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Home My WebLink AboutX2019-0775 - PermitsCity of Newport Beach - Building Division IIII�I�I��f Illlllllf I�IIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2019-0775' a 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 0 7 7 5 Project No: Permit Counter Phone (949)644-3288 s. 45 Inspection Requests Phone (949)6443255 Combination Type - SFP. : ..Issued Date : 03/1112019 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 Holidays Job Address`. 126 E BALBOA BLVD NB Description: SFR T/O (E) 18 SQ, INSTALL COMP. SHINGLE, CLASS 'B' Legal Desc.: EAST NEWPORT BLK 1 LOT20 Owner: HUTCHINSON GAIL Contractor: R H ROOFING INC-. Architect: Address: 32502 CRETE RD - Address: - 620 S GRAND AVE #104 Address: y� DANA POINT CA 92629 SANTA ANA, CA 92705 Phone: Phone: 714-381-1870 Phone: State Lie: Applicant. RAFAEL/R'H ROOFING INC Con State Lie: 1007845 Engineer: Address. 620 S GRAND AVE #104 Lie Expire: 10/31/2019 Address: SANTA ANA, CA 92705 Bus Lie: BT30053038 Phone: 714-381-1870 - Lie Exp Date:... 11/3012019.' Phone: State Lie: Code Edit: 2016 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: EMPLOYEES SERV Address: Occupancy Group: R31U Policy No: CWC719491028 hF7 Added /New sq.ft. Bldg: 0 Expire: 02/26/2020 Phone: Added /New sq. ft.. Garage: 0 No of Stories:. 2 Building Setbacks Rear: I Special Conditions: LIQUEFCTION AREA No of Units : 1 Front: Bldg Height; 0 Left: l Bldg Sprinklers: Right: Flood Zone: 0.2 Use Zone: Parking Spaces: 0 Fire Hazard Zone :N Construction Valuation: $9.700.00 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 WQ Insp. Fee: $0.00 .Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00. PM 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 Feer $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $325.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $325.00 PROCESSED BY: a FiUBLIC WOPK`APPROVAL:. o cau ec e.. ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: _ APPROIVAL,'[D ISSUE: : uo., mu ao � c wo ice 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 :he 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 Irofessions 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 lot 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 structure is not intended or offered for sale (Section 7044, 3usiness 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 mprovements 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 mproved 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 apply 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: 3y 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 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 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 00) of Df the Business and Prolosi s Code, and my license is in full force and effect. License Class License No Date ivision 3 oContractor Signature ,,_ NORKERS' COMPENSATION DECLARATION YARNING: 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 :OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 th, Ierlonnance of the work for which this permit is issued. Policy No. have and will maint�'ih,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' rance carrier and poll vlaumber are: / 'N _ Date 1e of Agent v y Phone a certify that, in the pert ante 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 agree if I should become sq/bleu /ttoOthe wrkRrs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. lature of Applicant l.I 'le_ I6_ / Da :LARATION REGAF(D NG CONSTRUCTION LENDING AGENCY reby 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 309 , Civil Code). der's Name Lender's Address ny 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 totel�e� theab ve-identified property for inspection purposes. ` / lature of Prooertv Owner or Authorized ADent YL- Print Property Owner's or Authorized Agent's NamA ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY / d REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED U I SUBMITTED ASBEST99 IA01I5ICATION iO • . i PERMITCANCELLED EPA • + • • • • • PERMIT EXTENDED QMD PERMITFINAL GG _ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO �•• CERTIFICATEOF p OPOSED EOLITI • • ••• OCCUPANCYISSUED �-�t•, SIGNATURE).�4+r4_+ • ' • '•+ a o T o c rg 5 •'ice A9 g � am) r roro ro o m E ro0 E �� a coi c �o =°2 2 e�Si0 E �e °�� k4 ,9 0' C ,o 3 N N w W c ro E ro N. 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