HomeMy WebLinkAboutX2021-1324 - PermitsM.-OMM-1.
City of Newport Beach - Building Division Illlllllillllllllllllllllllllllllllllllllllllll COMB Permit: X2021-1324
100 Civic Center Drive, Newport Beach, CA 92660 Pro'ecNo
Permit Counter Phone (949)644-3288 X !1 1i Inspection Requests Phone (949)644-3255 / \ t� 1 I
Combination Type - SFP1 .L� t �' �Y� `� Issued Date: 05124/2021
` l� /� V Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 05/24/2024 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: 1620 GALAXY DR NB
Description: SFR REROOF TEAR OFF WOOD SHINGLES W/ EX PLYWOOD, 30# FELT, DAVINCI BELLA FORTE #2119 1.5B LBS 43 SQ, TEAR OFF FLAT ROOF &,APPLY CAPSHEET 13 SQ
Legal Desc.: N TR 4224 LOT 48
Owner: WALKER GEORGE LAIRD
Address: 1940 W ORANGEWOOD AVE #205
ORANGE, CA 92868
Phone:
Applicant: ELASON DEBORAH
Address: NIA
Phone:
Code Edit: 2019
Type of Construction: V -B
Occupancy Group: R31U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 1
No of Units, 1
Bldg Height: 0
Bldg Sprinklers:
Flood Zone:
11 Construction Valuation: $4
Building Permit Fee: $343.00
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:
$2.00
TOTAL FEE: $345.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor:
SANTIAGO ROOFING INC
Address:
361 OAK STE H
Fair Share :
BREA CA 92821
Phone:
714.529-0440
Con State Lie:
576276
Lie Expire:
08131/2021
Bus Lie:
BT30075365
Lie Exp Date:
05/31/2022
Worker's Compensation Insurance
Carrier: CA INSURANCE
Policy No: 468645340106
Expire: 01/01/2022
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: I
Front: I
Left: /
Right: /
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Architect:
Address:
Phone: State Lie:
Engineer:
Address:
Phone: State Lie:
Designer:
Address:
Phone:
Special Conditions:
Fire Hazard Zone : N
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
PAN Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Plan Check Fee: $0.00 Fee Due at Permit Issuance
�-� PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
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• $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$345.00
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:
Plan Check Fee: $0.00 Fee Due at Permit Issuance
�-� PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
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• $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$345.00
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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 afpkant 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).
❑ I, 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
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).
❑ 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 legally
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 70 0) of Di3 of the Business and Professi o , and my license is in full force
and effect. License Class License No Date/�vi ion Contractor Signature r i 7
NORKERS' COMPENSATION DECLARATION
NARNING: FAILURF.V§I5 ]JRE 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
COST OF COMPENSATM,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
�v4WV:31flrm under penalty of perjury one of the following declarations:
a
I hive and Nill ril9intain 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
IArmynce of the -work for which this permit is issued. Policy No.
and w0malnfain 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'
carrier Arid policy number are:
• • •: Policy Number Expiration Date
at, injhe gerformance o the work fo 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
Ild become b' to th w rkers' mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /^
Applicant Date_
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
ly 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 coun dinances and state laws relating to building construction.
I authorize representatives of this city or count o me he abol('y�e-ident"ed property for inspection purposes.
i-+- ,.f o., 4. , n,.,.,e — A..+h , i- Anent .t A U �I � l- Print Pronertv Owner's or Authorized ADent's Name
PERMITCANCELLED
PERMITEXTENDED
PERMIT FINAL
CERTIFICATEOF
OCCUPANCY ISSUED
DATE BY �-B LAAATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
13-24 G�1/J
SUBMITTED ASBESTOS
SIGNATURE:
APPLICABLE TO
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