HomeMy WebLinkAboutX2020-2701 - Permitsw City of Newport Beach - Building Division
' 100 Civic Center Drive, Newport Beach, CA 92660
F Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
*,po' Combination Type - SFP
COMB Permit: X2020-2701 IIIIXIIIIIIIVIIIUIII�llllllll�l7lllll�lllllq II
Project No:
Issued Date, 1112012020
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1112112023 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: 1906 HOLIDAY RD NB
Description: SFR T/O (E) 51 SQ, REPLACE SHEATHING AS NEEDED, INSTALL COMP. SHINGLE, CLASS'B'MIN
Legal Desc.: N TR 3763 LOT 61
Owner: MENA VICTOR
Contractor:
LION ROOFING INC
Architect:
Address: 1906 HOLIDAY RD
Address:
413 S NUTWOOD ST
Address:
NEWPORT BEACH, CA 92660
ANAHEIM CA 92804`d�
Phone:
Phone:
714-904-5188
Phone:
State Lie:
Applicant: ANGELILION ROOFING INC
Con State Lie:
1018956
Engineer:
Address: 413 S NUTWOOD ST
Lie Expire:
10/31/2022
Address:
p�
ANAHEIM CA 92804
Bus Lie:
BT30065698
Phone: 714-904-5188
Lie Exp Date:
01/31/2021
Phone:
State Lie:
Code Edit: 2019
Workers Compensation
Insurance
Designer:
Type of Construction: VB
Carrier:
STATE COMP
Address:
Occupancy Group: R3IU
Policy No:
9167032
0
Added /New sq.ft. Bldg: 0
Expire:
12/03/2020
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 2
Building Setbacks
Rear I
Special Conditions:
No of Units : 1
Front: I
Bldg Height: 0
Left: I
Bldg Sprinklers: N
Right: I
Flood ZoneX -
Use Zone: Parking Spaces:
0
Fire Hazard Zone : N
Construction Valuation: $20,000.00
Building Permit Fee: $343.00
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
WQ 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 Fee: $1.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $344.00
6Plan Check Fee:
$0.00
Fee Due at Permit Issuance :
$344.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
e
d
a "epl�L°JC WORKS APPROVAL:
d e »e .Q.
PLAN CHECK BY:
APPROVAL TO ISSUE:
a
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)
iection 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
is 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).
11, as owner of the property, or my employees with wages as their sole compensation, will do (_) 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: I
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 legally
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:http://www.leginfo.m.gov/calaw.htmi.
ignature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 0,10f - iviS n 3 of the Business and Professions Cod and I en is in full force
nd effect. License Class License No Date I ontractor Signat _ _ ,
VORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENT LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSII S (E�00, H 111, 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 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
�erf ante of the work for which this permit is issued. Policy No.
e 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' compensatiol
Isurance car' r rid policy nur>eL rare.
;arrier ,a1 ft c, Number C( i5,7n:4, 2 ( Expiration Date
lame of AG _ r Phone #
3 certify that, in the performance oft ork far whit ' 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
rat, if I should become so bject to thew keys' co pe atio provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
;ignalure of Applicant
IECLARATION REG DING C T U ION L ING AGENCY
hereby affirm under nalty of "u the here is a nstruction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Ender's Name Lender's Address
ly 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 la re ating to building Construction.
I authorize representatives of this cityor coun Triter the a ive-Identi 'e rr artyfor inspection purposes.
tionature of Property Owner or Authorized Agent i' �/! Print Property Owner's or Authorized Agent's Nam T I/U('o E42)EDt--S ate I f/713/ZD7.r
ACTION DATE BY IL DECLAR Z214 F COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403 •• ...
PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICAeION TO • • ` ` • • a
PERMITCQNCELLED EPA • • • • : • •• ••
PERMITEXTENDED QMD
PERMIT FINAL LJASBESTOS NOTIFICATI 15 N T P ICABLE TO
CERTIFICATE OF �Z. �, PRO S D OLI710N •• ••• a • •••
OCCUPANCY ISSUED NATU e • e • + �•° e ° e
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