HomeMy WebLinkAboutX2021-2017 - Permits.�1Y4 City of Newport Beach - Building Division
.g� 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
�... , Inspection Requests Phone (949)644-3255
Combination Type -SFP
COMB Permit: X2021-2017
IIIIIIIIIIIII0IIIIIIIIII�IIIIIIIIIIIIIIIII II
Project No:
Issued Date : 08/03/2021
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0810312024 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
Job Address: 1522 CORNWALL LN NB
Description: SFR TIO (E) 36 SQ, INSTALL COMP. SHINGLE, CLASS 'B'MIN.
Legal Desc.: N TR 1896 LOT 8
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
O O O O O
PJBtIC WOI' K$ APPROVAL:
PLAN CHECK BY:
coG o m�ARP'kO I!TO ISSUE:
Ra cc c e c
o o
o a
Z
Owner: HRA RENTALS LLC
Contractor:
SUPERIOR METAL ROOFING
Architect:
Address: PO BOX 15926
Address:
360 E IST ST
#701
Address:
Cn
NEWPORT BEACH CA 92659
TUSTIN CA 92780
Phone:
Phone:
866-783.4400
Phone:
State Lic:
Applicant: SUPERIOR METAL ROOFING
Con State Lic:
865713
Engineer:
�y
Address: 360 E IST ST #701
Lic Expire:
10/31/2021
Address:
TUSTIN CA 92780
Bus Lic:
BT30062175
Phone: 866-783-4400
Lic Exp Date:
01/31/2022
Phone:
State Lic:
Code Edit: 2019
Worker's Compensation
Insurance
Designer:
Type of Construction: VB
Carrier:
STATE FUND
Address:
a„®
-'✓11
Occupancy Group: R3/U
Policy No:
1957583
0
Added /New sq.ft. Bldg: 0
Expire:
01/01/2022
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 1
Building Setbacks
Rear: /
Special Conditions:
No of Units : 1
Front: /
Bldg Height: 0
Left: /
Bldg Sprinklers:
Right: I
Flood Zone: X
Use Zone: Parking Spaces:
0
Fire Hazard Zone : N
Construction Valuation: $22,000.00
Building Permit Fee: $351.00
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
PNd 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 : $352.00
Plan
Check Fee :
$0.00
Fee Due at Permit Issuance :
$352.00
O(lO ROC
0 O O
O
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
O O O O O
PJBtIC WOI' K$ APPROVAL:
PLAN CHECK BY:
coG o m�ARP'kO I!TO ISSUE:
Ra cc c e c
o o
o a
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
le 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).
7 I, 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,
Iusiness 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).
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
poly 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:
Iy 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 legalll
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 000) io 3 of the Business and Prof ssio `dde'' d i ylic se is in full force
nd effect. License Class License No DatSMI= ctor Signature
VORKERS' COMPENSATION DECLARATION II
IARNING: 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 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 th
erf ance of the work for which this permit is issued. Policy No.
�I have and will mi�Rn n workers' com ensation 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
Isurance carrier and`golic number ar ::
ie of Agent i
certify that, in the I
if I should becom
Iature of Applicant
Date
lance of the W's
his permit is I shall not employ any person in any manner so as to become subject to the workers' compensati71as of7C11fornia, and agre
:ct tot rketion provisions of Section 3700 of the Labor Code, shall forthwith comply with those provisions.
3 COVISTRUJCTION 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, CIVII Code).
Ender's Name Lender's Address
Iy my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner's be�Aff.
I have read this application and the information I have provided is correct.
agree to comply with all applicable city and co nt rdi a state laws relating to building construction.
I authorize representatives of this city or county end So ppperty for inspection purposes. �/ (n �.
PERMITCANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
vner's or Authorized AD
DATE BY f1 RAfI01rOrCOMfbLT -NCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
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