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Home My WebLink AboutX2013-0686 - Permits (2)o City of Newport Beach Building Division w PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 Combination Type - SFP/ COMB Permit No: X2013-0686 PROJECT NUMBER: Inspection Requests/Telephone (949)644-3255 Job Address: 1621 ORCHARD DR NB Issued Date : 03/19/2013 Description:SFR-REROOF 22 SQ COMP SHINGLE, T/O (E) COMP, USE (E) SHEATHING, INSTL 1 LAYER 30# FELT /'��.0 Inspector Area: 3 Legal Desc.: T014 Owner: QUEBBEMAN TOM Contractor: HOYT ROOFS INC Architect: Address: 1621 ORCHARD DR Address: 1809 N ORANGETHORPE PK Address: NEWPORT BEACH CA 92660 ANAHEIM CA 92801 - Phone: Phone: 714-773-1820 Phone: State Lic: Applicant: HOYT ROOFS INC Con State Lic: 606111 Engineer: Address: 1809 N ORANGETHORPE PK Lic Expire: 12/31/2014 Address: ANAHEIM CA 92801 Bus Lic: BT30001509 Phone: 714-773-1820 Lic Exp Date: 10/31/2013 Phone: State Lic: oc°o Code Edit: 2010 Worker's Compensation Insurance Designer: Type of Construction: V -B Carrier: STATE COMP INS FUND Address: Occupancy Group: R3/U Policy No: 9002169 Added /New sq.ft. Bldg: 0 Expire: 08/17/2013 Phone: Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: I Special Conditions: C. ° No of Units : 1 Front: I Bldg Height: 0 Left: / Bldg Sprinklers: Right: / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $10.700.00 oo°°oo Building Permit Fee: $231.28 Solar System PC: $0.00 Planning Department - Fire Department ° Plan Check Fee: $0.00 Excise Tax: $0.00 Plan check Fee : $0.00 Fire Inspection: 40.00 40.00° Overtime Plan Ck $0.00 Fair Share : $0.00 Fire Plan Rev $8.°00 Investigation Fee: $0.00 SJH Trans: $0.00 Demolition Fee Record Management : $1.00 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 P/W Plan Check: $0.00 Fee Increase: Fee: $0.00 Electrical %: $0.00 San Dist: $0.00 Additional Fee : $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Hazardous Mat : $0.00 Plumbing %: $0.00 $0.00 Building Green Fee : $1.00 TOTAL FEE: $233.28 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $233.28 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. INSTALL OR VERIFY SMOKE AND CARBON MONOXIDE DETECTORS ARE EXISTING PER CRCR 314.1 & 315.2 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 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 L) all of or L) 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). 13 '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 legal) 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. html. 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 Pro ions Code, and y i ense is in full force and effect. 7 License Class License No Dat;zr 0 / 6 Contractor Signat r NORKERS' GbVftNSATION DECLARATION 0 NARNIN& FAILURE�r'b%tCURE 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 rSf 000MPERSATIOK DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. j erepy affirm Waupenalty of perjury one of the following declarations: Y Inave and wAl 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 the 3erfopnance of" (k for which this permit is issued. Policy No. �rrooftdve 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' compensation Rsursnce carriel'apd policy number are: r L% 4artieCOLI icl� Policy Number ��`n � Expiration Date JI certify that,16 Mi )Ifor a 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 agree iat,lf;1 shoulg become sub' 't t the wor rs' comn on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of App la Date �CLARATION DIN CO TRUCC&ION ENDING 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 y my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners 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 s relating to building construction. I authorize representatives of this city or counte O r the�ah�nv�e Idji ti property for inspection purposes. �/ ignature of Property Owner or Authorized Age, / V �!i`— Print Property Owner's or Authorized Agent's Nart _;, Ic/Y TILGIJ Date AC710N I DATE BY LK_6R1if"4111 EXTENDED CERTIFfi TE OF OCCUPANCYISSUED ❑ I St1BWTTEDASBESTOS N071FICATIONTO: ❑ EPA ❑ AQMD 04�SBESTOS NORACARONIS NOT APPLICABLE TO PROPOSED DEMOLITION. ,