HomeMy WebLinkAboutX2019-1855 - PermitsCity of Newport Beach - Building Division' IIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIII III II COMB Permit: X2019-1855
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 1 8 5 5
Project No
r; Permit Counter Phone (949)644-3288
's Inspection Requests Phone (949)644-3255
Combination Type - SFIP Issued Date : 06/12/2019
Inspection Area : 5
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 Sundaydr�oi3tya9 o
Job Address: 316 NARCISSUS AVE NB @g,
Description: SFR -TIO COMP, APPLY 2-LYRS 30# FELT, INSTALL 15 SOS CLASS " A" GAF TIMBERLINE ESR -1475
s
Legal Desc.: CORONA DEL MAR BILK 241 LOT 18 t< h &
Owner: SHERMAN TAMI
Contractor:
PERFORMANCE ROOFING CO Architect:
Address:. 316 NARCISSUS AVE
Address:
2506 S BROADWAY Address:
CORONA DEL MAR, CA 92625
SANTA ANA CA 92707
Phone:
Phone:
949-645.2382
Phone:
State Lie:
Applicant: PERFORMANCE ROOFING. CO
Con State Lie:
797003
Engineer:
Address: 2506 S BROADWAY
Lie Expires
0713112019
Address:
....
SANTA ANA CA 92707
Bus Lie:
BT00006327
° I....
Phone: 949-645-2382
Lie Exp Date:
0513112020
Phone:
State Lie: ° °
Code Edit: 2016
Worker's Compensation Insurance
Designer.
Type of Construction: VB
Carrier:
STATE COMP
FUND INS Address:
.Occupancy Group: R3
Added/New sq.ft. Bldg: 0
Policy No:
Expire:
9094635
04101/2020
Phone:
IN9T4LL On VERIFY SM°QIfB'�ND CA4� °�
Added /New sq. ft. Garage: 0
MONOXIDE DETECTOQS AJOE EXISTING °
No of Stories: 1
Building Setbacks
Rear: /
Special Conditions:
PER CRCR 3J4A & 345.2 0..... .
No of Units: 1
Front: /
°so•c
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: I
,,,
Flood Zone:
Use Zone: Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $10.250.00
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
WO 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 %:
$0.00,
NMUSD Fee: $0.00
$0.00
.Plumbing %: -
$0.00
$0.60
TOTAL EE : $325.00
Plan
Check Fee :
$0.00 Fee Due
it Issuance : $325.00
PROCESSED BY:
PUBLIC WORKS APP OVAL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjurythat 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)
'action 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
is 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 five hundred dollars ($500)..
1 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,
usiness 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
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).
1 am exempt from licensure under the Contractors' State License Law for the following reason:
y 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 eoVere�'b his permit, I cannot legal[)
=.11 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 I , Section 7044 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.
ignature of Property Owner or Authorized Agent e
ICENSED CONTRACTOR'S DECLARATION
hereby affirm uncjpl VPnslty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 of the Business and Pr fession license is in full force
nd effect. License Class License No Da { Contractor Signatur
4QIJL(MS' COVPANSATION DECLARATION
NRNING: FAILURE 10 9F.CyRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO C IMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TH NO LARS ($100,000), IN ADDITION TO THE
DST OPCOMPENSATION, 6AMAGEE AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
liere4.a4firm undef penalty of perjury one of the following declarations:
a0g and A@ trfatlaina certificate of, consent to self -insure for workers' compensation,
mance of the work for which this permit is issued. Policy No.
..
Iiia %and will �ipnt$in workers' ion insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
dQ ICe carrier an olic num are:
issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
Policy Number
ofAaent
Date
r4ertify that, i itle JJe'rWtrk ofhich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation aws o California, and agre�f�lshould besomas pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant DateCLARATION REG RD NOING AGENCYrreby affirm under anala pnstruction lending 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 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. r
I authorize representatives of this city or cowry to enter t� above -I ntified property for inspection purposes.
nature of PrODertv Owner or Authorized Aaent Y-' f. hQ-� tai _ Print Property Owner's or Authorized Agent's Na /G Dat
ACTION
PERMIT EXPIRED
PERMIT CANCELLED
DATE BY �II REGULATONSP RT 610 TIITLE 40 AND AQMD RULE
RAL FOR OFFICE USE ONLY
DECLARATION OF COMPLIANCE WITH CODE OF J
SUBMITTED
TO
CERTIFICATEOF l�// V NATURE: EMOI fTIO N APPLICABLE TO
OCCUPANCYISSUED
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