HomeMy WebLinkAboutX2020-0503 - Permits (3)104 City of Newport Beach - Building Division I��IIIIIIII��IIIIIIIIIIIIIIIIIIIIIIII I� COMB Permit: X2020-0503
100 Civic Center Drive, Newport Beach, CA 92660 -- _ X 2 0 2 0 0 5 0 3 Project No
h. Permit Counter Phone (949)644-3288
v '# Inspection Requests Phone (949)644-3255 NO CONSTRUCTION
ONST 1 @6"�5 ION NOISE Issued Date: 0212512020
'.arigp�y* Combination Type -SFP 4lRa k R !�I !tl
Inspection Area : 1
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturcl . No wank on Sundays or Holidays
Job Address: 122 33RD ST NB'
Description: SFR REMOVE (E) 15 SQ OF B.U.R, INSTALL SINGLE -PLY, CLASS'B'
Legal Desc.: NEWPORT BEACH CITY LOT 14 BLK 32 AND LOT 15 BLK 32 e�
Owner: P A &GAB
Address: 3624 BEVERLY RIDGE DR
SHERMAN OAKS CA 91423
Phone:
Applicant: GM -ET ROOFING
Address: 130 112 47TH STREET
NEWPORT BEACH CA 92663
Phone: 714-272-1118
Code Edit: 2019
Type of Construction: VB
Occupancy Group: R3IU
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation: $7,500.00
Building Permit Fee: $324.00
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: $325.00
PROCESSED BY:
ZONING APPROVAL:
Contractor:
GM -ET ROOFING
Architect:
Address:
13011247TH STREET
Address:
al
co
NEWPORT BEACH CA 92663
Phone:
714-272-1118
Phone:
State Lie:
�u -
Con State Lie: 937852
Engineer:
-
1
Lie Expire:
0913012021
Address:
Bus Lie:
BT30040448
Lie Exp Date:
08131/2020
Phone:
State Lie:
>�
Worker's Compensation Insurance
Designer:
Carrier:
Policy No:
STATE FUND
9082018
Address:
Expire:
01/01/2021
Phone:
Building Setbacks
Rear: I
Special Conditions:
HIGH DENSITY AREA
Front: I
Left: I
Right: I
Use Zone:
Parking Spaces:
0
Fire Hazard Zone:
N
Excise Tax:
$0.00
Planning Department-
Fire Department
Additional Fee,
$0.00
Plan check Fee :
$0.00
Fire Inspection:
$0.00
Grading Bonds Fee:
$0.00
Fair Share :
$0.00
Fire Plan Rev
$0.00
Grading PC Consultant :
$0.00
SJH Trans :
$0.00
Demolition Fee
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
$0.00
Building Dept Adm
$0.00
Grading PC Fee:
$0.00
Public Works Department-
General Service
$0.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
PAN Plan Check:
$0.00
Grading Bond:
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
Plan Check Fee
: $0.00
Fee Due at
Permit Issuance :
$325.00
4
PUBLIC,-WDRKS APPROVAL:
oc„
PLAN CFkCK BY:
GRADING APPROVAL: o p APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION
1 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
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 U all of or (_) 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 Cade: 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/Galaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I n licensed under provisions o Chapter 9 (commencing with Section7f,000) o Msiion 3 of the Business and Pro s o e, an Js n ul force
and effect. License Class 13, C. '3 Y License No 3 7 �S 'a- Date m 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:
D 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 the
34rmance of the work for which this permit is issued. Policy No.
have and will npir4pn 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'
rance carrier a po y number are: V—%
ier _ 1 Y/ / 1 Po umbcExpiration Date
1e of Agent I
JI 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 laws of California, and agrei
iat, if I should become pu ect to the work ' com tie r v sl sO,Section 3700 of the Labor Code, I shall forthwith comply with those provisions. n�1
signatureof Applicant 1/� D
IECLARATION REGARDING CONSTRUCTION LENDMG AGENCY
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
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 have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction. /
I authorize representatives of this city or coun o r the above -identified property for inspection purposes. ar. ,n �S Iicnature of PMDertv Owner or Authorized ADent ty Print Pronertv Owner's or Authorized Anent's Na 4,q_--ePX i� 6�G.�-'�T na1w
ACTION DATE BY DECLARATION OF II REGULAT ONS PA T061 OF IITLE 0 AND QMD RULECE WITH CODE OF
FOR OFFICE USE ONLY
PERMITEXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO •+•
PERMITCANCELLED EPA ••• �• ••` • .••
PERMITEXTENDED QMD + • • + + :+ • •• •++
PERMITFINAL T �,` J(I` SRE5T05 NOTIFICATION IS N PPLICABLE •f0
CERTIFICATE OF J Vv PROPOSED DEMO ITION
OCCUPANCy1SSUED SIGNATURE: oeo +
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oc� goo 000 0 o coo .moo.