HomeMy WebLinkAboutX2021-2407 - PermitsNwtrrf City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - MFP
`X2021-2407*
i.®
COMB Permit: X2021-2407
Project No:
Issued Date : 09/09/2021
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 09/09/2024 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: 117 54TH ST NB St: 1 FI: 1 Unit: 1/2
Description: MFR REROOF T/O COMP SHINGLES & REPLACE WI COMP SHINGLES 14 SOS CLASS B
Legal Desc.: RIVER SECTION LOT 8 BLK 54 POR IN SEC 29 T 6 R 10
Owner: CARNECCHIA SCIPIO M
Contractor:
REFINED ROOFING
Architect:
Address: 2484 RAMONA ST
Address:
309 MARWOOD AVE
Address:
PALO ALTO, CA 94301
FULLERTON, CA 92832 -
Phone:
Phone:
714-737-2282
Phone: State Lic:
Applicant: BIADINO MIKE
Con State Lic:
1062926
Engineer:
Address: 309 MARWOOD AVE
Lic Expire:
02/28/2022
Address:
FULLERTON, CA 92832
Bus Lic:
BT30076549
Phone: 714-737-2282
Lic Exp Date:
09/30/2022
Phone: State Lic:
Code Edit : 2019
Workers Compensation Insurance
Designer:
Type of Construction: V-B
Carrier:
CAROLINA CASUALTY INS
Address:
Occupancy Group: R3/U
Policy No:
BNUWC0154706
Added /New sq.ft. Bldg: 0
Expire:
07123/2022
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 2
Building Setbacks
Rear: /
Special Conditions:
No of Units : 2
Front: /
Bldg Height: 0
Left: /
Bldg Sprinklers:
Right: /
io0a cone:
Construction Valuation: $3,800.00
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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
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
Disabled Access :
$0.00
PNJ 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 W
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE: $352.00
Plan Check Fee
: $0.00
Fee
Due at Permit Issuance :
$352.06
PROCESSED BY:
PUBLIC WORKS APPROVAL:
ZONING APPROVAL: PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE: L
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
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 71 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 L) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Cade: 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 `ro.r. licensure under the Contractors' State License Law for the following reason:
By my signature h) Jlgw 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
,PII P qt.. ucture 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 Co.ie, i.. a. ailable 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 Date
'_I(:FNSED CONTRACTOR'S DECLARATION
I hereby affirm umer pprialty of perjury that I am licensed under provisions of Chapter 9 (commencing with Se 7 ) of ivision 3 of the Business and Prof i n C de, and my license is in full force
an, eff6ct. LiceosC Class License No to Contractor Signature
1NCIRKERS' 000PI-NSATION DECLARATION
WARNING: FAILURE rU StCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUWECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSA'90N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under. --natty of perjury one of the following declarations:
I have and wii, 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
performance of fie woe'( forwhich this permit is issued. Policy No.
I 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' compensatio
e carrier and policy number are:
Carrier Policy Number Expiration Date
Name of Agent Phone #
I certify that, in the Deno nce 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 agre
that, if I should become su jet the w compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �Cyl//
Signature of Applicant Date/ r/ 2
DECLARATION REGAI�DIK ONSTRUCTION LENDING AGENCY Y
I 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).
Lenders Name Lender's Address
By 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.
agree to comply with all applicable city and county o dinances and state laws relating to building construction.
I authorize representatives of this city or county o e ntifed property for inspection purposes. ®•Q��� 2
Signature of Property Owner or Authorized Agen Print Property Owner's or Authorized Agent's Name LY Dat
ACTION DATE BY LARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED EPA
PERMIT EXTENDED A
PERMITFINAL "L J2 SBEST OTIFICA ON IS NOTAPPLICABLE TO
CERTIFICATE OF PROPOSED OLITIO
OCCUPANCYISSUED SIGNATURE'
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