthwith comply with those provisions:
Sige$ture of• D e_
13EChARP —E ARDING ONSTRUCTION LENDI CY
hpLeby affirm ppderpenalty of perjury that there is a ion lending agency for the performance of the work forwhich this permit is issued (Section 3097, Civil Code).
i Le�ddt's Name •a. Lender's Address
Wy 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 ordinanc 5hd statejovt relating to building construction.
I authorize representatives of this city or county to an v of property for inspection purposes. l� ' / % "r�/`7�"�
Signature of Property Owner or A ze Agent Print Property Owner's or Authorized Age s e at
ACTION DATE BY DECLA ON OF PLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403.
PERMITEXPIRED El I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED LJEPA
PERMIT EMENDED QMD
PERMITFINAL (/ l ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATEOF IR
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