HomeMy WebLinkAboutX2019-1241 - Permits` t.� City ofNewport Beaches Building Divisior, IIIIIIIIIIIIIIIIIII�III�IIIIIIIIIIIIIIIIIIIIIIII
COMB Permit: X2019-1241
100 civic 8 ntePQrivea NiWQgrtBJaQ CA 92660
X 2 0 1 9
1 2 4 1.
Project No
Permit Counter Ph(meg949)G44-3288•
Energy Compliance: $0.00
Inspection Requests Phone {9A8)&4 -13255.
Disabled Access : $0.00
,r Combination Type -MFP
Hazardous Mat $0.00
Issued bate: 04/19/2019
wry.'e
Fire Department
Inspection Area : 5
• • •o'. e • eo oea
.$0.00.
o e a • • e e • • • e e PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
ee %:PERMITS
$0.00
o •. Ve • e a
M¢Pyday;'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: 619 ORCHID AVE NB
$0.00
Fire Plan Rev
Description:. MFR- TIO COMP SHINGLES. INSTIL 30 # FELT. REPLACE SHEATHING AS NEEDED. INSTL 22 SQ COMP SHINGLES
SJH Trans :
Legal Desc.:
$0.00
Demolition Fee
Owner: WASSERMAN BARRY .Contractor: GUARDIAN ROOFS
Architect
Address: 619 ORCHID AV Address: 1010 N. BATAVIA #F
Address:
$0.00
CDM CA 92625 ORANGE. CA 92867
General Service
Phone: Phone: 951-264-0008
Phone:
State Lie:
Applicant: GUARDIAN ROOFS Con State Lica. 847279
Engineer:
$0.00
Address: 1010 N. BATAVIA #F Lie Expire: 09130/2020.
Address:
ORANGE CA 92867 Bus Lie: BT30054609
$0.00
San Dist:
Phone: : 951-264-0008 - Lie Exp Date:. 04130/2019
Phone:
State Lie:
Code Edit: - 2016Worker's Compensation Insurance
Designer:
$0.00
Type of Construction: V -B Carrier: STATE FUND
Address:
$0.00
Occupancy Group: R31U Policy No: 9077388
Added /New sq.ft. Bldg: 0 Expire: 03/01/2020
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 2 Building Setbacks Rear: /
Special Conditions:
[tea
No of Units : 2 Front: I
j
'
Bldg Height 0 Left: I
9 b
Bldg Sprinklers: Right: I
Flood Zone: Use Zone: Parkins Soaces: 0
Fire Hazard Zone : N
Building Permit Feer $324.00
TOTAL FEE: $325.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Excise Tax:
Additional Fee :
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee
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 FEE: $325.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Excise Tax:
Additional Fee :
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
$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 : $325.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
Planning Department -
Fire Department
Plan check Fee :
.$0.00.
Fire Inspection:.
$0.00
Fair Share :
$0.00
Fire Plan Rev
$0.00
SJH Trans :
$0.00
Demolition Fee
In -lieu Housing Fee:
$0.00
Building Dept Adm
$0.00
Public Works Department-
General Service
$0.00
Park Dedication:
$0.00
Refund Deposit
$0.00
PM Plan Check :
$0.00
Grading Bond:
$0.00
San Dist:
$0.00
NMUSD Fee:
$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..:••• • • •• •• •••
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 checkaFk(s)d! awe lacRe�d n ex6 fo the applicable items)
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prIo6to Its jss/1apCEC also r4quires 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 (commenclht w111fi4Sectlon 7000) oPDiviSlbti 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).
❑ 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 structare•is nel intended -or offered for sale -(Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personalsftort, hullds orimprovas the prp4e4, arovided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-Buildb6Will J1aye thebygdeppj provog th2[ jtewas not built or
im roved 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
ap ly 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:
By 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 legal)
sell 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
Professions 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
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sect§7 00) of 1D Vlsion 3 of the Business and Professigft Code, and my license is in full force
and effect. License Class License No D Contractor Signatura/ye'Q WORKERS'COMPENSATION DECLARATION +�
WARNING: 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
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
1 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 the Labor Code, for IN
rhavece of the work for which this permit is issued. PolicyNo.
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' compensatio
carrier and policy numb, 19 7 �r/�--/-� Policy Number %� C� GS Expiration Date
Name of Agent Phone #
I 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
that, if I should become subl''`ct\to the workers' comp9piation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant ,=L=A 4-- Dau
DECLARATION REGA NG CONST TION LENDING AGENCY
I hereby affirm under penalty of perjury hat there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Name Lender's Address
By 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.
I authorize representatives of this city or county enter the above -identified property for inspection purposes. Y
Sicnature of Prooerty Owner or Authorized ADent . Print Property Owner's or Authorized Agent's Nam,'6��= Date
ACTION DATE BY / REGULATIONS PA T0MPLIANCE WITH CODE OF 61 OF TITLE 40 AND AQMD RULERAL I. FOR OFFICE USE ONLY
PERMIT EXPIRED
'I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED
EPA
PERMITEXTENDED
PERMITFINAL
OCCUPANCYISTIFICATE F
./�
I
,�/�UR
l IATURE:
SBESTOS NOTIFICATION IS NOT APPLICABLE TO
DEM�OCCUPANCYISSUED
AR,01OSED
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