HomeMy WebLinkAboutX2019-0925 - Permitsw , City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIII
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COMB Permits X2019-0925
n 100 Civic Center Drive, Newport Beach, CA 92660 X 2 9. 1 9
Y, Phone
9 9 2 5
Project No'.
).
a
9
Permit Counter (949)644-3288
Investigation Fee:
$0.00
aS :
: Inspection Requests Phone (949)644-3255
$0.00
Grading Permit Fee:
1�r."}yL »� - ' Combination Type - BLDG :
-$0.00
Issued Date- 03/2512019
CA Seismic Srife),,':°
$0.00
Inspection Area : 8
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION..
$0.00 .
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
JobAddressi 2020 AVENIDA CHICO NB
Electrical %:
on°
Buildi�ig GreenoFeoec:°o
Description: MFR - TIO (E) TILE ROOF. REPLACE UNDERLAYMENT. RE -INSTALL SAME TILE, 10 SQ 5.6 PSF
Mechanical %:
Dora°o
Legal Desc.i TR 5435 (L.L.84-214024) PAR 25 -
Plumbing%:
oTGTAL
Owner: IPPOLITO WM Contractor:. COOL ROOF SERVICE
Architect;
°
Address: 2020 AVENIDA CHICO Address: - 14927 SAN FELICIANO DR
Address:
NEWPORT BEACH CA 92660 LAMIRADA CA 90638
$0.00
Phone:. - Phone: 213.321.8488
Phone:
State Lic:
Applicant: COOL ROOF SERVICE Con State Lic: 920169
Engineer.
Address: : 14927. SAN FELICIANO DR Lic Expire: 08131/2019
Address:
LA MIRADA CA 90638 Bus Lic BT36066605
Phone 213-321-8488 Lip Exp Date: 0313112020
Phone:
State Lic:
Code Edit: : 2016 Worker's Compensation Insurance
Designer:..
Type of Construction V -B Carrier: STATE COMP. INS
Address:
Occupancy Group: - R31U Policy.. No:.. 9033740
Added /New sq.ft. Bldg:: 0 Expire: 11 /1 012 01 9
Phone:
Added/New sq. ft. Garage:.. 0
No of Stories: 2 : Building Setbacks Rear:. I
Special Conditions:
-
No of Units : 1 Front:
Bldg Height: 0 Left: l
Bldg Sprinklers; Right I
Flood Zone: Use Zone. Parking Spaces: 0
Fire Hazard Zone : N
Building Permit Fee:
$324.00
Excise Tax:
Plan Check Fee: $0.00
Additional Fee
Overtime Plan Ck:
$0.00
Grading Bonds Fee:
Investigation Fee:
$0.00
Grading PC Consultant:
Record Management:
$0.00
Grading Permit Fee:
Energy Compliance:
-$0.00
Grading PC Fee:
CA Seismic Srife),,':°
$0.00
WQ Insp. Fee:
-t9YsWed ACC6aE : `
$0.00 .
$0.00
d+wWdous Mat C-
$0.00
Electrical %:
on°
Buildi�ig GreenoFeoec:°o
'$1.00
Mechanical %:
Dora°o
Refund Deposit
Plumbing%:
oTGTAL
FEE: $325.00
Grading Bond:
°
$0.00
PR'bCESSED BY:` p0
G V °
ZONING APPROYALTG'
°caoac c'
GI$ADING°APPROVAL:°
olio°
$0.00
$0.00
$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:
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$325.00
Planning Department -
„s
Fire Oepartmen��'rr
Plan check Fee :
$0.00
Fire Inspectiom,
''
Fair Share!
$0.00
Fire Plan Rev
SJH Trans :
$0.00
Demolition Fee
In -lieu Housing Fee'..
$0.00
Building Dept Adm
Public Works Department-
General Service
Park Dedication :.
$0.00
Refund Deposit
PAN Plan Check:
$0.00
Grading Bond:
San Dist:
$0.00
NMUSD Feer
$0.00
$0.00 Fee Due at Permit Issuance:
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$325.00
OWNER -BUILDER DECLARATION
I herebyaffirm 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 theapplicable item(s) N
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
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).
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,
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)..
7 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 7000) of Division 3 of the Business and Professpps Code, and y IST cense is in full force
nd effect. License Class License No Date 61 0 i/ZS //� Contractor Signatu`(�3i �T/ 4— �---
I/ORKERS' 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 (5700,000), IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 5700 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
h 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,
e ance of the work for which this permit is issued. Policy No.
I. ve 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' compensatior
is nce carrier and policy number are:
Policy Number
Date
lame of Agent vnone v
: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, and agre
iat, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /
signature of Applicanta�— — Dft? 0�` Z6/1�
)ECLARATION REGARDING CONSTRUCTION LE AGENCY %o
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
ly 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 slate laws relating to building construction. •' °
I authorize representatives of this city or couply t�ennter the above= dentifiet d property for inspection purposes. `, �, J I r.� �.:. •...
:innahlre of Prnnarfv owner or Authorized AnentY7/ /�` !/y-�--- Print Prooertv Owner's or Authorized ADent's Name( NA 11, V-4--1 S Datta o _
ACTION
DATE
BY
PECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
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PERMIT EXPIRED
El I SUBMITTED ASBESTOS NOTIFICATION TO
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PERMIT CANCELLED
UEPA
PERMIT EXTENDED
PERMITF/NAL
ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFIC4TEOF
ROPOSED DE�Q�LITTON
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OCCUPANCY ISSUED
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