HomeMy WebLinkAboutX2019-2666 - Permitsr City of Newport Beach = Building Division
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COMB Permit: X2019-2666
'.. 1100 Ode Center Drive, Newport Beach, CA 92660
X 2. 0 1
9 2 6 6. 6
Project No
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
it Combination Type - CIF.
Issued Date: 08126/2019
ws�t
Inspection Area t 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
Job Address: -3400 IRVINE AVE NB _ -
- --
Description: COMM TIO (E) 140 SQ, INSTALL SINGLE PLY,CRRC# 0634-0001, CLASS'B'MIN. & REMOVEIREPLACE MANSARD RAFTER AS REQUIRED (X2019-2272)
Legal Desc.; N TR 706 LOT 76
Z
- Owner; CAMPUS CENTER LLC ..
Contractor: BROWN. CLIFF ROOFING INC Architect
co
Address:. 3400 IRVINEAVE
NEWPORT BEACH CA 92660
Address: 302 VIA ALEGRE Address:
SAN CLEMENTE CA 92672 -
Phone:
Phone: 949/458-9440
Phone:
State Lie:
M
.Applicant:. BROWN CLIFF ROOFING INC.
Con State Lic: 506664
Engineer:.
/°�.
Address: 302 VIA ALEGRE
Lie Expire: .08/31/2021
Address:
SAN CLEMENTE CA 92672.
Bus Li¢ BT30068171
-1
Phone: 9491458-9440
Lie Exp Date:. 07/3112020
Phone:
State Lie:
0
Code Edit: 2016
Worker's Compensation Insurance
Designer:
�,�gy�/
..Type of Construction; III-B
Carrier: ' STATE COMP
FUND Address:
.AJ
Occupancy Group: B -
_ Policy No: 9072710
Added /New. sq.ft. Bldg: 0 -
Expire: 10/01/2019
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 2
Building Setbacks Rear: /
Special Conditions:
No of Units: 0
Front:
Bldg Height: 0
Left: 1
Bldg Sprinklers: N
Right:
Flood Zone: X
Use Zone: Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $80.000.00
-
Building Permit Fee: $973.00
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
PAN Plan Check: $0.00
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %: $0.00
San Dist: $0.00
Building Green Fee :. $4.00
Mechanical %: $0.00
NMUSD Fee: $0.00
$0.00
Plumbing %: $0.00
$0.00
TOTAL FEE : $977.00
Plan Check Fee
: $0.00 Fee Due at Permit Issuance : $977.00
PROCESSED BY;
v o
ee �; IruBLIV'*OF2,e S APPROVAL:
ZONING APPROVAL:
p
o ",, FLANSTHEGK 43Y:
0
GRADING APPROVAL:
APPROVAL TO ISSUE:
ooc ¢a
Hca e, c tic ��
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 tie 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 U 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).
1, as ownerof 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.htmi.
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 D' ' o he Business and Pro es ns odd my license is ' tFfaree
and effect. License Class License No Date 00 Contractor Signature /
INORKERS' 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.
hereby affirm under penalty of perjury one of the following declarations:
1 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
)erjgrmance of the work for which this permit is issued. Policy No.
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'
rance carrier and policy nurgher are: I _
1e of Agent X VY_
certify that, In a performance of the
if I should become s ject t wo
Number
Date
this permit' 's d, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree
�,/yp, _ at' visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant !� DaM_
CLARATION REGA DING C(CMITRUCTION LENDING AGENCY
Heby 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).
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 o ances and state laws relati Ing construction.
I authorize representatives of this city or countt9 ter he ab tifie erty for inspection purposes.
nature ed of Pmnertv Owner or AuthorizADent X Print Prooertv Owner's or Authorized ADent's Name
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED -EPA •` •s
PERMIT EXTENDED 0AQMD • • • • • : : • • `
PERMITFINAL ASBESTOS NOTIFIC IS NOPAPP LE TO
CERTIFICATE OF PR POSED DEM ITI N
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0634-0001
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INITIAL 3YEAR
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r.11
01
o634-0001 Seaman
FiberTite Roofing Systems DC196 Off
Single -Ply
Off -White
o.83 o.66
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too
76
Corporation
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