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X2019-1203 - Permits
HF1 City of Newport Beach - Building Division *X20191203* COMB Permit: X2019-1203 100 Civic Center Drive, Newport Beach, CA 92660 _ Project No: ) 'k Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 °°+crrru� Combination Type - MFP Issued Date : 0411612019 Inspection Area : 5 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: 479 MORNING CANYON RD NB Description: MFR -APPLY ASTM ESR #1549, SINGLE PLY ROOF SYSTEM OVER EXTG 1-LYR BUR CLASS A 38 SQS Legal Desc.: PM 270-25 PAR 1 OF PROJECT 938-01 LOCATED ON AP 459-151.27 TOGETHER a r� $, „� �` r bf Owner: BLANNING TRUST Address:. 481 MORNING CANYON #2 Contractor: COASTAL ROOFING CO INC -Architect: Address: 3303 HARBOR BLVD SUITE G-4/5 Address: CORONA DEL MAR, CA 92625 COSTA MESA CA 92626 ° a°"°Q Phone: 714.637.9534 Phone: 714-842-2830 Phone: State Lie: Applicant: ROGERS MIKE Con State Lie: 767366 Engineer: Address: 3303 HARBOR BLVD SUITE G4/5 Lie Expire: 12/31/2019 Address: COSTA MESA CA 92626. Bus Lic: ST20080401 Phone: 714.842-2830 Lie Exp Date: 07/31/2019. Phone: State Lie: Code Edit: 2016. Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: EMPLOYEE SERVICE GROUP Address: Occupancy Group:. R3/U Policy No: WC018971401 e oaa0'' Added /New sq.ft. Bldg: 0 Expire: 12131/2019 Phone: ° Added /New sq. ft. Garage: 0 No of Stories:. 2 Building Setbacks Rear: / Special Conditions: ° • ° ° ° No of Units : 2 front: / INSTALL OR VERIFY S9IVKF",! CARF", Us-il!epQ.° Bldg Height: 0 Left: / MONOXIDE DETCCT099P:Fck Bldg Sprinklers: Right: / PER CRCR 314.1 3315.2 Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone: N Construction Valuation: - $19.900.00 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 PMI 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 Fee: $0.00 $0.00 Plumbing %: $0.00 - $0.00. TOT FEE : $325.0 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $325.00 PROCESSED BY: PUBLIC WOZKVAPPROVAL.'ZONING APPROVAL: PLAN CHECY: GRADING APPROVAL: APPROVAL TO ISS 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) ction 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 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 fessions 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 more than five hundred dollars ($500). 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or i_) portions of the work, and the structure is not intended or offered for sale (Section 7044, ;iness 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 Movements 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 (roved for the purpose. of sale). 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 fly 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: 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 a structure that.l.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 fessions Code,, 15.8vganable upon request when this application is submitted or at the following Web site:hltp://www.leginfo.ca.gov/calaw.htmi. gVgr#;)f Proppjty Qwner or Authorized Agent Date TENSED CONTJ%gTOR'S DECLARATION :7 ebyaffirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0) isi 3 of the Business and Prof'ons e, ancj�my li a is irce I efkei License Class License No Dat Contractor Signature,( o DICKERS' CGMP&;SATION DECLARATION ININCPFAILURE 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 q pF ¢OMPENSI,TR. !VAS AGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. je,byaffirm untler penalty of perjury one of the following declarations: 44rav© 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 the arjce of th4%Vgry for which this permit is issued. Policy No. •K agnd 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' compensation rt oe carrierena policy number are: Her ... . t Policy Number Expiration Date lame 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 agree iat, if I should become subject to t e workers' ompe]pa/ay'on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of Applicant%0� Y -Vi-/ Date `7 y )ECLARATION REGUG C STRUCTIDIN ENCY hereby affirm under penalty of perjury that there is a conction 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 ordina as and at a laws re ting to building construction. I authorize representatives of this city or county to enter 7above-idi9e r erty for insp> n purposes. Owner's or Authorized Au ACTION DATE BY DECLARATION OF COMPLIANCE YTH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TIT,K 40 AND AQMD RULE 1403 I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT EXTENDED UAQMD PERMITFINAL \Q .$.,CI SBESTOS NOTIFICATION IS NOT APPLICABLE TO OCCUPANCYISF PROPOSED DEZOLIIION OCCUPANCYISSUED SIGNATOR. ((z/j¢