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Home My WebLink AboutX2021-0683 - Permitsrwj� o,� City of Newport Beach - Building Division III11111111111111111111111111111111111111111111111111 X 2 0 2 1 0 6 8 3 II COMB Permit: X2021-0683 J 100 Civic Center Drive, Newport Beach, CA 92660 Project NO h r Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Issued Date . 0312312021 4' Combination Type - CIP YP Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0312312024 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: 2826 NEWPORT BLVD NB Description: COMM -T/O 12 SQ B.U.R, 10 SQ COMP. INSTL 12 SQ B.U.R. ICC-ESR# 1274. INSTL 10 SQ COMP ]CC-ESR# 1475. CRRC# 0646-0001 Legal Desc.: NEWPORT BEACH SEC A BLK 225 LOT 14 Owner: SZABO ALAN Contractor: PERFORMANCE ROOFING CO Address: 1401 KINGS RD Address: 2506 S BROADWAY NEWPORT BEACH CA 92663 SANTA ANA CA 92707 Phone: Phone: 949-645-2382 Applicant: PERFORMANCE ROOFING CO Con State Lic: 797003 Address: 2506 S BROADWAY Lic Expire: 07/3112021 SANTA ANA CA 92707 Bus Lic: BT00006327 Phone: 949-645-2382 - Lic Exp Date: 0513112021 Code Edit : 2019 Worker's Compensation Insurance Type of Construction: V-B Carrier: STATE COMP INS FUND Occupancy Group: B Policy No: 9094635 Added /New sq.ft. Bldg: 0 Expire: 0410112022 Added /New sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: I No of Units: 0 Front: I Bldg Height: 0 Left: I Bldg Sprinklers: Right: I Flood Zone: X Use Zone: Parking Spaces: 0 Construction Valuation: $21 790.00 Building Permit Fee: $450.00 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 TOTALFEE PROCESSED BY: ZONING APPROVAL: Architect: Address: Phone: Engineer: Address: State Lic: Phone: 'rVO F-, gt'State Lic: Designer: H�7�, Address: }tic "ON �® Phone: 6 Special Conditions: 1 111&9rdynZ q Fire Hazard Zone : N Excise Tax: $0.00 Planning Department - Additional Fee : $0.00 Plan check Fee Grading Bonds Fee: $0.00 Fair Share Grading PC Consultant : $0.00 SJH Trans Grading Permit Fee: $0.00 In -lieu Housing Fee Grading PC Fee: $0.00 Public Works Department - WQ Insp. Fee: $0.00 Park Dedication : $0.00 PAN Plan Check: $0.00 Electrical %: $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 I , V SP Fire Department $0.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 .00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $451.00 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 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 II-m-roved for the purpose of sale). u 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 legall), 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.htmi. 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 7000) q Div�5iog 3 y{ t. Business and Professgn full force and effect. License Class License No Date 7' G 7 ' Wt. Signature — (/(/(i WORKERS' COMPENSATION DECLARATION NARNING: 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 (E100,000), 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 36rformance of the 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' ie of Agent certify that, in the performance , if I should become subject toi Policy Number 9�K6 3 S 26 2 Expiration Date 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 Mien provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant �( "Kw'" Dg21( '% CLARATION REGARN4 CONSTRUCr/ N LENDING AGENCY �— Ireby 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). Ider's Name Lender's Address 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 cougert nance d to s re g to building construction.( ei I authorize representatives of this city or coup e ve-i ed pert for inspection purposes. //////nature of Property Owner or Authorized Agent Print Provertv Owner's or Authorized Aaent's Name' V ( (�C/i 2 .3. 2tr ACTION DATE BY " DECLARATION OF COKPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY v f REGULATIONS PART 610E TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO - PERMITCANCELLED UEPA PERMIT EXTENDED QMD PERMIT FINAL ,�J,L" /� ASBESTOS NOTIFICATION IS 50f APPLICABLE TO CERTIFICATEOF '/T PROPOSED DEM LI��^�/yu'•�/�f OCCUPANCY ISSUED SIGNATIIRE��.1/(/l