HomeMy WebLinkAboutX2019-2625 - Permitsr $ , City of Newport Beach - Building Division
' 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
- Inspection Requests Phone (949)644-3255.
Combination Type - SFP
COMB Permit: X2019-2626
X 2 0 1 9 2 6 2 5�� II
Project No :
Issued Date : 08121/2019
Inspection Area : 1
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 Sundays or Holi�sZ
Job Address: 1019 E BALBOA BLVD NEI � .
Description: SFR - REROOF, REMOVE EXTG CLAY TILE INSTALL 2 LYRS 40# I^ LIREINSTALL SAME TILE ON 2 STORY PORTION ONLY (CL A) 22 SQ
Legal Desc.: BALBOA TR EAST SIDE ADD BLK 16 LOT 10 -
Owner:. SIGALOS DIANA & JIM Contractor: NEWPORT COAST ROOFING INC Architect: 4®�
Address: 1019 BALBOA BLVD E Address: 120 TUSTIN AVENUE #C-1084 Address:
NEWPORT BEACH, CA 92661 NEWPORT BEACH, CA 92663
Phone: Phone: 949--355-6074 Phone: State Lia
Applicant:
NEWPORT COAST ROOFING INC
Address:
120 TUSTIN AVENUE #C-1084.
Record Management:.
NEWPORT BEACH, CA 92663
Phone
949--355.6074
Code Edit 2016
Type of Construction. VB
Occupancy Group: R31U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Construction
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
TOTAL FEE: $325.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Con State Lie:
1052517
Lie Expire:
04130/2021
Bus Lia
BT30066998
Lie Exp Date:
04/3012020
Worker's Compensation Insurance
Carrier: STATE COMP INS FUND
Policy No: 9249162
Expire: 0411712020
Building Setbacks
Excise Tax:
Additional Fee:
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: I
Front: I
Left: I
Right: I
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Engineer:
Address:
Phodc�f OCO1\IST State Lie: e o e o
eOvebe
Designer: V UCTI®N NoIsgem.,
Address:
0
Phone: ON
Special Conditions rHE WEEKEND
Planning Department -
Fire Department
Plan check Fee
Fire Inspection:
Fair Share :
Fire Plan Rev
SJH Trans :.
Demolition Fee
In -lieu Housing Fee:
Building Dept Adm
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:.
$0.00
Plan Check Fee : $0.00
Zone: N
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6 OfJ
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c°coe
$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:
o °
POeeCC
0
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Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00.
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
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6 OfJ
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c°coe
$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:
o °
POeeCC
0
°oa�oco
a
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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 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
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 not1nteritled 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
n 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 Codes 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). _
I am exempt from licensure under the Contractors' State License Law for the following reason:
H 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 bythis 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 700 Div on 3 of the Business and Profess' e, and m cense is in full farce
nd effect. Licerin pass License No Date Contractor Signatu
I/ORKERS' CCW j jNSATION DECLARATION
4dl$Iry:;�AILURE TO S1tURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO
OST OF aOMPENSATIO MAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm unter'p1nalty of perjury one of the following declarations:
�
I A3ve and wUlT irtain a certificate of consent to self -insure for workers' compensation, issued by the
o�o�7ance of the work for which this permit is issued. Policy No.
rrFaye and wil:, ainf in workers' compensation insurance, as required by Section 3700 of the Labor Code,
t fftr. carrier SRd' policy number are:
fI&* Policy Number
Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
for the performance of the work for which this permit is issued. My workers'
Date
y�l F�rtiey that, in the perfor ance of th hick this per ued, I shall not employ any person in any manner so as to become subject to the workers' co en anon laws of California, and agree
(nat if 1 should bacDme.s 'act to orker ' on pi Tv f Section 3(00 of the Labor Code, I shall forthwith comply with those provisions.
•les
Signature of Applic*aRt' Da e_
)ECLARATION REG RIDING TRUCTION LENDING AGENCY
hereby affirm under penal y of perjury that there is a is
lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
-ender's Name Lender's Address
3y 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 cou ty ordin tate laws relating to building construction.
I authorize representatives of this city or county o er the abo 'entified roperty for inspection purposes./_,71 n !1/-2!1/-22
31gnature of Property Owner or Authorized Agent Print PropertyOwner's or Authorized Agent's Name 6 ' 4 ��0fi Date /A
ACTION DATE DEC OMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED I LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT FINAL 11.47
CERTIFICATE OF
OCCUPANCYISSUED
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