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HomeMy WebLinkAboutX2020-0081 - Permits<"t City of Newport Beach - Building Division s 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 . Inspection Requests Phone (949)644-3255 Combination Type - SFP Ili iiiiiiiiiiii1ii II COMB Permit: X2020-0081 Project No : Issued Date: 01/10/2020 Inspection Area : 5 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 13:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 4715 SURREY DR NB Description: SFR - T/O SHAKE ROOF. USE (E) SHEATHING. INSTIL 2 LAYERS 30# FELT. INSTIL BORAL TILE 5.7 PSF. ESR #1647 40 SQ Legal Desc.: N TR 3519 LOT 65 Owner: SCACCHI WALT Address: 4715 SURREY DR Record Management : CORONA DEL MAR, CA 92625 Phone: $0.00 Applicant: 3 A ROOFING Address: 762 HUDSON AVENUE Hazardous Mat COSTA MESA CA 92626 Phone: 714.785.7378 Code Edit: 2019 Type of Construction: V -B Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Building Permit Fee: $324.00 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 : $1.00 TOTAL FEE : $325.00 PROCESSED BY: ZONING APPROVAL: Contractor: 3 A ROOFING Address: 762 HUDSON AVENUE Fair Share COSTA MESA CA 92626 Phone: 714-785-7378 Con State Lie: 873754 Lie Expire: 03/31/2020 Bus Lie: BT30040807 Lie Exp Date: 01130/2020 Worker's Compensation Insurance Carrier: STATE COMP Policy No: 9030930 Expire: 11/01/2020 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: / Front: / Left: / Right: / $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Architect: Address: Phone: State Lie: Engineer: Address: Phone: State Lie: Designer: Address: Phone: Special Conditions: 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 PAN Plan Check: $0.00 San Dist : $0.00 NMUSD Fee: $0.00 Plan Check Fee: $325.00 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: o PLAN CHECK BY: GRADING APPROVAL: c c`. c c c. c ` c e ® APPROVAL TO ISSUE: i C P'OG OL>O O G eOG GOa nvt� $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 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: Plan Check Fee: $325.00 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: o PLAN CHECK BY: GRADING APPROVAL: c c`. c c c. c ` c e ® APPROVAL TO ISSUE: i C P'OG OL>O O G eOG GOa nvt� $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 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 ie 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 of 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, 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). 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). 1 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 1 must have resided for at least one year prior to completion of the improvements covered by this permit; I cannot legally 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.html. 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 700) f Di Sion 3 of the Business and Prof�si (2ode, and�ir y license is in full force nd effect. License Class License No Date O U Contractor Signatu �/ UORKERS' COMPENSATION DECLARATION IARNING: 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 OST 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: 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, e finance of the work for which this permit is issued. Policy No. 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' Ind oolicv number are: Policy Number 2.36) Expiration Date is of Agent certify that, in the a subman - If the work foywhiph 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 I, if I should become subj—ec o t e workers' IL\�om�p nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. J nature of Applicant Dt5e__ J/%©/2t7 CLARATION REGARDu6rcoN§TRUCT&R LENDING AGENCY weby 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 i nces and st la s relating to building construction. I authorize representatives of this city or county to a to the above -id tifi property for inspection purposes. �_� !��"� nature of Prooertv Owner or Authorized AoenIV Print Property Owners or Authorized Agent's Names/-% 6� ACTION DATE BY DECLARATION COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY r REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE 1403 • •+• ••• • •+. PERMIT EXPIRED DI SUBMITTED ASBESTOS NOTIFICATION TO: •; ••. ••• ••• PERMITCANCELLED EPA ••• ': PERMIT EXTENDED OMD PERMITFINAL ASBESTOS NOTIFI I NIS NOTAPPL AB TO CERTIFICATEOF 2 frl L/.� PROPOSED DE1 I O a• ••• ••• ••e �•• �'• OCCUPANCY ISSUED SIGNATURE: •• • o i �•