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Home My WebLink AboutX2020-2650 - PermitsCity of Newport Beach - Building Division 04 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 re Inspection Requests Phone (949)644-3255 Combination Type - SFP IIIIIIIIIIIII'llllllllllll II COMB Permit: X2020-2650 Project No : Issued Date : 1111612020 Inspection Area : 4 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 11/17/2023 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: 915 ALDER PL NB Description: SFR TIO (E) 37 SQ, INSTALL COMP. SHINGLE, CLASS'B' MIN Legal Desc.: N TR 4705 LOT 7 Owner: PANEHAL JAMESIKRISTIN Contractor: J D CLARK ROOFING Architect: Address: 915 ALDER PL Address: 15569 ROLLING RIDGE DR Address: NEWPORT BEACH, CA 92660 CHIL HILLS CA 91709 Phone: Phone: 909-636-9057 Phone: State Lic: Applicant: J D CLARK ROOFING Con State Lic: 416967 Engineer: �� Address: 15569 ROLLING RIDGE DR Lic Expire: 01/31/2022 Address: CHIL HILLS CA 91709 Bus Lic: BT30047826 _9 Phone: 909-636-9057 Lic Exp Date: 07/3112021 Phone: State Lic: 0 Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: STATE COMP Address: Occupancy Group: R31U Policy No: 9073636 Added /New sq.ft. Bldg: 0 Expire: 06118/2021 Phone: Added /New sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: I Special Conditions: No of Units : 1 Front: I Bldg Height: 0 Left: I Bldg Sprinklers: Right: I Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $23,000.00 Building Permit Fee: $0.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $167.00 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 : $168.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $168.00 PROCESSED BY: PUBL'C WOFKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: o 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 :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 iot 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 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 i�m roved 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 from Iicensure under the Contractors' State License Law for the following reason: By 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 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 Professions Code, is available 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 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 of ' isio 3 of the Business and Prof ssio d my license is in full force and effect. License Class License No Date /6 Z.d Contractor Signature WORKERS' COMPENSATION DECLARATION NANNING: 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. 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 the oe¢or mance of the work for which this permit is issued. Policy No. have and will rcmI�fain workers' rance carrier andbtiicv number' of Agent insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' Expiration Date Phone # certify that, in the performance o or r 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( t, if I should become su ject to e o compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. y, nature of Applicant DD l�%,z D CLARATION REGA CTION LENDING AGENCY areby affirm under nalty 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). ider's Name Lender's Address my signature below, I certify to each of the following: —ZDhh 6`,ttp-1c I am the property owner or authorized to act on the property o/ir If. I have read this application and the information I have provideI agree to comply with all applicable city and county ordinanclaws relating to building construction. I authorize representatives of this city or county to en r ted property for inspection purposes. mature of Prooertv Owner or Authorized ADent Print Propertv Owner's or Authorized Agent's Na ate l% ACTION DATE BY PART 61 OOF TITLE 40 AND AQMD RULE NCE WITH CODE OF AL FOR OFFICE USE ONLY I REGULATIONS PERMITEXPIRED U SUBMITTEDA5BE5TO5NOrIFICAii0NTO__ PERMITCANCELLED PERMITFINAL 0]/O)r/Zy ASBESTOS NO CATIO APPLICABLE TO CERTIFICATEOF PROPOSED LITIO OCCUPANCY ISSUED SIGNI