HomeMy WebLinkAboutX2022-1363 - Permitsy,N no4,r City of Newport Beach - Building Division IIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIII II
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100 G1vic Center Drive, Newport Beach, CA 92660 X 2 2 1 3 6 3
Permit Counter Phone (949)644-3288
x"•: "m Inspection Requests Phone (949)644-3255
Combination Type -MFP
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PERMIT EXPIRES 160 DAYS AFTER ISSUANCE OR LAST VALID I PECTION. PROD MUST BE MPI
Construction Hours: Monday- Friday 7:00 a.m. to 6:3 .m. anal Saturc(�1p om 8:00}}}���.m. t :L
Job Address: MF VISTA BO T/O IL fie' d
Description: MFR REROOF TIO TILE AND REPLACE WI BORAL TILE CRRC 942-01?�S SO$ �� /
Legal Desc.: TR 5877 (L.L.84.214030) PAR 10 11��G f
Owner:
ATKINS ROBERT I W
Contr or:
,0MLIFO d
Address:
611 VISTA BONITA
A ss:
894 A
NEWPORT BEACH, CA 92660
INSI
Phone:
Phone:
7 847-768!
Applicant:
CALIFORNIA ROOF LIFE CO INC
Con ate L'
509623,0
Address:
8941 MINT AVENUE
Expir
_ 441 2023
WESTMINSTER CA 92683
us L'
058654
Phone:
714-847-7663
Lic
/30/2023
i'
Code EditZBIdg:
Wor s omp ion Ins`q�'
Type of ConstrEarn, S T
Occupancy GrRIo: 8 7
Added /New sq`Expire: 12
Added /New sq>,�No of Stories: ` Iding Setba ' ra INo of Units :' d �s t: IBldg Height:Left: /
Bldg SprinklersRight.Flood Zone**I ll� � Parkins Sna
INC Architect:
Address:
COMB Permit: X2022-1363
Project No :
Issued Date : 0511112022
Inspection Area : 4
:TED BY OR PERMIT WILL BE INVALID
p,m. No work on Sundays or Holidays
A 92683
Phone:
Engineer
Addre9r�.
ho
(Signet:
FUND Addr��:
C Come:
� Special ond�tjb 1
0 O \`
Fire az� Zone : N
Building=Perm as, .00 KAB T
Plan CheF;ee $0.0 Adtlio 0.1
ee : �`$
Overtime Pled k, �0'.00 G[_ onds Fee:A 6 00
Investigation F s $0.00 Gr g PC Consultan $0.00
Record Managernbnt $0.00 Grading Permit FeQ 00
Energy Compliance' _ 0.00 t` rading PC Fe �i��b h��$d.00
CA Seismic Safety 00 ��" WO Insp. F g r�\` $0.00
Disabled Access $0.
Hazardous Mat ''Q.00 Electra $0
Building Green Fee : 's 0 aril I G/ . .00
ng %: $9.0
TOTAL FEE: ^$352.00 , / P n CtitSeck Fee :
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
In -lie''""'' ''o��ng Fee:
Pub' verksDepartment-
arrYDedication : $0.00
Plan Check: $0.00
n Dist: $0.00
NMUSD Fee: $0.00
irff.wc: o a o
�7
Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $352.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY: v �`
APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION I-
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) 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 S tion 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 U all of or U po ns of the ork, 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 w -,-through emp eas' of.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 o ear of completign, 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 act (Section 7044 �s ness an rofe9's_ions 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 w' a licensed Contra pursuant th ontrat:tprs' State License Law).
I am exempt from licensure under the Contractors' State License Law for the following reas
By my signature below I acknowledge that, except for my personal residence in which I mus ve re ' or at I one year for to compleb of theoimprovements 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 an ' ty by Ii ed cynira tors. I and stand that a copy o e applicable law, Section 7044 of the Business and
Professions Code, is available upon request when this application is submitted or at th Ilowin� site:h`ttp'//www.legi, o.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent l Dat=
LICENSED CONTRACTOR'S DECLARATION ���� a 0
I hereby affirm under penalty of perjury that I am licensed under provisions of apter 9 (coTnmen�with SeG 7 0 of Div' io 3 of the Business and f sLBn de, and m fen ce
and effect. License Class License No ate Contractor Signatur
WORKERS' COLVENSATION DECLARATION r
WARNING: FAILURE T6 LEJJRE WORKERS' COMPENSATION COVERAGE IS UNLA UL, AND SH SUBJEE�CT AN EMPLQQM TO CRIMINAL PENALTIES AND CIVIL FINES OPJf1d HUNDRED THO No L A" ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF T ABOR COD , NTERES7a'AND ATTORNEti'S FEES.
I hareby afirm under penalty of perjury one of the following de atons:
I have and will maintain a certificate of consent to s -insure for orkers' compensation, issued by the Director of Industrial ati s as provided for. §Q00on 700 of the Labor Code, for th
perf rmance of the work for which this permit is issued. lic
have and will maintain workers' compensation uran e, requiredAy Section 3700 of the Labor Code, for the perfon of tjl�,��rk for wh' mi issued. My workers' compensatio
Sur ce carrier and policy number are:
Carrier
oI' No ��'-^'' cf pirationD e
Name of Agent Phone # ' W
' certify that, in the ^erlormance o e work for ich thisf rmit is issued, I shall not eni . y person in y - r ato become bjecWilheAprkers compensation laws of California, and ogre
that. if I should becurne(s�u ject o workers mp� provisions of Section 3700 of the Labor Code s fo Wit �e6mply with ose plwisi�.
Signature of Applicant C It
\ 0� Date
DECLARATION REGA D C NSTION LENDING AGENCY -
1 hereby affirm under pe ty of pe{jgij'that there is a construction lending agency_for the performance of the work for which thi permit i ss (Section 3097, Civil ode).
Lender's Name - V ." Lender's Address
By my signature below, I c ify to each the following. 1
I am the property owner utho d to act on the property owner s behalf.
I have read this application d the r ' n 1 have provided tsscorrect.
I agree to comply with all appli ble ci d cou j;1',' - anc d state laws re o ilding cons/s.//
I authorize representatives of this 'ty or coun ove-ide 'ti' action puSignature of PropertOwner or Authoriz Age Print ProOwne' o uth"'z rl Agents Name ` • Dat ^�i
ACTION DATE Y CE ODE OF F. RRAIL0 FFICE USE ONLY
ULATIONN S TI�V€ AND AQM ULE
1403
PERMITEXPIRED ZPANI ISU41ftASBESWNOTIFICATTP1qTO
PERMIT CANCELLED
PERMIT EXTENDED NSIGNR
PERMITFINAL S OTIFICA71 IS NOT APPLI LE TO
CERTIFICATE OF OL C�
OCCUPANCYISSUED ^N////A ///�
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