HomeMy WebLinkAboutX2022-1791 - PermitsWil(J�. City of Newport Beach - Building Division
COMB Permit : x2022-174
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. 100 Civic Center Drive, Newport Beach, CA 92660
X 2 2
Project NO
�. : n: Permit Counter Phone (949)644-3288
s3 2 Inspection Requests Phone (949)644-3255
Combination Type - SFP
Issued Date : 06/29/2022
Inspection Area : 2
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY
OR PERMIT WILL BE INVALID
Construction Hours: Monday- Friday 7:00 a.m.
to 6:30p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays
Job Address: 654 HARBOR ISLAND DR NB
Description: SFR REOOF T/O WOOD SHAKE AND REPLACE W/ ASPHALT SHINGLES 27 SQS & FLAT ROOF 4 SQS
Legal Desc.: N TR 3867 LOT 21
Owner: RINGQUIST JACK Contractor:
EVERLASTING ROOFING CORP Architect:,
Address: 654 HARBOR ISLAND DR Address:
2215 E LA PALMA AVE APT 232 Address:
li i %
NEWPORT BEACH, CA 92660
ANAHEIM, CA 92806
Phone: Phone:
714-640-0914 Phone:
State Lic: '
Applicant: EVERLASTING ROOF CORP Con State Lic: 1082025 Engineer:
Address: 2215 E LA PALMA AVE APT 232 Lic Expire:
10/31/2023 Address:
ANAHEIM, CA 92806 Bus Lic:
ST30079129
Phone: 714-640-0914 Lic Exp Date:
06/30/2023 Phone:
State Lic: -
Code Edit: 2019 Worker's Compensation
Insurance Designer:
-
Type of Construction: V-B Carrier:
CLEAR SPRING Address:
Occupancy Group: R3/U Policy No:
CWC00175200
Added /New sq.ft. Bldg: 0 Expire:
Phone:
_
Added /New sq. ft. Garage: 0
No of Stories: 2 Building Setbacks
Rear: / Special Conditions:
No of Units : 1
Front: I
Bldg Height: 0
Left: /
Bldg Sprinklers:
Right: /
Flood Zone: Use Zone:
Parking Spaces: 0 Fire Hazard Zone : N
Construction Valuation: $23,000.00
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
P/W 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 : $0.00 Fee Due at Permit Issuance : $352.00
PROCESSED BY:
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO ISSUE:
Ali
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for thereason(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
'he 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 Iicensure 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 sale compensation, will do U all of or U 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 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 fry.. !:censure under the Contractors' State License Law for the following reason:
By my signature blow 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
si?II R Onicture 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.; avJable upon request when this application is submitted or at the following Web site:http://wWw.leginfo.ca. gov/calaw.htm 1.
Signature of Property Owner or Authorized Agent Date
L'CENiSED CONTRACTOR'S DECLARATION
I hPrebv affirm unuer oenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0 Div si n 3 of the Business and Profeps)ons C nd my lic n� full force
aId affect. Licence Class License No Date Z 2'Z Contractor Signature
VORKERS' COMPE)4SATION DECLARATION
NARNINC:' 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.
I hereby of irm under p=nalty of perjury one of the following declarations:
I have and wid 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
performance of thL wo-k for which this permit is issued. Policy No.
`
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' compensatior
surance carrier and policy number are:
Policy Number
me of Agent _
Date
I 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 agree
lot, if I should becomes lect to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
IEnature of TIONp1REGt � O A Datg�j
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,,CiJvil Code).
Ender's Name Lender's Address
y 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.
authorize representatives of this city or count tcj7enteI th-above-i ntified propay for inspection purposes. fx .7 1 1 r
ACTION I DATE
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY ISSUED
BY V aY-G A ATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
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I SUBMITTED ASBESTOS NOTIFICATION TO
EPA
NOTIFICATION IS NOTAPPLICABLE TO