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Home My WebLink AboutX2016-2562 - Permits,Mror City of Newport Beach - Building Division r 04 d 100 Civic Center Drive, Newport Beach, CA 92660 ti '•.. Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - MFP IIIIIIIIIIIIIIillllllllllll II COMB Permit: X2016-2562 Project No : Issued Date : 08/04/2016 Inspection Area : 8 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. INSTALL OR VERIFY SMOKE/CARBON MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED Job Address: 857 AMIGOS WAY NB Description: MFR REROOF W/ COMP, TIO EXISTING (40 SQ) Legal Desc.: N TR 5425 LOT 2 Owner: SOLTEROS APARTMENTS Address: 18627 BROOKHURST ST #524 FOUNTAIN VALLEY CA 92708 Phone: Applicant: ADAM'S ROOFING INC Address: 3435 SOUTH SILVER SPUR SANTA ANA CA 92704 Phone: 714-965-0245 Code Edit: 2013 Type of Construction: VB Occupancy Group: R2/U Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 2 No of Units: 4 Bldg Height: 0 Bldg Sprinklers: Flood Zone: 0 6 Contractor: ADAM'S ROOFING INC Address: 3435 SOUTH SILVER SPUR SANTA ANA CA 92704 Phone: 714-965-0245 Con State Lie: 524341 Lie Expire: 06/30/2018 Bus Lie: BT30056023 Lie Exp Date: 07/31/2017 Worker's Compensation Insurance Carrier: STATE FUND Policy No: 1300240 Expire: 03101/2017 Building Setbacks Rear: I Front: / Left: I Right: / Use Zone: Parkino SDa Architect: rp§g+ Address: j r Phone: State Lic: Engineer: Address: Phone: Designer: Address: Phone: State Lie: Special Conditions: INCLDS UNITS 857,859,861 863 Fire Building Permit Fee: $264.00 Excise Tax: $0.00 Planning Department - Plan Check Fee: $0.00 Additional Fee : $0.00 Plan check Fee Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share Investigation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans Record Management: $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - CA Seismic Safety: $0.00 WQ-Insp. Fee: $0.00 Park Dedication : $0.00 Disabled Access : $0.00 PAN Plan Check : $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 Plumbing %: $0.00 TOTALFEE: PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Plan Check Fee Fire Department $0.00 Fire Inspection: $0.0u $0.00 Fire Plan Rev $u.Z0 $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 Fee Due at Permit Issuance : $265.00 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 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 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 U 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 'mproved 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 licensure under the Contractors' State License Law for the fallowing 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:llwww.leginfo.ca.govlcalaw.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 7000 o Di ision 3 of the Bu sand Profession ,and rq�i license is in full force and effect. License Class License No D Contra r Signature q� WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUWECT AN EMPLOYER TO C MINAL 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. I 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 th, �once of the work for which this permit is issued. Policy No. h ve 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' compensatiol In nce carrier and policy nuLmber are/% Carrier ='97 7 N cl M Policy Number 2jjj Expiration Date Name of Agei,l _ Phone # ❑I certify that, in the performance Of he work for w ch this permit is issued, I shall not employ any person in any manner so as to become subject to the w kers' compensat' n laws of California, and agre that, `f I shouk, hecorne subject to workers' co ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �� Sigrature icant Date_ LECLARAT NJREGARDING CONSTRUCTION LENDING AGENCY I hereby 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). LPride-'s Name Lender's Address By my signatLrc Lelow, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I nave read this application and the information I have provided is correct. amree to ccmply with all applicable city and county ordinan :as and slat aws relating to building construction. I authorize representatives ofs city, or county to enter t above -de Pied property for inspection purposes. �l�rL6 13,gnawre of ProlArty-0 rAuthorized Agent Print Property Owner's or Authorized Agen me Date ACTION IDATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY V REGULATIONS PART GI OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED DEPA PERMIT EXTENDED MD PERMIT FINAL �(.- rASBYESTIONOTIFICATIONI OT APPLICABLE TO CERTIFICATE OF MOL ON OCCUPANCYISSUED S" R�:�,�