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Home My WebLink AboutX2022-1144 - Permitswt}oF City of Newport Beach - Building Division IIII'IIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIII II 100, Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 2 1 1 4 4 N a Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 ee Combination Type - MFP ®�+ry CONS CONS UCTIO NOISE COMB Permit: X2022-1144 Project No Issued Date : 04/20/2022 Inspection Area : 1 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 04/20/2025 OR PERMIT WILL BE INVALID Construction Hours: Monday- Friday 7:00 a.m. to 6:30 p.m. and Saturdayfrom8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job OREPPACE ^g N Description: MFR EE MO (E) B.U.R 11 SQ, CLASS'B'MIN. THE WEEKEND D Legal Desc.: NEWPORT BEACH SEC B BILK 18 LOT 18 Owner: CORONA DEL MAR PROPERTIES INC Contractor: RON PAVELOFF ROOFING Architect: Address: 3407 E COAST HWY Address: 5142 LAKEVIEW AVE Address: NEWPORT BEACH CA 92625 Phone: Phone: YORBA LINDA CA 92886 714-931-3157 Phone: State Lic: 01 Applicant: RON PAVELOFF ROOFING Con State Lic: 786691 Engineer IC Address: 5142 LAKEVIEW AVE Lic Expire: 10/31/2022 Address: P'N` F1 YORBA LINDA CA 92886 Bus Lic: BT30078532 Phone: 714-931-3157 Lic Exp Date: 04/30/3023 Phone: State Lic: Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: STATE FUND Address: Occupancy Group: R2/U Policy No: 9081839 Added /New sq.ft. Bldg: 0 Expire: 12/1412022 Phone: ` Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: / Special Conditions: No of Units : 4 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: N Right: / Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N _ Construction Valuation: $25,000.00 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 WO Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access :. $0.00 PAN Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Pee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 - $0.00 TOTAL FEE : $352.06 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $352.00 ..mow.. o PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: 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 applicab'. 'Bm(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 thelapplica t 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 Tot more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U 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 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). ❑ I 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 legall) 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 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 of ivisio 3 of the Business and Prof s" ns e, y licen e " " II force and effect. License Class License No Date 2.0 22 Contractor Signature NORKERS' COMPENSATION DECLARATION NARNING: 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. hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 3e,VeflWance of the work for which this permit is issued. Policy No. have and wiIVflTajntain 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' ie of Agent - certify that, in the perfor nce of if I should become s1/bj t to the Iature of Applicant Date which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation I��WWNS of Ca " ornia, and agree npe;�tio0,11ra qy 'ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. •� j /Z� �z IECLARATION REGARDIRG CONSTRUCTION L^END�IN��((GG////�� 1 Det`e\N / hereby affirm under natty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 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 behalf. I have read this application and the information I hav is correct. I agree to comply with all applicable city and c n ordi cas rid state laws lating to building construction. C I authorize representatives of this city or coWttt ente-igentifie0jr�rty for inspection purposes. , Civil Code). Signature of Property Owner or Authorized Agent - Print Property Owner's or Authorized Agent's Name ["-NJ D ACTION DATE BY LARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REG TIONS PART 61 OF TITLE 40 AND AQMD RULE I 1403 PERMITEXPIRED 0 I SUe ITTED ASBESTOS NOTIFICATION TO • • • + PERMITCANCELLED EPq PERMITEXTENDED Q D PERMIT FINAL tL Z� SBE OS TIFICA O ISN APPLIC TO CERTIFICATE OF +•• Op0 DD OLITION + • •• .•• • ••+ OCCUPANCY ISSUED SI N URE: • • • • • a • o e e•� ne ae e e e+e ae