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Home My WebLink AboutX2020-2596 - Permitst City of Newport Beach - Building Division IIIIIIIIIIIIIIII�III�IIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2020-2596 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 0 2 5 9 6y Project No: 1338-2019 ' Permit Counter Phone (949)644-3288 "tu. +4 Inspection Requests Phone (949)644-3255 r tx,�sRaa� ` Combination Type - MFP Issued Date :1110512020 0 Inspection Area : 1 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 11/0612023 OR PERMIT WILL BE INVALID 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: 1200 W BALBOA BLVD NB Description: MFR REROOF TIO ASPHALT SHINGLES AND REPLACE W/ ASPHALT SHINGLES CLASS B 21 SQS Legal Desc.: N TR 234 BLK 112 LOT 1 Owner: MCBRIDE JULIE Contractor: TOP QUALITY ROOFING Architect: NO y� l�' -p-® �+ y,py p 1 WORK ry l/ CONS 9 E' UCTION 4/ ORK Address: 6016 VICTORIA AVE Address: P 0 BOX 4476 Address: RIVERSIDE CA 92506 SAN CLEMENTE CA 92674 Phone: 949-887.0996 Phone: 949-292-7729 Phone: State Lic: Applicant: TOP QUALITY ROOFING Con State Lie: 617178 Engineer:ON �'��-�®�� Address: P O BOX 4478 Lic Expire: 04/30/2021 Address: • • • •, • �, o SAN CLEMENTE CA 92674 Bus Lic: BT30072367 _ a • •, Phone: 949-292-7729 Lic Exp Date: 0713012021 Phone: -- State Lic: , • • ° ° Code Edit : 2019 Worker's Compensation Insurance Designer: ,' • ° • oe ° Type of Construction: V -B Carrier: STATE FUND Address: - ••+•� +� •'• Occupancy Group: R21U Policy No: 1886676 . • . • ° ° Added /New sq.ft. Bldg: 0 Expire: 01/01/2021 Phone: I(�{a• . INSFraT o • ... 0 0 Added /New sq. ft. Garage: 0 Q�p No of Stories: 2 Building Setbacks Rear: / Special Conditions: � ° ° LIQUEFACTION • + • ° • c . ° No of Units : 3- Front: / `® Bldg Height: 0 Left: I cooc c°O°�O ° Bldg Sprinklers: Right: I e ®° • • Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $12.900.00 Building Permit Fee: $343.00 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 PAN 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 TOTAL FEE : $344.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $344.00 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: - APPROVAL TO ISSUE: C OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjurythat 1 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 the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing with Section 7000) of Division 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 (_) portions of the work, and the structure is not 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 personal effort, builds or improves the property, provided 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 -Builder will have the burden of proving that it was not built or improved 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: 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 legall) 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:/Avww.leginfo.ca.gov/calaw.htmi. Signature of Property Qwner or Authorized Agent Date LICENSED CfWF%CTOR'S DECLARATION k hereby -affirm ugder pgnalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0) of Division 3 of the Business and Pro sion de d m ' s In full force andeffsct. Lioeusr Wess License No Date i Contractor Signature MRKERS' COVPENSATION DECLARATION NARNING: 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 COMPENyM DAMAGES AS PROVIDED FOR IN SECTION 6706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. IVete+byaffirm urlHbti5enalty of perjury one of the following declarations: Q 1 h®ve and L111*mlintain 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 apDSnce of il7a work for which this permit is issued. Policy No. u" if y and will,maijitpin 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' compensatioi u nce cardee a ndpolicy number are: 3wrilw- • Policy Number Expiration Date JI certify that, in the performance of the work for which this permit is issued, I shall not employ—anyy person in any manner so as to become subject to the workers' c pensation laws of California, and agre iat, if I should becorfla ubject to th work Is' compensation provisions of Section 37 0 -of the Labor Code, I shall forthwith comply with those provisions. s— signatureofApplican Date DECLARATION REAR ING ClZiNSTRUCTION LENDING AGE hereby affirm under penalty of perjury that there is a constnictLIPendiffiragency for the performance of the work for which this permit is issued (Section 3097, Ci it 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 c�ouryy ordinances and state laws relating t ulldin`g construction. I authorize representatives of this city or coud{y tpp�,rthe�bove-identified pro rt for inspection purposes.r `� j t, J 8nnahlra of Prnnedv nwner nr Authnrized Anent `l�`—�l% Print Prooertv Owner's or Authorized Agent's Namel�(`�%efli'v,0 1KJKp�I�6C Sa✓Ci Da b/ l u% ACTION DATEI BY f REGULATIONS DECLARATION OF CO l O ANG E 4tTR AND A0MCODE F FEDERUDERAL FOR OFFICE USE ONLY PERMIT EXPIRED VUI SUBMITTED ASBESTOS NOTIFICATION TO PERMITCIINCELLED EPA PERMIT EXTENDED *D PERMITFINAL CERTIFICATE OF OCCUPANCYISSUED tL't1 3L ASBES 5 OTIFICATIO AS NOT APPLICABLE TO POSED MOLTT ON� IG TORE: (((