HomeMy WebLinkAboutX2019-3070 - PermitsCity of Newport Beach - Building Division IIII��I��IIIII�I�IIII�I���VIVlI�I1IlIlII�IIII
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COMB Permit: X2019-3070
100 Civic Center Drive: Newport Beach, CA 92660
X 2 0 1 9
3 0 7 0
Project No .
- Permit Counter Phone (949)644 3288
Inspection Requests Phone (949)644-3L55
Issued Date: 09/2712619
Combination Type - MFP
Inspection Area: 5
ION.
PERMITS EXPIRE 180 DAYS AFTER 1 aS€fAOR LAST VALID INSPECTION.
Construction Hours: Mondav -Friday 7:0 a.m. to 8:30 p.m. and .Saturday from 8:00 a.m. to 6.00 p.m. No work on Sundays car Ho idays
Job Address: 614 BEGONIA AVE NB
Description: ' REROOF DETACHED BACK UNIT W/COMP 8.5 SQ CL"A" TIO EXTG
Legal Desc.: CORONA DEL MAR BLK 630 LOT 16
Owner: GRAY THOMAS A Contractor: GUARDIAN ROOFS
Architect:
Ns'
Address: 614112 BEGONIA AVE Address: 1010 N. BATAVIA #F
Address:
CORONA DEL MAR, CA 92625 ORANGE CA 92867
SO
Phone: 949-644-1447 Phone: 951-264-0008
Phone:
State Lie:
° a
Applicant GUARDIAN ROOFS Con State Lie: 847279
Engineer:
;
Address: 1010 N. BATAVIA #F Lie Expire: 09130/2020
Address:
ORANGE CA 92867 Bus Lie: BT30054609
Phone: 951-264-0008 Lie Exp Date: 05/31/2020
Phone: State Lie: 8 0
NO NSTRUCTIQ*
Code Edit: 2016 Worker's Compensation Insurance
Designer:
° NN*NO18-E °
Type of Construction: V-B Carrier. STATE FUND
Address:
Occupancy Group: R31U Policy No: 9077388
Added /New sq_ft, Bldg: 0 Expire: 03/01/2020
Phone:
Added /New sq. ft. Garage: 0
ON
No of Stories: 1 Building Setbacks Rear /
Special Conditions:
THE EEKE O
No of Units : 1 Front: /
® fi o v
Bldg Height: 0 Left: /
Bldg Sprinklers: Right: 1
Flood Zone: _ Use Zone: Parking Spaces: 0
Fire Hazard Zone: N
Construction Valuation: $4,500.00
Building Permit Fee: $324.00
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
IITOTAL FEE: $325.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Excise Tax:
$0.00
Planning Department-
Fire Department
Additional Fee:
$0.00
Plan check Fee:
$0.00
Fire Inspection:
Grading Bonds Fee:
$0.00
Fair Share:
$0.00
Fire Plan Rev
Grading PC Consultant:
$0.00
SJH Trans:
$0.00
Demolition Fee
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
$0.00
Building Dept Adm
Grading PC Fee:
$0.00
Public Works Department -
General Service
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
PIW Plan Check:
$0.00
Grading Bond:
Electrical %:
$0.00
San Dist:
$0.00
MechanicalL°o:
$0.00
NMUSD Fee:
$0.00
Plumbirad14
$0.00
Plan Check Fee
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance: $325.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION
1 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 sti?scture, priorto its issuance, also requires the applicant for
the 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).
❑ 1, as owner of the property ormy 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 iCode: 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 for 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
improved for the purpose of sate).;
II
❑ 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
apply to an owner of property. ufo' 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 Iicens�rel under the Contractors' State License Law for the following reason:
By my signature below I acknoy}%(edge 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 1 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 1s° vailable Upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signature, of Prope,ty,Owner or!Authorized Agent Date
Klr ENZED CONITRACTOR'S DECLARATION
I hereby affirm ard?%penalty of perjury that I am licensed under provisions of Chapter 9 (commencing With Section 70 0) of Division 3 of the Business and Professi Code, an y ' se is in full force
rid eft`e:t. License Class License No Datgs f` - Z 7-1:l Contractor Signature
WORKERS' CQIVIRT�NSATION' DECLARATION
INARNMCr FAILURE TQ SECJRE WORK' ERS' 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
eOS7eC.r COMPENSATION, DAMAGES! AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNErS FEES.
f i;er&Lryy affirm under penalty of perjury one of the following declarations:
LOVI ave and wflj 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 the
er�orr , e of the work for which this permit is issued. Policy No.
!J have and "I maikam 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
uranse carrier. end Policy nu ber are: a
(Carrier'-%/�� / t%/�' Policy Number �® 2 G �j� Expiration Date
ie of Agent
JI certify that, in the performance vof 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, and agref
lat, if I should become subje he workers' corn ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /
ignature of Applicant 7M Dam — 2—
IECLARATION REGARDING CONSTR CTION 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).
ender s Name Lender's Address
y 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.
1 have read this application and the information I have provided is correct.
I agree to comply withla{i applicable city and county ordinances and state laws relating to building construction.
Ignature of Properly Owner or f this city or coon Yer the ab9ve-identified property for inspection purposes.��� 7
I authorize representatives o
Authorized Agent o - - - Print Property Owner's or Authorized Agent's Nanye ate
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
El 1 SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
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PERMIT EXTENDED
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PERMITFINAL
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SBESTOS NOTIFICATION iS NOT PLiCABLE TO
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