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HomeMy WebLinkAboutX2018-3728 - PermitsCity of Newport Beach - Building Division I!�� IIII i�IIIII II IIIIIIIII III III I II COMB Permit: X2018-3728 .�? T 100 Civic Center Drive, Newport Beach, CA 92660 IX 2 0 1 8 3 7 2 8 Project No Permit Counter Phone (949)644-3288 ur Inspection Requests Phone (949)644-3255 Issued Date :12I71/2018 Combination Type - SFP Inspection Area : 3 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. 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: 1715 STARLIGHT CIR NB Description: SFR REROOF T/O B.U.R AND REPLACE WITH NEW BUILT-UP WI TORCH DOWN CLASS "A" 38 SGS Legal Desc.: N TR 3763 LOT 26 Owner: KLOHSJOHN Address: 1715 STARLIGHT CIR NEWPORT BEACH, CA 92660 Phone Applicant: NEWPORT ROOFING INC Address: 120 TUSTIN AVE #C NEWPORT BEACH CA 92663 Phone: 949.645-0104 Code Edit: 2016 Type of Construction: V-B Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units: 1 Bldg Height: 0 Bldg Sprinklers: Flood Zone: Building Permit Fee: $324.00 Plan Check Fee: $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $325.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: NEWPORT ROOFING INC Architect: Address: 120 TUSTIN AVE #C Address: NEWPORT BEACH CA 92663 .� Phone: Con State Lie: 949-645-0104 524454 Phone: Engineer: State Lie: 's J Lie Expire: 09/2912020 Address: BLip: B 506 Lie Exp Date: 10/31120I31/2019 Phone: State Lie: Worker's Compensation Insurance Designer: Carrier. STATE COMP Address: Policy No: 9161897 Expire: 0710112019 Phone: Building Setbacks Rear: / Special Conditions: Front: / Left: / Right: I Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Excise Tax: $0.00 Planning Department - Fire Department Additional Fee : $0.00 Plan check Fee : $0.00 Fire Inspection: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 PAN Plan Check: $0.00 Grading Bond: $0.00 Electrical W $0.00 San Dist: $0.00 $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $325.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: 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 items) (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). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) 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 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). ❑ 1 am exempt from licensure 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 legal 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 PrJperty Owner or Authorized Agent LICENSED CONTPACTOR'S DECLARATION I hereby affirm • Inde- penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 00q) of Dion 3 of the Business And Profe II force and e6ect. License i :lass License No Da L� f j , Contractor Signature COMPENSATION DECLARATION ARrt,NG: FAILURF TO SE:URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CR)MINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE OST OF COMPE:IC4.T.Jd, 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: 111 i lave ano will m,.intain 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 ?iprmance of the work for which this permit is issued. Policy No nave and wPl mail;tain 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' range carrier and policy number are: Policy Number Expiration Date of Agent Phone #_ certify that, in the perfo ante 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' c mpensation laws of California, and t, if I should becomes ject to or ar 'tom en revisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Q nature of Applicant Dat _� �I v CLARATION REG STR ENDING AGENCY .reby affirm under p nalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 30 , Civil Code). ider's Name Lender's Address my signature belo , 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 count ordinances Slaws relating to building construction. I authorize representatives of this city or county t en abov -iden "" d property for inspection purposes. nature of Property Owner or Authorized Aqent Print Property Owner's or Authorized Agent's Name FOR OFFICE USE ONLY PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED / LIISUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMITEXTENDED I [\LlAoMD PERMIT FINAL QS/27/Z2 �,W` SBESTOSN IFICATION IS NOT APPLICABLE TO CERTIFICATE OF yam, I'!'E' RO SEE DE O B OCCUPANCY ISSUED 0.��-°` SIGNA F