HomeMy WebLinkAboutCOMB22-0131 - PermitsCity of Newport Beach
100 CIVIC CENTER DRIVE
NEWPORT BEACH, CA 92660
Permit No:COMB22-0131
5/2/2022Final:
Job Address:1305 ANTIGUA WAY,
NEWPORT BEACH CA, 92660
Final Inspection by:
Description of Work:Tear off existing tile roof and replace with new U.S. Tile S tile roofing
Legal Description:N-TRACT: 3852 BLOCK: LOT: 22
Owner:Michael Potoma
1305 Antigua Way
Newport Beach, CA 92660
747706Contractor:
JSL ROOFING INC
Jeffrey Scott Lehman
2415 MARGARET DR
NEWPORT BEACH CA, 92663
Worker's Compensation Insurance:
Carrier:STATE COMPENSATION INSURANCE F
Expire:06/18/2022
Jeffrey Scott LehmanApplicant:
2415 Margaret Drive
Newport Beach CA, 92660
Amount ($)Fee Description Qty
Re-Roof Permit Fee 351.00 1
$351.00
The issuance of this permit shall not prevent the Chief Building Official from thereafter requiring the correction
of errors in the plans and specifications or from preventing building operations being carried on thereunder
when in violation of the California Building Code or of any provision of the Newport Beach Municipal Code .
Except as otherwise stated, a permit for construction under which no work is commenced within six months
after issuance, or where the work commenced is suspended or abandoned for six months, shall expire, and
fees paid shall be forfeited.
Owner Builder Declaration
You certified to each of the following:
·I am the property owner or am 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 City ordinances and
state laws relating to building construction.
·I authorize representatives of this City to enter the
above-identified property for inspection purposes.
License Contractor Declaration
You certified to the following:
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 Professions Code, and that
my license is in full force and effect.
WARNING: 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR
CODE, INTEREST, AND ATTORNEY’S FEES.
DOC200Finalpermit_Document_CNB.rpt / version 2015-11-04