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X2020-0480 - Permits
1Gt City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 v .�- 8pection Requests Phone (949)644-3255 e<uv Combination Type - SFP COMB Permit: X2020-0480 IIIIIII�IIII�II0�IIIIIIIIIIIIIIIIII0IIIIIIIIIIIIIIIII II Project No : Issued Date: 02/24/2020 Inspection Area : 3 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 6:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 2209 HEATHER LN NB Description: SFR REROOF TIO COMP SHINGLES AND REPLACE W/ COMP SHINGLES, REMOVE/REPLACE FLAT ROOF CLASS B 31 SQS Legal Desc.: N TR 3138 LOT 26 Owner: DOROUDIAN SEAN Contractor: 3 A ROOFING Address: 2209 HEATHER LN Address: 762 HUDSON AVENUE CA Seismic Safety: NEWPORT BEACH, CA 92660 Disabled Access: COSTA MESA CA 92626 Phone: 714-785-7378 Phone: 714-785-7378 Applicant: 3 A ROOFING Con State Lie: 873754 Address: 762 HUDSON AVENUE Lie Expire: 03/3112020 COSTA MESA CA 92626 Bus Lie: BT30040807 Phone: 714-785-7378 Lie Exp Date: 01/3012021 Code Edit: 2019 Type of Construction: V -B Occupancy Group: R3IU Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Construction 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: GRADING APPROVAL: Worker's Compensation Insurance Carrier: STATE COMP Policy No: 9030930 Expire: 11101/2020 Building Setbacks Excise Tax: Additional Fee: Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical W Mechanical %: Plumbing %: Rear: I Front: I Left: / Right: I Parkino Spaces $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee Architect: Address: Phone: Engineer: Address: Phone: Designer Address: Phone: INSPECTOR eoem • a comm State Lic: m m e m •e Special Conditions: FLOODZONE Fire 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 State Lie: e m m • m o em moom e 0000 0 00 m a oom oeoo 0 00000 $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: j� n APPROVAL TO ISSUE: 0 0 oeoeoo 0 0 momoo 0 00000 moocca 0 o c m o eom000 m o 0000 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: e m m • m o em moom e 0000 0 00 m a oom oeoo 0 00000 $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: j� n APPROVAL TO ISSUE: 0 0 oeoeoo 0 0 momoo 0 00000 moocca 0 o c m o eom000 m o 0000 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 require:, the applicant for :he 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 etif 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 ($500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or 'mproved for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds -or -improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legalq sell a structure4Ra41 Rave built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions CodB!159vailable upon request when this application is submitted or at the following Web site:http:/Iv ww.leginfo.ca.gov/calaw.html. �ignefu$e of Propertyy++00wner or Authorized Agent Date LICENSED cbNfP 1CTOR'S DECLARATION L Rgre%affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio) Divi 'on 3 of the Business and Pr es Ions, ode, an /`ny l cense is in full force And Effect. Licegse Q,IWss License No Date/� Contractor Signatu % _ VQRKERS' COMPENSATION DECLARATION hARNM: FAILURrj Z09ECURE 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 GOSTOi COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 1706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I.hecab/ affirm under penalty of perjury one of the following declarations: 'P=t12Qe and w111 me�ltain 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 petformance of tv WWI for which this permit is issued. Policy No. W4 Re and wil6maintain 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' compensatioi 2rICe came} argypolicy number are: Carrier �_ 4L 7-)_� Policy Number y� d `/s�'D Expiration Date 1441 Z � of certify that, in the pert rmance e w rk for which this permit is issued, I shall not employ any person in any manner so as to become subject tote worker 'compensation laws of California, and agree I, if I should becomes bject to he wo/ ers' comp satin provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant D ems• 0� 2 CLARATION REG DIN S UCTIO DING GENCY •reby affirm under rally of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3 97, 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. 1 agree to comply with all applicable city and cou ntifi -prope ty rd and state laws relating to building construction. 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