HomeMy WebLinkAboutX2019-1688 - Permitsa
City of Newport Beach -Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2019-1688
100 Civic Center Dove, Newport Beach, CA 92660 X 2 0 1 9 1 6 8 6 Project No
Permit Counter Bone ,' x19)644-3286
Inspection Requests Phone (949)644-3255
Combination Type - CIP Issued Date: 05/28/2019
Inspection Area : 7
Code Edit: 2016
Type of Construction: II-BSPR
Occupancy Group: S-11B/R3
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 0
Bldg Height: 0
Bldg Sprinklers: Y
Flood Zone:
Valuation:
Building Permit Fee: $903.00
Plan Check Fee: $0.00
Overtime Plan Ck:
$0.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
$0.00
Record Management:
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:
1111 CAMELBACK ST NB St: A Fl: BLDG A
-
Disabled Access:
$0.00
Description:
COMM APPLY CLS"A" TPO OVER EXTG CAPSHEET ROOF (200 SQS) CRRC 0628-0002 (COOL ROOF)
Building Green Fee :
$3.00
Legal Desc.:
P M 304-5 PAR 2 POR OF PAR
$0.00
Owner:
DSI NEWPORT GROWTH & INCOME FUND
Contractor: HULL & SONS ROOFING INC
Architect:
Address:.
18552 MACARTHUR BLVD 11495
Address: 8960 JURUPA ROAD
Address:
IRVINE, CA 92612
RIVERSIDE CA 92509
Phone:
Phone: 951-685-9499
Phone:
State Lic:'
ooma
Applicant:
HULL & SONS ROOFING INC
Con State Lic: 554747
Engineer:
' °m ° o• °
Address:
8960 JURUPA ROAD
Lic Expire: 0713112019
Address:
°"" i�••"'^"`%
RIVERSIDE CA 92509
Bus Lic: BT30055626
Phone:
951-685-9499
Lic Exp Date: 07131/2019
Phone:
State Lic: • ® ""°` e ` m
Code Edit: 2016
Type of Construction: II-BSPR
Occupancy Group: S-11B/R3
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 0
Bldg Height: 0
Bldg Sprinklers: Y
Flood Zone:
Valuation:
Building Permit Fee: $903.00
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 :
$3.00
TOTAL FEE: $906.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Worker's Compensation Insurance
Carrier: AMERICAN ZURICH
Policy No: WC01874800
Expire: 1 2/3112 01 9
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: I
Front: I
Left: /
Right: I
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Designer:
Address:
Phone:
Special Conditions: NRCC-ENV- 03 ATTACHED
Hazard Zone : N
Planning Department -
Fire Department
Plan check Fee:
Fire Inspection:
Fair Share
Fire Plan Rev
SJH Trans
Demolition Fee
In -lieu Housing Fee
Building Dept Adm
Public Works Department -
Park Dedication :
$0.00
P11N Plan Check :
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Plan Check Fee: $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Fee Due at Permit Issuance : $906.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
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:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Fee Due at Permit Issuance : $906.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION
1 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 placq 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 AS 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 (_) all of or U 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
ap ly loan 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).
I 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 legall)
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 Proqp1ty Owner or Authorized Agent
Date
LICENSED COJJTRACTOR'S DECLARATION
4are4yaffirm u rider penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) D'vis n 3 of the Business and Profes ' ss Code, and my license is in full force
and effect. LIJACe toss License No Date 5195f / 1S/ 1S Contractor Signature d= --�
WQWRS' 60111 SENSATION DECLARATION
NARIAlle: 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 (5100,000), IN ADDITION TO THE
OOST OF COMPEUE&TI01t,0AMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hecaby affirm Viler penalty of perjury one of the following declarations:
t lige and "ifrmnintain 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
mance of 4he0ork for which this permit is issued. Policy No.
94ve and Till 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
urafice center and�policy number are:
ahTer fi�6U� 0N24c{ Policy Number Of �`1$ 0 ( Expiration Date
aA of AgeR� ` Phone #
I certify that, in the perfo ce 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 agre
that, if I should become su ect�ttoo the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant
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:
1 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 toe a the above -i ntifie l property for inspection purposes.
Signature of Property Owner or Authorized Agent � Print Property Owner's or Authorized Agent's Name &/ %. lfdl Date S PS
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 I U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT EXTENDED
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