HomeMy WebLinkAboutX2020-0970 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII III Project
Permit :X2020-0970
= 100 Civic Center Drive, Newport Beach, CA 92660 COMB
No
Permit Counter Phone (949)644-3288
t�
Inspection Requests Phone (949)644-3255
•�zrr.7a+�'> Combination Type - CIP Issued Date : 04/15/2020
Inspection Area : 7
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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: 592 SUPERIOR AVE NB St: C
Description: COMM *CITY JOB" RE -ROOF REMOVEIREPLACE (E) 64 SQ, CRRC# 0700-0028
Legal Desc.: IRVINE SUB LOT 169 BLK 2 10 AC IN LOT -INC POR OF ST ADJ- -EX FREE
Owner:
CITY OF NEWPORT BEACH
Address:
PO BOX 1768
Record Management:
NEWPORT BEACH, CA
Phone:
9496443141
Applicant:
CHO KATHRYNE
Address:
100 CIVIC CENTER DR
Bus Lic:
NEWPORT BEACH CA 92660
Phone:
949-644-3014
Code Edit:
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 0
No of Units: 0
Bldg Height: 0
Bldg Sprinklers:
Construction
Contractor:
SAN MARINO ROOF CO INC
Address:
2187 N BATAVIA
Record Management:
ORANGE CA 92665
Phone:
714.974-3070
Con State Lic:
249559
Lic Expire:
07/3112020
Bus Lic:
BT30008923
Lic Exp Date:
04/30/2020
2019 Worker's Compensation Insurance
VB Carrier: REDWOOD FIRE
Policy No: SAWC033687
0 Expire: 07/01/2020
Building Permit Fee: $1,360.00
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 :
$6.00
TOTAL FEE: $6.00
PROCESSED BY:
ZONING APPROVAL:
Building Setbacks Rear: /
Front: I
Left: /
Right: /
Use Zone:
Parking Spa
1
Fire Inspection:
Excise Tax:
$0.00
- Additional Fee :
($1,360.00)
Grading Bonds Fee:
$0.00
Grading PC Consultant:
$0.00
Grading Permit Fee:
$0.00
Grading PC Fee:
$0.00
WQ Insp. Fee:
$0.00
Electrical %:
$0.00
Mechanical %:
$0.00
Plumbing %:
$0.00
Architect
Address:
Phone:
State Lic:
Plan check Fee
Fire Inspection:
Fair Share
Fire Plan Rev
e
Demolition Fee
Engineer:
Building Dept Adm
°
• o
Address:
P/W Plan Check :
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Phone:
State Lic:
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Designer:
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Address:
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Phone:
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Special Conditions:
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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: $6.00
Fee Due at Permit Issuance
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
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:
Fee Due at Permit Issuance
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
UWNCK-t3GILUCK uc�u Mm- wn
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(:)
'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
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 3 of the Business end
-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
iot more than five hundred dollars ($500). , -
:1 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) 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
mprovements 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 legalll
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 'iso ww
available upon request when this application is submitted or at the following Web site:http://w.leginfo.ca.gov/calaw.html. Date
Signature of Properly 6wrier or Authorized Agent
LICENSED CORfRACTOR'S DECLARATION
I dJUI Iffirm uflddt:renalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section ,of 1v n 3 of the Business and Profes 'dh od5;�+� y license is in full force
ani effect. License Etas: License No Date "' - ? Contractor Signatur
VQORkWRS' COMPENSATION ONE HUNDRED THOUSAND
,SATION DECLARATION f
NABNINCi FAILURE JDSEUIW`E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO LLARS ($100,0001, IN ADDITION TO THE
COST.OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I li �reg;affirm undarpimalty of perjury one of the following declarations:
I.;;g and hill Melntain 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
pF firma n ce of the work for which this permit is issued. Policy No.
I Aav4and wW0rrWttin 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
carrier cy numbe e:
Aw, r • • • • � p 1 �� li umber Expiration Date
••• L Phone#
4ame of
Agent
71 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 la s of alifornia, and agre
hat, if I should become su 'act to the workers' p D tion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /
signature of Applicant Date /0
)ECLARATION REGAR ING CONSTR C ON LLENDING AGENCY
hereby affirm under pe ally 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
3y 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. L MA � Ii0 �-04
I agree to comply with all applicable city and county ordinances and state laws relating to building construction. J Y l q
I authorize representatives of this city or cou ty� o enter �byv -identified property for inspection purposes. �.% 1 „ ,l/
signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name '�w 3 7 1 41C/✓r• D
ACTION DATE BY I DECLARATl�7 1�OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED EPA
PERMIT EXTENDED QMD
PERMIT FINAL f `ZASBESTOSNOTIFICATIO ISNOTAPPLICABLE TO
CERTIFICATE OF PRO SE DEM�ITIGN-�^
OCCUPANCY ISSUED SIGNA E• �' "`
0700-0028
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