HomeMy WebLinkAboutX2021-1931 - PermitsCity 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
-,crraa's Combination Type - SFP
*X2021-1931*
COMB Permit: X2021-1931
Project No :
Issued Date: 0712612021"' .3
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0712612024 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: 623 IRVINE AVE NB
Description: REROOF T/O ASPHALT SHINGES AND REPLAVCE WI ASPHALT SHINGLES CLASS B MIN 29 SQS
Legal Desc.: NEWPORT HEIGHTS LOT 28 SWLY 40 FT SELY 145 FT
Owner: SPETH DOUGLAS ROBERT
Contractor:
OWNER/BLDR
Architect:
I S
1 `U
Address: 623 IRVINE AVE
Address:
O/B ATTACHED
Address:
O°°°
m•°",;°
NEWPORT BEACH, CA 92663
Phone:
Phone:
Phone:' ._
State Lic:
^C
Applicant: SPETH DOUGLAS ROBERT
Con State Lic:
O/B
Engineer:
Address: 623 IRVINE AVE
Lic Expire:
Address:
NEWPORT BEACH, CA 92663
Bus Lic:
cmmm
°°•m
°p
Phone: 949-929-7935
Lic Exp Date:
Phone:
State Lic:
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mOC(lp
Code Edit: 2019
Worker's Compensation
Insurance
Designer.
Type of Construction: V-B
Carrier:
Address:
° • %
Occupancy Group: R3/U
Policy No:
Added/New sq.ft. Bldg: 0
Expire:
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 1
Building Setbacks
Rear: /
Special Conditions:
No of Units : 1
Front: /
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: /;i,
Flood Zone: +'
i. Use Zone: Parking S aceu: 4 -:
0
Fire Hazard Zone : IN','
Construction Valuation: $6,500.00
Building Permit Fee: $351.00
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
PNV 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 : $352.00
Plan Check Fee :
$0.00
Fee Due at Permit
Issuance :
$352.00
PROCESSED BY:
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION
(thereby 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)
action 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 egned gatement 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
ofessions 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
tmore than five hundred dollars ($500).
kas_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,
Isiness and Professions Code: The Contractors' State License Law does not apply to an owne of p7rmperty who, through employees' or personal effort, builds or improves the property, provided that the
provements 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
proved 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
ply 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).
•N•
I am exempt fror Plicensure under the Contractors' State License Law for the following reason:
mysignatur€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 legalll
II•a.structurq thpt Iffave 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, Sectio 70 of the Business and
ofessions Code, is available upon request w n t Is appjl tion is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. • 6• �7 OZ
p1tyre of Property Owner or Authorized Agen Date ^ l 4
DENSED CQNTRACTOR'S DECLARATtCiIN
ereby affirm6IWJ9r denalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, I my license is in full force
8e4fect. Lice.n.sg.Class License No Date Contractor Signature
0WERS' ICMIR•6NSATION DECLARATION
RIMHG: FAILURE TQ 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
ST OF•COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Lteby affirm yr?det penalty of perjury one of the following declarations:
.•
,there and wjll mantain 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
(fppQdnce of 4Ne work for which this permit is issued. Policy No.
I have and 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' compensatiol
urance carrier and policy number are:
Policy Number Expiration Date
of Agent
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 agre
It, if I should beco�5/subject to the � workers' �comppensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /)) �1
Inature of Applicadt)� `/V \ Date X \� J, 20Z I,:CLARATION REGfRD ONSTRUCTION LENDING AGENCY /J�\
ereby 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 W., Civil Code).
nder's Name Lender's Address
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 couinty ordinances and state laws relating to building construction. y
I authorize representatives of this city or co ty o ant r the he above -identified grope y for inspection purposes.
mature of Procertv Owner or Authorized Aoent ��i Print Property Owner's or Authorized Aqent's Name
ACTION DATE BY / DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
V , Il REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED EPA
PERMIT EXTENDED AQMD
PERMITFINAL BETOS OTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF �,� ROPOSED OLITIO �^
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