HomeMy WebLinkAboutX2021-1466 - PermitsCity of Newport Beach - Building Division
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h00 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - MFP
COMB Permit: X2021-1466
IIPIIIIIIIIIIIII�III�IIIIIIIIIIIIIIIIIIIIIIIIIIIII II Project
Issued Date: 06/08/2021
Inspection Area : 1
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0610812024 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: 123 28TH ST NB
Description: MFR RE -ROOF. TIO COMP SHINGLE. INSTIL 1 LAYER 30# FELT. INSTIL 14 SQ COMP SHINGLE. (REPLACE WOOD AS NEEDED)
Legal Desc.: NEWPORT BEACH CITY BILK 28 LOT 24
Owner:
MORNINGSTAR LINDA
Address:
123 28TH ST
NEWPORT BEACH CA 92663
Phone:
Applicant:
CURTIS ROOFING
Address:
163 DUMOND DR
LAGUNA BEACH CA 92651
Phone:
949-702-2471
Code Edit : 2019
Type of Construction: V-B
Occupancy Group: R3IU
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 2
Bldg Height: 0
Bldg Sprinklers: N
Flood Zone:
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 :
$1.00
TOTAL FEE: $344.00
PROCESSED BY:
ZONING APPROVAL:
Contractor:
CURTIS ROOFING
Address:
163 DUMOND DR
LAGUNA BEACH CA 92651
Phone:
949-702-2471
Con State Lic:
647204
Lic Expire:
06/30/2022
Bus Lic:
BT30066187
Lic Exp Date:
06130/2022
Worker's Compensation Insurance
Carrier: STATE COMP INS FUND
Policy No: 9168751
Expire: 0510112022
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
ma,
Rear: /
Front: /
Left: /
Right: /
larking Spaces
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee
0
Architect:
Address:
Phone:
State Lic:
Engineer N® C
Phone: ®��� S4 lai)T:,®u,
Designer: /V ®/SiEF
Address:
Phone:
Special Conditions: HIGH DENSITY
Planning Department -
Plan check Fee:
Fair Share
SJH Trans
In -lieu Housing Fee:
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
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:
$0.00 Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
-o
o�c �Vo 0 o m
c
a
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$344.00
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
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).
7 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,
',usiness 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
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:
',y 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 legall,
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:hftp://Ww .leginfo.ca.gov/calaw.html.
',ignature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury t at Ism licensed under provisions of Gha ter 9 (co encing with Section 700) f Di 'Sion 3 of the Business and Professi o my license is in full force
nd effect. License Class — License No (�'f t Y' D�(.e, 'B 21 Contractor Signatur
WORKERS' 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 HUNDR T OUSAND DOLLARS ($10%[100(, IN ADDITION TO THE
DST 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 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
60o.w4nce of the work for which this permit is issued. Policy No.
tI 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' compensatioi
s ante carrier and policy number are:
�-C-�'T-C� -}'V+�l�
3arrier Policy Number Expiration Date
flame of Agent elPhone #
:1I certify that, in the performance of the workfowh' h 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
hat, if I should become subject t the wor rsensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant
De�ti !o rY
DECLARATION REGA G ONSTRUCTION LENDING AGENCY
hereby affirm under pe ally 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. j Al
l:N
I have read this application and the information I have provided is corr
I agree to comply with all applicable city and county ordinances and a laws relating to building construction.
I authorize representatives of this city or countv to entef the e d tified property for inspection purposes.
2
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Na
Date 67
ACTION
DATE
BY
ECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
1 GULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMITEXPIRED
I SUBMITTED ASBESTOS NOTIFICATION TO
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PERMIT CANCELLED
EPA
PERMIT EXTENDED
QMD
PERMITFINAL
13
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ASBESTOS NOTIFICATION IS NOT P CABLE TO
CERTIFICATE OF
PR POSED DE OLITIO
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OCCUPANCYISSUED
SIGNATURE
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