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Home My WebLink AboutX2020-0500 - PermitsC4 of Newport Beach - Building Division 100 Civic Center Drive. Newport Beach, CA 92660 h' Permit Counter Phone (949)644-3288 v Inspection Requests Phone (949)644-3255 Combination Type - SFP COMB Permit: X2020-0500 IIIIIIIII�IIIIIII�IIIIII�IIIIIIIIIII�III II Project No : Issued Date: 0212512020 Inspection Area : 3 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. 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: 1621 DOROTHY LN NB Description: SFR REROOF T/O SHAKE AND REPLACE W/ STANDING SEAM METAL ROOFING CLASS B 33 SQS Legal Desc.: N TR 1973 LOT 26 RIZOFVASKO ROOFINGINC Architect: -rOR f N � E� Address: 16211 DOROTHY LN Address: P.O./BOX 8788 Address: V 1 NEWPORT BEACH, CA 92660 MAMMOTH LAKES CA 93546 Phone: Phone: 760-9375636 Phone: State Lie: Applicant: D & J ROOFING INC Address: P.O. BOX 8788 MAMMOTH LAKES CA 93546 Phone: 760-937.5636 Code Edit : 2019 Type of Construction: V-B Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Construction Valuation: $33,500.00 Con State Lie: 886300 Lie Expire: 1013112020 Bus Lie: BT30038799 Lie Exp Date: 03/3112020 Worker's Compensation Insurance Carrier: ESG Policy No: WC018974900 Expire: 12131/2020 Building Setbacks Rear: I Front: I Left: I Right: I Engineer: Address: Phone: Designer: Address: Phone: Special Conditions: State Lie: 0000 ° co 0 m o 0 .o 0 oo�o• ° 00000 000sa• e- o 0 o o�m Building Permit Fee: $324.00 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 Shan:: $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 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access: $0.00 P/W Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $2.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $326.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $326.00 PROCESSED BY: �. PUBLIC WORKS APPROVAL: ZONING APPROVAL: GRADING APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: C8 V V _ 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) action 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 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 �fessions 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 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 L) portions of the work, and the structure is not intended or offered for sale (Section 7044, :iness 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 Kovements 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 Proved 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 Ply 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: 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 Iegalll 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 ,fessions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html. nature of Prop qy, Owner or Authorized Agent Date TENSED CONTRACTOR'S DECLARATION areby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 of Divis� 3 of the Business and Profess_i C tle, and my licen a is in full force i M61. Licer'se MIS License No Dat/Ll'ENAL � Zj � ntractor Signature �BJl% )RK,ERS' COMPEASATION DECLARATION L -RING, FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINTIESAND CIVIL FINES UP TO ONE HUNOR THOUSAND DOLLARS ($100,000), IN ADDITION TO THE IT OF COMPENSATION CAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. undL pel+alty of perjury one of the following declarations: Jye and 46 : alntain 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 WTm flce of the w8& for which this permit is issued. Policy No. laveand 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' compensa 'incdcarrierendiokv number are: Policy Number Date wia,ctAgent ------ Phone# ow. 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 work ' compensati IT laws of California, and agre I, if I should become sut/�to t workers' comp ael}s tion provisionction 3700 of the Labor Code, I shall forthwith comply with those provisions. _ nature of Applicant G -1/—\4 %-V\ ate : 2 CLARATION REGAVING CONSTRUCTION LEND(N'G AGENCY ' rmby affirm under p ally of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 097, Civil Code) Ider's Name r Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and co u ordinances and state laws relating to building construction. I authorize representatives of this city or county r�(��/f�Je above -identified r erty for inspegion purposes. �//�.+ (/'�j '� ' nature of ProDertv Owner or Authorized Acent 1 X7 J n Prid,ProDertv Owner's or Authorized Aaent's Na `� k L,, ACTION DATE BY DECLARATION OF CO 10FTITLWANDAgMCL-WITH CODE F FEDERAL I FOR OFFICE USE ONLY PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED OEPA PERMIT EXTENDED QMD PERMITFINAL CERTIFICATE OF OCCUPANCY ISSUED S'S� ASBESTOS OTIFICATION IS NOT APPLICABLE TO R POSED MOLTI�ION n ,N uR :..�i-. I/