HomeMy WebLinkAboutX2015-0556 - Permits�yR City of Newport Beach - Building Division
D� 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
nrNsnalKs Combination Type - MFP
*X2015-0556*
COMB Permit
Project No
Issued Date :
Inspection Area : 3
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
INSTALL OR VERIFY SMOKE/CARBON MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED
Job Address: 2018 VISTA CAUDAL NB
Description: MFR TIO (E) WOOD SHAKE, INSTALL, OSB RADIANT BARRIER PLYWOOD 15/32", BORAL SAXONY SLATE TILE 700 ESR# 1647, (30SQ)- CLASS "A"
Legal Desc.: TR 5435 (L.L.84-214024) PAR 15
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Owner: CHAUDNRY TAQI
Contractor:
SUPERIOR ROOFING Architect:
Address: 2018 VISTA CAUDAL
Address:
6022 W 5TH STREET Address:
_
NEWPORT BEACH, CA 92660
SANTA ANA CA 92703
Phone:
Phone:
714-554-0267
Phone:
State Lic:
Applicant: SUPERIOR ROOFING
Con State Lic: 908238
Engineer:
JOHNSON CHARLES A JR
,
Address: 5022 W 5TH STREET
Lic Expire:
12/3112015
Address:
P.O. BOX 6284
SANTA ANA CA 92703
Bus Lic:
BT30049544
GARDEN GROVE CA 92846
Phone: 714-554-0267
Lic Exp Date:
01/31/2016
Phone:
714-898-6180 State Lic:S-002537 .. _
Code Edit: 2013
Worker's Compensation Insurance
Designer:
Type of Construction: VB
Carrier:
STATE COMP
Address:
--- --.
Occupancy Group: R2/U
Policy No:
9062886
5... �?
Added /New sq.ft. Bldg: 0
Expire:
01101/2016
Phone:
-
Added /New sq. ft. Garage: 0
No of Stories: 0
Building Setbacks
Rear: I
Special Conditions:
No of Units : 3
Front: /
Bldg Height: 0
Left: /
Bldg Sprinklers: N
Right: /
Flood Zone: X
Use Zone:
Parking Spaces:
0 Fire Hazard
Zone : N
Construction Valuation: $19,500.00
'
Building Permit Fee: $369.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $265.68
Additional Fee :
$0.00
Plan check Fee :
$0.00 Fire Inspection:
$0.0t;
Overtime Plan Ck: $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
P/W 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
$0.00
Plumbing %:
$0.00
$0.01i
TOTAL FEE : $635.68
Plan Check Fee
: $0.00 Fee
Due at Permit Issuance :
$635.68 ,
PROCESSED BY:
J PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
" .` PLAN GHECI: 3Y:
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 items)
Section 7031.58Gsin63s 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
ie 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
'rofessions 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
of more than fue 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,
lusiness 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
nprovements 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
nproved 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
pply 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 following reason:
ly 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
ell 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
'rofessions 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
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0 of ivisi 3 of the Business and Professj'ohe C d an y I'censg is in full force
nd effect. License Class License No Date Contractor Signature LJ
VORKERS' COMPENSATION DECLARATION
'ARNING: 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 ($100,000(, IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS 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 th
erfymlance of the work for which this permit is issued. Policy No.
1111 have a 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' compensation
insurance ri r d polic ber are:
Carrier Policy Number Expiration Date
Name of Ag 1NM . ) - Phone #
❑I certify that, in the performanle of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
that, if I should become subjec to thew ers: ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 2
Signature of AprAcant Dat �) I 1 CJ I ��
DECLARATIOP tLICTION LENDING AGENCY
I hereby affirm Lender penalty of penury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Name Lender's Address
By 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 county ordinances and state laws relating to building construction.
I authorize Iapresentatives of this city or county t9 e ter ft a e-identified property for inspection purposes. f _ t r �Ul„ Wkbl l� D e `' 2 `
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name I
At 7MW DATF RV DECLARATION Of CONPLIANCE WITH CODE OF Fuji OhHI:E USk tMT
FEDERAL REGULATIONS PART 61 OF TITLE40 AND
.�FaA.tIT FXaERi=n AOI110 i7iiiC 1403.
❑ I SINThNTTI11AS1YST0_q WTIFMATION TO:
PE7147 CANCELLED ❑ EPA
PEH14IT EYTeKDED y J ❑ -9QyfD
+SSBES TOS AOTIAC.I:T..7W LS NOT APPLICABLE TO
PErrIlBfT 171NAL 03/25/ 15 ��tM cc awec. P POSEDDEMOLITICN.
CERCUPA 1TEGF `HS �, „ , �J1I
rJCT,'FFC TEOFLrED IG ArtRtt' .AV//;1F�\�LF.
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THESE CALCULATIONS CONTAIN INFORMATION PROPRIETARY TO CHARLES A. JOHNSON, JR.
THIS DOCUMENT OR ITS CONTENTS MAY NOT BE REPRODUCED OR DISCLOSED TO OTHERS
WITHOUT THE PRIOR WRITTEN CONSENT OF CHARIES A. JOHNSON, JR. ALL RIGHTS RESERVED
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WITHOUT THE PRIOR WRITTEN CONSENT OF CHARLES A. JOHNSON, JR. ALL RIGHTS RESERVED
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WITHOUT THE PRIOR WRITTEN CONSENT OF CHARLES A. JOHNSON, JR. ALL RIGHTS RESERVED
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