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Home My WebLink AboutX2019-1877 - Permitsrewro� City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2019-1877 100 Civic Center Drive, Newport Beach, CA 92660 X 2 8 1 9 1 0 7 7 Project No Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Issued Date : 06/13/2019 Combination Type - SFP Inspection Area : 4 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: 11 DEERWOOD LN NB Description: SFR T/O (E) 68 SQ, INSTALL BORAL 91647, 6.7psi, CIASS'B' f, : Legal Desc.: N TR 763E LOT 39 - Owner: KATZ STANLEYIELYSE Contractor: COASTAL ROOFING CO INC Architect: i Address: 11 DEERWOOD LN Address: 3303 HARBOR BLVD SUITE G-4/6 Address: NEWPORT BEACH, CA 92660 COSTA MESA CA 92626 Phone: Phone: 714-842-2830 Phone: State Lic: Applicant: MIKECOASTAL ROOFING CO INC Con State Lie: 767366 Engineer: Address: 3303 HARBOR BLVD SUITE G-416 Lie Expire: 12/3112019 Address: .._.�.�c COSTA MESA CA 92626 Phone: 714-842-2830 Bus Lie: Lie Exp Date: BT20080401 07/31/2019 Phone: State Lie: Code Edit: 2016 Worker's Compensation Insurance Designer: a Type of Construction: VB Carrier: EMPLOYEE SERVICE GROUP Address: Occupancy Group: R31U Policy No: WC018971401 Added /New sq.ft. Bldg: 0 Expire: 1213112019 Phone: Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: / Special Conditions: No of Units : 1 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: Right: / - Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $61,000.00 Building Permit Fee: $324.00 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 PAN Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical W $0.00 San Dist: $0.00 Building Green Fee : $3.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $327.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $327.00 PROCESSED BY: PUTA WORKS APPROVAL: ZONING 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 (_) 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). 1, 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 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 Sectio 70001.0f D'v' ion f the Business and P ofes 'o odgland lic ns ' n full force and effect. License Class License No Date S-' Contractor Signatur J K_. WORKERS' COMPENSATION DECLARATION ✓DARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAR IE700,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I hereby affirm under penalty of perjury one of the following declarations: 111 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 th pe "Brice of the work for which this permit is issued. Policy No. rl have and will m In 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' compensatiol Insurance carrier and oli number are: Date of Agent a v certify that, in the performance ofPe 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 ogre 1, if I should become sub' t to workers' co pensa ion provi ns of Section 3700 f the Labor Code, I shall forthwith comply with those provisions. nature /C/ nature of Applican ea-f�_(3 CLARATION REGARDING C STRUCTION LE ING AG NCY Heby affirm under penalty of perjury that there is a construQrIon IS Ing 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 owners 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. I authorize representatives of this city or coun-ty trn`enter a abov nied pr—operty/for inspection purposes. .mod 7 d nature of Prooertv Owner or Authorized AgentY \�iL.�_�/ C.��-'" Print Property Owner's or Authorized Agent's Name ACTION DATE BY DECLARATION1REGULATIONS DART 6IPOF TITLE 40 AND AQMD RULE NICE WITH CODE OF AL FOR OFFICE USE ONLY 1403 PERMIT EXPIRED PERMITCANCELLED PERMIT EXTENDED NOTICICAT:CC TO PERMITFINAL W/I5/I9j .,rVk XoC BESTOS NOTIFICATION IS NOT CERTIFIC4TEO/�'PPLICABLE TO OCCUPANCYISF �. P POSEQD�rv10L1T j V� OCCUPANCYISSUED a t� SIGNATUR � 1_