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HomeMy WebLinkAboutX2020-0455 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIII II COMB Permit: X2020-0455 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 0 0 4 5 5 Project No Permit Counter Phone (949)644-3288 '$ Inspection Requests Phone (949)644-3255 -r''taviha'`' Issued Date : Area : '2020 Combination Type - SFP Inspection Area 2- 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: 430 TUSTIN AVE NB Description: SFR PARTIAL REROOF W/CLS "A" COMP (5 SQS), T/O WOOD Legal Desc.: FIRST ADD TO NEWPORT HEIGHTS BILK 26 LOT 8 Owner: HICKEY BETTY Contractor: LEMUS ROOFING Architect: Address: 430 TUSTIN AVE Address: 19881 BROOKHURST ST #C-152 Address: Disabled Access : NEWPORT BEACH, CA 92663 Hazardous Mat HUNTINGTON BEACH CA 92646 Building Green Fee : Phone: $0.00 Phone: 949.735.2377 Phone: State Lie: Applicant: LEMUS ROOFING Con State Lie: 826813 Engineer: .... Address: 19881 BROOKHURST ST #C-152 Lie Expire: 10/31/2021 Address: ° • ° ° ° ° HUNTINGTON BEACH CA 92646 Bus Lie: BT30066951 Phone: 949-735-2377 Lie Exp Date: 04/30/2020 Phone: State Lie: o ®• ° o mo Code Edit: 2019 Type of Construction: VB Occupancy Group: R3 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 TOTALFEE: PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Worker's Compensation Insurance Carrier: STATE COMP Policy No: 1845899 Expire: 05/27/2020 Building Setbacks Use Zone: 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: / Left: I Right: I king Spa $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: 0 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 P/W 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 : $325.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: o < oee•oo o � oomoo 0 om000 oom000 c o 0 0 0 ommoou 0 0 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 : $325.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: o < oee•oo o � oomoo 0 om000 oom000 c o 0 0 0 ommoou 0 0 OWNER -BUILDER DECLARATION a 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). ❑ I, 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). ❑ 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 Iegalll 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.Jeginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED COfJ-[U#CTOR'S DECLARATION I hereby affirm Underppenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sect' 00 of Division 3 of the Businapf and Profes o ode, n li nse is qn full force eAd eff ut. License R s License No \D4Ee Contract Signature ,Alb L J 6RK2RS' CejIAPENSATION DECLARATION N KyyINO: AILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE Si(r. MPENSATICN, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm u9derj*0alty of perjury one of the following declarations: • • •• • I l4i¢ve 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 thi Irrier mance of the Vofk,for which this permit is issued. Policy No. 0e and will r9aintain 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' compensatior e carrier and policy number are: ^5»�a '�y+-�� Policy Number �ti,� Cl �I Expiration Date Z'1 'Z C7 Q2MEaf',Agent Phone # ••• I certify that, inthe 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 work compensation laws of California, and agree hat, if I should brant, subP�'p�e/Hp the work rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. iignature of p ICU i-r�Wli/� .. Date. 1�© �'z..0� t�1PCI ARATIr)NRDIN . Cr)N-gTRIICTIr)N I PiulniNr: Ar:FNCV areby 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 ordinances and state laws relating to building construction. I authorize representatives of this city gG.county,"ntEg the abgyg-identified property for inspection purposes. 2-0 ACTION DATE of 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 PERMIT CANCELLED DEPA PERMIT EXTENDED QMD PERMITFINAL TTIAPPLICABLE TO AfkBESTOS�rNNOO,TIIIFICr�yArnTION IS NOT OCCUPANCYIDSSUED /�' I9,O �-, P TUBE: 1\ANl11A R) l I a �� cEO CLO 0N� dw grn m m EE m o m c as m N ° m +' N . N Y O Cm c`0 OE O y0m .+'a Xv NE vomma ro-rio Mca yrO aZL 3cO c an d pd Q J o 0 U C cw .c = m y ZOc o Uro:. =my c .'OO.O� m—Q o moo 2 m 0tm .0 €R c �fz-0 3 o E c o --E cc d o m °; d `o N m a m C Y Q LL m t o y a a. On EE p a N N c0 N %. c E o„" °m Go) wm0ON asE� W y/. 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