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Home My WebLink AboutX2019-1964 - PermitsCity of Newport Beach- Building Division IIIIIIIIIIIIIIIIIII�III�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2019-1964 100 Civic Center Drive, Newport Beach, CA 92660 Project NO Permit Counter Phone (949)644-3288 c"$ Inspection Requests Phone (949)644-3255 `rhvrryr,� Combination Type - SFP Issued Date: 06/2412019 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: 306 DAHLIA AVE NB Description: SFR REROOF TIO WOODSHAKE AND REPLACE WI COMP SHINGLE CLASS B 29 SOS Legal Desc.: N TR 15935 LOT 69. Owner ALBERT RICHARD Address: 306 DAHLIA PIL NEWPORT BEACH, CA 92625 Phone 949-637-0536 Applicant: CUSTOM ROOF COMPANY Address: 293 EAST MC KINLEY AVENUE POMONA CA Phone: 909-623-7753. Code Edit : 2016 Type of Construction: V -B Occupancy Group: R3IU 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: TOTAL FEE: $325.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: Construction Valuation: $14 Architect: Building Permit Fee: $324.00 293 EAST MC KINLEY AVENUE Plan Check Fee: $0.00 Grading PC Consultant: Overtime Plan Ck: $0.00 Grading Permit Fee:. Investigation Fee: $0.00 909-623-7753 Record Management: $0.00 Con State Lie: Energy. Compliance: $0.00 Engineer: CA Seismic Safety: $0.00 04/30/2020 Disabled Access: $0.00 Bus Lie: Hazardous Mat $0.00 $0.00 Building Green Fee : $1.00 TOTAL FEE: $325.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: CUSTOM ROOF COMPANY Architect: Address: 293 EAST MC KINLEY AVENUE Address: Grading PC Consultant: POMONA CA Grading Permit Fee:. Phone:. 909-623-7753 Phone: Con State Lie: 859220 Engineer: Lie Expire: 04/30/2020 Address: Bus Lie: BT30067858 $0.00 Lie Exp Date: 06/30/2020 Phone: Workers Compensation Insurance Designer: Carrier: CA INSURANCE CO Address: Policy No: 4684225002 Expire: 0 810112 01 9 Phone: Building Setbacks Rear: / Special Conditions: Front: / Lek: / Right: I Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Excise Tax: $0.00 Additional Fee : $0.00 Grading Bonds Fee: $0.00 Grading PC Consultant: $0.00 Grading Permit Fee:. $0.00 Grading PC Fee: $0.00 WQ Insp. Fee: $0.00 Electrical %: $0.00 Mechanical %: $0.00 Plumbing %: $0.00 Planning Department - Fire Department Plan check Fee: $0.00 Fair Share .$0.00 SJH Trans :. Fire Plan Rev In -lieu Housing Fee: $0.00 Public Works Department - Park Dedication : $0.00 P/W Plan Check: $0.00 San Dist: $0.00 NMUSD Fee:.. $0.00 e. State Lie: ® e OY Y eo e State Lie- Building ic Plan Check Fee: $0.00 Fee Due at Permit Issuance : $325.00 PUBLIC WORKS APPROVAL:. PLAN CHECK BY: APPROVAL TO ISSUE: o n eoseoo 0 ocoYc 0 Cm600 YmYmoc e O f Y () ocomoc b o 09G8 Fire Department $0.00 Fire Inspection: .$0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $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: o n eoseoo 0 ocoYc 0 Cm600 YmYmoc e O f Y () ocomoc b o 09G8 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 3rofessions 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 iot 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 L) 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' Stale 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 legally sell a structure tgftl it'Sie 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 Pjofessions Codep it available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Date Silgrmiure, of Propsriy.Qwner or Authorized Agent LTCENAD CIINTRATOR'S DECLARATION I jiarRb)! affirm undgr penalty of pP,fjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00) of Ivis' n 3 of the Business and Prof 0 Code, y ense is in full force aft err2ct. Licenlae Class C 3 _ License No SfsYZ Z'- Date b / Contractor Signature W6&RKF.RS' CbRIDENSATION DECLARATION ✓dARNIRC. FAILURE.TP.SPCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRI NAL PENALTIES AND CIVIL FINES UP TO ONE HUN ED THOUSAND DOLLARS (1100,000), IN ADDITION TO THE COibGroCOMPENSATIOM DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 14iareby affirm under penalty of perjury one of the following declarations: ['%llf . and wa maigtain 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, performance of til@ veorle'for which this permit is issued. Policy No. i have'and willevaintnin 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' compensatiol I Mte carrie%rLcCgdticy number are: Carrier Policy Number Expiration Date Phone # Name of Agent DI certify that, in the pe rmance 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 becom ct tot a vuglkers' ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �Z Signature of Applicant 7/�/ D DECLARATION REGenDING CONSTRUCTION LENDING AGENCY (Section 3 7, Civil Code). I hereby affirm under alty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued 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 informal n I have provided is correct. I agree to comply with all applicable city and cQ' ordinances nd tate laws relating to building construction. I.F) I authorize representatives of this city or co my j�enter t e ve entified property for inspection purposes.�Ir/�P'4E �atew��Ainnature of ProDertv Owner or Authorized Ag t ((I ))) O Print Property Owner s or Authorized Agent's Na J 'ti' 1� 7 OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY / PART 61 OF TITLE 40 AND AQMD RULE �! PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMITEXTENDED I If J% I AAJAQMD /1 PERMIT FINAL �GN ED DE 0 O LE TO CERTIFICATE OF ED DE 10 OCCUPANCY ISSUED URE•