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Home My WebLink AboutX2021-2968 - Permitsrwwhck City of Newport Beach - Building Division `X2021-2968* COMB Permit: X2021-2968 r i� as 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 0395-2021 Permit Counter Phone (949)644-3288 "* Inspection Requests Phone (949)644-3255 T_ Combination Type - MFP i 's Y�V Issued Date : Inspection Area :2 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1110112024 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: 201 COLLINS AVE NB Description: MFR REROOF: T/O (E) ROOF. INSTALL CLASS 'A' COMPOSITION SHINGLES W/ SYNTH UNDERLAY. (23 SQ). INSTALL (4 SQ) OF TORCH DOWN TO FLAT ROOF. Legal Desc.: BALBOA ISLAND RESUB SEC 1 LOT 1 BILK 14 ALL -EX ST- Owner: ZATICA BRYAN Address: PO BOX 11029 SANTA ANA CA 92701 Phone: 714-863-4184 Applicant: HEASTON JEANELLE Address: Phone: 909-633-4094 Code Edit : 2019 Type of Construction: V-B Occupalcy Group: R2/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 2 Bldg Height: 0 Bldo Sprinklers: N Contractor: MC CORMACK ROOFING ENERGY Architect: '.... , . Address: 1260 N HANCOCK #108 Address: ANAHEIM CA 92807 Phone: 714-777-4040 Phone: State Lic: Con State Lic: 643700 Engineer: Lic Expire: 0613012022 Address: Bus Lic: BT30075880- Lic Exp Date: 0713112022 Phone: State Lic: Worker's Compensation Insurance Designer: Carrier: EMPLOYEE SVC GRP Address: Policy No: WC900085108 Expire: 12/3112021 Phone: - Building Setbacks Rear: / Special Conditions: ' Front: / Left: I Right: / Flood Zane: A01 use tone: FarKing a aces: u nie neceiu c.ouo . . Construction Valuation: $11,000.00 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 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 PNV 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 : $352.00 Plan Check Fee : $352.00 Fee Due at Permit Issuance : $0.00 PROCESSED BY: ZONING APPROVAL: PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: 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 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 (_) 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 im raved 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). ❑ 1 am exempt from Iicensure under the Contractors' State License Law for the following reason: By my signature oelow 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 P. ofessicns Coda, i- ar ilable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm]. Sig.natu,e of Property Owner or Authorized Agent Date L'CENSED CON-i RACTOR'S DECLARATION I hereby affirm under p. nalty of,.per u that I am licensed under provisions of Chapter 9 `commencing with Section 7000) of Division 3 of the Business an Profe Code, and my y� is in f II force a.,d : ffec(. LicenoE Class �� License No �D f-f- 3�C Date i 1- 1-7. ( Contractor Sign r /� � �' (J WORKERS' COYIPENSATION DECLARATION WARNING: 'rAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES LIFT ONE HUNDR USAND 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. ner.=by Pffirm under penalty of perjury one of the following declarations: and WE: ,Tlaintain 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( ice of thr work for which this permit is issued. Policy No. 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' compensatior carrier and policy number are: , In /1 r9 7Ati✓1 Policy Number w Iq 01)11 AS I Expiration Date is of Agent certify that, in the performance of the work for which this if I should be e s D the workers' compensatiq Iature of ADDkan is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ions of action 3700 of the Labor Code, I shall forthwith comply with those provisions. Date l/ IECLARATION REGA DING ONSTRUCTION LENDING AGENCY hereby affirm under p f 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 ly 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 county ordinances and state laws relating to building construction. I authorize representatives of this city or GevnTFtD�,t r the above-idenkfiFq/roperty )or inspection purposes. ACTION DATE BY DE LARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY GULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED LJEPA PERMIT EXTENDED LIAcMD PERMITFINAL ps-d- DASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF -/712I fbh PROPOSED DEMOLITION OCCUPANCY ISSUED q SIGNATURE: