HomeMy WebLinkAboutX2021-1107 - Permits"� City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2021-1107
f, 100 Civic Center Drive, Newport Beach, CA 92660 x 2 0 2 1 1 1 0 7 Project No
n: Permit Counter Phone (949)644-3288
c1. Inspection Requests Phone (949)644-3255
r`atvd.rv:ta. Combination Type - MFP Issued Date: 05110/2021
0 Inspection Area : 1
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0511012024 OR PERMIT WILL BE INVALID
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
Jab Address: 128 45TH ST NB
Fire Hazard Zone : N
Description: MFR T/O (E) HOT MOP. INSTIL 2" INSULATION BOARD. INSTIL 1/2" OSB, INSTIL 19 SQ TORCHDOWN
Legal Desc.: RIVER SECTION BLK 44 LOT 13
Construction Valuation: $23.000.00
Owner: BOWMAN BRADFORD S Contractor:
ALL SEASON ROOFING INC Architect:
Address: 21301 TULSA ST Address:
17750 VANOWEN ST Address:
CHATSWORTH, CA 91311
RESEDA CA 91335
Phone: Phone:
818-620-1587 Phone: State Lic:
Excise Tax:
� t4010S,
Yg'
Applicant: ALL SEASON ROOFING INC Con State Lic:
1059641 i0, fir:
Address: 17760 VANOWEN T Lic Expire:
��.
3112021 Q Address:
RESEDA CA 91335
BT/30075210 C'0011'
9�
Phone: 818.620-1587 Lic Exp Date:
05/31/2022 n tl
Phone: State Lic:
Code Edit : 2019 Worker's Compensation Insurance ,
Type of Construction: V -B Carrier:
STATE FUND �1t@Ss
Occupancy Group: R3/U Policy No:
�pp
9133546 A`�
Added /New sq.ft. Bldg: 0 Expire:
05/26/2022 Phone:
Added INew sq. ft. Garage: 0
Fair Share :
No of Stories: 2 Building Setbacks
Rear: / Special Conditions: high density
No of Units : 2
Front: / liquefaction
Bldg Height: 0
Left: /
Bldg Sprinklers:
Right: /
Flood Zone:
Use Zone:
Parking Spaces:
0
Fire Hazard Zone : N
Construction Valuation: $23.000.00
� 1
Building Permit Fee: $343.00
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
P/W 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 W
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
-
$0.00
TOTAL FEE : $344.00
Plan Check Fee:
$0.00
Fee Due at Permit Issuance :
$344.00
PROCESSED BY: - - PUBLIC WORKS APPROVAL:
ZONING APPROVAL: ` - PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
;
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(a)t
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).
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,
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).
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
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).
I 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 I 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 7000)GivI2 3 of the Business and Professio, no my license is in full force
ns ode
nd effect. License Class License No Date Contractor Signatur
IIORKERS' COMPENSATION DECLARATION
'ARNING: 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 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
� 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 the
-e'rformance of the work for which this permit is issued. Policy No.
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'
ranee carrier and policy number are:
Policy Number
Date
'afire of Agent r'none N
]I 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 agre
Iat, if I should become subject tot a workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant �'
DECLARATION REGAAAI ONSTRUCTION LENDING AGENCY
hereby affirm under penalt 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 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 cougtylo enter the above -identified property for inspection purposes.
ACTION
of Prooertv Owner or Authorized
I DATE I
bECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
1403
Name
PERMIT EXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO
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