HomeMy WebLinkAboutX2019-1476 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIII
0000
Building Permit Fe o
COMB Permit: X2019-1476
100 Civic Center Drive, Newport Beach, CA 92660
X 2 0 1 9
1 4 7 6
PfOJ@Ct NO
Permit Counter Phone (949)644-3288..
'ar
Plan Check Fee: $0.00
Inspection Requests Phone (949)644-3255
Additional Fee`.
$0.00
Combination Type - MFP
$0.00
Issued Date : 0 510 712 01 9
$0.00
Inspection Area : 2
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID. INSPECTION.
Grading Bonds Fee:
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: 111MARINEAVENB-
$0.00
Fire Plan Rev
Description;'. MFR -TIO COMP. INSTIL 2PLY 30# FELT. 14 SQ COOL ROOF COMP SHINGLE. CRRC # 0890-0016A
I x e%ffrysrion Fe@:' ° °
- Legal Desc.: BALBOA ISLAND SEC 4 ELK 1 LOT 8
. Grading PC Consultant :
3 - \ ^
SJH Trans :.
$0.00.
Demolition Fee
Owner WELKER JUDY Contractor: GUARDIAN ROOFS
Architect:
Record Managem unt=:v
Address: 111 MARINE AVE Address: 1010 N. BATAVIA#F
Address:
$0.00
NEWPORT. BEACH, CA 92662 - ORANGE CA 92867
$0.00
Building Dept Adm
Phone: Phone: -951-264.0008
Phone:
State Lie:
Applicant: GUARDIAN ROOFS Con State Lie: 847279
Engineer.
$0.00
'. Address: 1010 N. BATAVIA #F Lie Expire: 09130/2020.
Address:
General Service
ORANGE CA 92867 Bus Lie: BT30054609 -
CA Seismic Safety:
Phone: 951-264-0008 Lie Exp Date: 05/31/2020
Phone:
State Lie:
Code Edit: 2016. Worker's Compensation Insurance
Designer:.
Refund Deposit
Type. of Construction:. V -B Carrier: STATE FUND
Address:
Disabled Access:
Occupancy Group: ..... R31U Policy No: 9077368
Added'Mew sq.ft. 61d9p Q 0 Expire: 0310112020
Phone:
Grading Bond:
Ad&ddClodJ sq. ft. Garage: 0.
...
No of Stories: ° o ° 1°,2 - Building Setbacks Rear: / :
Special Conditions:
FLOOD ZONE
No [)(C1gi(s.: - 2 Front: 1
LIQUEFACTION AREA
. Bldg. to:9pt: ° 0 Left: I
Building Green Fee :
Bldg Sprinklers, Right:
Mechanical W
$0.00.
NMUSO Fee: $0.00
FlogaMnei o' ° ... Use Zone: Parking Spaces: 0
Fire Hazard Zone :
N
Qenstruoi on Valuct."am $6,400.00
Plumbing %:
0000
Building Permit Fe o
$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
Qvertime,Plan CF: , cc ,
$0.00
Grading Bonds Fee:
$0.00
Fair Share'.
$0.00
Fire Plan Rev
$0.00
I x e%ffrysrion Fe@:' ° °
$0.00.
. Grading PC Consultant :
$0.00
SJH Trans :.
$0.00.
Demolition Fee
_
Record Managem unt=:v
$0.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee :
$0.00
Building Dept Adm
'.$0.00
Energy Complianes;c , °
$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 %:
$0.00
San Dist: $0.00
Building Green Fee :
$1.00
Mechanical W
$0.00.
NMUSO Fee: $0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL
FEE : $325.00
Plan Check Fee:
$0.00 Fee
Due at Permit Issuance:
$325.00
PROCESSED BY:
2iihy.
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO ISSUE:
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
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
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
of more than five hundred dollars ($500).
7 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,
Iusiness 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
Troved 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
only 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:h@p://www.leginfo.ca.gov/calaw.htmi.
ignature of Property Owner or Authorized Agent Dale
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chagje�r�Sc80�mencing with ection 7000) of Division 3 of the Busines nd Profes s Code, nd my license is in full force
nd effect. License Class License No 7f `� /z 7�i'atei^ 7-/�L Contract signature _ ��—�
YORKERS' 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 ATTORNEY'S 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•tlhetabor Code jqr the
e7e of the work for which this permit is issued. Policy No.
u•ooc
ave 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. fay Vt9 ftrs' corppensagor
"' ce carrier and policy number are: ' ' :•eouo
7arrier 5 ? �'� l e'll— � Policy Number /� � � � �� Expiration Date � - /` � / •
Vame of Agent Phone # •'
•
:1I certify that, in the performance of the 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, aril agree
•. '
hat, if I sh ruki become s 'ect to the works t' provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. • •"' •
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Signature o p licant
IECLARATION REGARDING CONSTRUCTION LENDING AGENCY
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).
' "'
• e
Name Lender's Address
_ender's
3y my signature below, I certify to each of the following: .""•
1 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 representatives of" city or county to enter the above -identified property for inspection purposes.. ''tt
3i nature of Property Owner or -- - Print Pro ert Owner's or Authorizednature of Property Owner or - Print Pro ert Owner's or Authorized n"
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED
LIEPA
PERMITEXTENDED
D
PERMITFINAL
qqASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATEOFSE
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