HomeMy WebLinkAboutX2020-0364 - Permits*X20200364" COMB Permit: X2020-0364
Project No :
Issued Date : 02/1012020
Inspection Area : 8
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: 554 GLORIETA NB
Description: MFR REROOF (GARAGE ONLY) TIO ASPHALT AND REPLACE WI SINGLE PLY CLASS B 5 SCIS
Legal Desc.: TR 6230 (L.L.84-214033) PAR 46
Owner: REYNOLD JULIE
City of Newport Beach - Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone(949)644-3288
2054 CONTINENTAL AVE
Inspection Requests Phone (949)644-3255
NEWPORT BEACH, CA 92660
Combination Type - MFP
*X20200364" COMB Permit: X2020-0364
Project No :
Issued Date : 02/1012020
Inspection Area : 8
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: 554 GLORIETA NB
Description: MFR REROOF (GARAGE ONLY) TIO ASPHALT AND REPLACE WI SINGLE PLY CLASS B 5 SCIS
Legal Desc.: TR 6230 (L.L.84-214033) PAR 46
Owner: REYNOLD JULIE
Contractor:
PREMIUM ROOFING SYSTEMS
Architect:
Address: 554 GLORIETA
Address:
2054 CONTINENTAL AVE
Address:
NEWPORT BEACH, CA 92660
$5.000.00
COSTA MESA, CA 92627
Phone: 818-264-5549
Phone:
714-884-5108
Phone:
Applicant: PREMIUM ROOFING SYSTEMS
Con State Lic:
1042214
Engineer:
Address: 2054 CONTINENTAL AVE
Lie Expire:
07/3112020
Address:
COSTA MESA, CA 92627
Bus Lie:
BT30064792
Additional Fee :
Phone: 714-884-5108
Lie Exp Date:
11/30/2020
Phone:
Code Edit: 2019
Worker's Compensation Insurance
Designer:
Type of Construction:
Carrier:
STATE COMP
Address:
Occupancy Group: U
Policy No:
9233137
$0.00
Added /New sq.ft. Bldg: 0
Expire:
06/13/2020
Phone:
Added /New sq. ft. Garage: 0
$0.00
Demolition Fee
No of Stories: 0
Building Setbacks
Rear: /
Special Conditions:
No of Units : 2
In -lieu Housing Fee:
Front: I
$0.00
Bldg Height: 0
$0.00
Left: I
$0.00
Bldg Sprinklers:
$0.00
Right: I
State Lie:
State Lie:
Flood Zone:
Use Zone:
Parking Spaces:
0
Fire Hazard Zone : N
Construction Valuation:
$5.000.00
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:
$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 :
$1.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $325.00
Plan Check Fee
: $325.00
Fee Due at Permit Issuance :
$0.00
PROCESSED BY:
ZONING APPROVAL:
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
OWNER -BUILDER
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
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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) 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
improved for the purpose of sale).
❑ 1, 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 legalli
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 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect. License Class License No Date Contractor Signature
WORKERS' 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:
❑ 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
Derformance of the work for which this permit is issued. Policy No.
01 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' compensatiol
Insurance carrier and policy number are:
Policy Number Expiration Date
of Agent
certify that, in the performance 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
if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
signature of Applicant Date_
IECLARATION REGARDING 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 Code).
ender's Name Lender's Address
ly 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 enter the above -identified property for inspection purposes.
linnature of Prnnertv Owner or Authorized Anent Print ProDertv Owner's or Authorized Agent's Name
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 63 OF TITLE 40 AND AQMD RULE
1403
EXPIRED I I I LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT EXTENDED VLJAQMD
PERMITFINAL U ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF /� ❑ PROPOSED DEMOLITION
OCCUPANCYISSUED SIGNATURE:
Date
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