HomeMy WebLinkAboutX2018-1510 - Permits�1etp$a City of Newport Beach - Building Division
'6 100 Civic Center Drive, Newport Beach, CA 92660
N . Permit Counter Phone (949)644-3288
. - Inspection Requests Phone (949)644-3255
'errry�a Combination Type - MFP
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2018-1510
x 2 0 1 8 1 5 1 0 Project No :
Issued Date : 05/16/2018
Inspection Area : 1
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: 1421 1/2 W BAY AVE NEI
Degsaclription: MFR - TIO CLAY TILE, APPLY OSB W/JIF VERSASHIELD & CLASS "A" STANDING SEAM METAL ROOF 10 SOS (BACK UNIT)
is P C
Owner: �-
BRYSHA ANDRE Contractor: LUKE ROOFING INC Architect: • •.• e...e
Address: 1421 W BAY AVE Address: 26081 MERIT CIRCLE#125 Address: •.e• o e m
NEWPORT BEACH CA 92661
Phone: 909-203.0846
Applicant:
LUKE ROOFING INC
Address:
26081 MERIT CIRCLE#125
Con State Lic:
LAGUNA HILLS CA 92653
Phone:
714-612-8806
Code Edit :
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 2
No of Units : 2
Bldg Height: 0
Bldg Sprinklers:
Flood Zone:
2016 Worker's Compensation Insurance
LAGUNA HILLS CA 92653
Phone:
714-612.8806
Con State Lic:
672569
Lic Expire:
06130/2019
Bus Lic:
BT30036360
Lic Exp Date:
07131/2018
2016 Worker's Compensation Insurance
VN Carrier:
STATE NATIONAL INS
R31U Policy No:
CWC71949-1001
0 Expire:
01/01/2019
0
CA Seismic Safety:
Building Setbacks
Rear: I
$0.00
Front: I
$0.00
Left: I
-
Right: I
Construction Valuation: $10,000.00
Building Permit Fee: $304.00
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
TOTAL FE$$305.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Phone: State Lic:
Engineer:
Address:
Phone: State Lic:
Designer:
Address:
Phone:
Special Conditions:
Excise Tax:
$0.00
Planning Department -
Fire Inspection:
Additional Fee :
$0.00
Plan check Fee:
Demolition Fee
Grading Bonds Fee:
$0.00
Fair Share
General Service
Grading PC Consultant :
$0.00
SJH Trans
Grading Bond:
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
P/W Plan Check:
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$0.00
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$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee: $0.00 Fee Due at Permit Issuance : $305.00
PUBLIC WORKS APPROVAL
PLAN CHECK BY:
APPROVAL TO ISSUE:
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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:
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$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee: $0.00 Fee Due at Permit Issuance : $305.00
PUBLIC WORKS APPROVAL
PLAN CHECK BY:
APPROVAL TO ISSUE:
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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)
Iction 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
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
ifessions 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
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,
:iness 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
)rovements 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
)roved for the purpose of sale).
I, as owner of illpgroperty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
)ly to an owner of Qrro perty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors; State License Law).
.l." &xemptJrpjn licensure'Lnder the Contractors' State License Law for the following reason:
my signature below [-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,
.a structure At I Alva 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
fA;sidhs Code, it available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
nature of Property Owner or Authorized Agent Date
.ENSED COI4'iI UTOR'S DECLARATION
'reby affirm underpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 70 f Division 3 of the Business and Pro essr s Code, d i se' in full force
f NTL%. Licebsd£jpts License No Date —11f Contractor Signature
5knRS' COMPENSATION DECLARATION
.....
tWNG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES IIP TO ONE HUNDRED THO NO DOL ($10,000), IN ADDITION TO THE
IT OF COMPENSATION, SIMAGES AS PROVIDED FOR IN SECTION 3TD6 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
.reby affirm underPenalty of perjury one of the following declarations:
'PnQNave and wild 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
7ante of the work for which this permit is issued. Policy No.
ha a 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' compensatioi
Ir ce carrier and Dolicv number are:
is of Agent �
certify that, in the perform mer
. if I should become su ebt'ct to
hs41*14)6o[icy Number GwG 7l9 N1- 100.1 Expiration Date OVOV /I
Phone# 9Nf^f5 r3^94'ee
nature of Applican
CLARATION RE DING C NST END
rreby affirm under penalty of er' y that t re is a cc
Ider's Name
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the I
I have read this application and the information I h '
I agree to comply with all applicable city and c my
I authorize representatives of this city or co ty jo'e
ACTION DATE
PERMIT EXPIRED
PERMITCANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATEOF
OCCUPANCYISSUED
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 agre
D9fovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. r
JJ Date
AGENCY
Iction lending agency for the performance of the work for which this permit is issued (Section 309 , Civil Code).
Lender's Address
owner's behalf.
`ed is torr ct.
.es an ate laws, relating to building construction.
ab for inspection purposes.
Print Property Owner's or Authorized Agent's Nam 6S 1` Dat i
"I MPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
ONS PART 61 OF TITLE 40 AND AQMD RULE
1403
I SUBMITTED ASBESTOS NOTIFICATION TO
TO