HomeMy WebLinkAboutX2022-0581 - PermitsCity of Newport Beach - Building Division
10, Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
..fir ip Inspection Requests Phone (949)644-3255
Combination Type - MFP
IIIIXI�I III0�I� I�IIII�IIIII1 II.
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COMB Permit: X2022-0581
Project No : 0364-sM2
Issued Date: 02128/2022
Inspection Area : 2
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0212812025 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: 204 S BAY FRONT NB
Description: MFR REROOF T/O FLAT ROOF AND INSTAL B.U.R CLASS A 15 SQS
Legal Desc.: BALBOA ISLAND RESUB SEC 1 LOT 3 BLK 3(AND SELY1/2 LOT 2 BLK 3
Owner:
NICHOLSON MARILYN
Address:
204 S BAY FRONT
NEWPORT BEACH, CA 92662
Phone:
Applicant:
NEWPORT COAST ROOFING INC
Address:
120 TUSTIN AVENUE #C-1084
NEWPORT BEACH, CA 92663
Phone:
949--355-6074
Code Edit : 2019
Type of Construction: V-B
Occupancy Group: R3/U
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 2
No of Units: 2
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation:
Building Permit Fee: $351.00
Plan Check Fee: $0.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management :
$0.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $352.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor:
NEWPORT COAST ROOFING INC
Address:
120 TUSTIN AVENUE #C-1084
NEWPORT BEACH, CA 92663
Phone:
949--355-6074
Con State Lic:
1052517
Lic Expire:
0413012023
Bus Lic:
BT30066998
Lic Exp Date:
04130/2022
Worker's Compensation Insurance
Carrier: STATE COMP INS FUND
Policy No: 9249162
Expire: 04/17/2022
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WO Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: /
Front: /
Left: /
Right: /
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Architect:
Address:
Phone: State Lic:
Engineer:
Address:
Phone: State Lic:
Designer:
Address:
Phone:
Special Conditions:
Planning Department -
Plan check Fee
Fair Share
SJH Trans
In -lieu Housing Fee:
Public Works Department -
Park Dedication :
$0.00
PM/ Plan Check :
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
Plan Check Fee : $0.00 Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL:
• a
•ee•
ee e
s s
e ee
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$352.00
PLAN CHECK BY:
APPROVAL TO ISSUE: Y
C
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0000
OWNER -BUILDER DECLARATION .r` -
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
the 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
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 ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature Ut? C& I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legalll
sell a structure ttat.l.heve built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
4refeasions Cods, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm].
Signatur2 of Prdpfi,y CWner or Authorized Agent Date
I,IC,EN$ED CONJRACTOR'S DECLARATION
fterOty affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0 of the Business and Pr a a my ' ense is full force
and effect. Licanse.G•lass License No Date Contractor Signature
UIC7RNERS' COIIIIPE*NSATION DECLARATION
00
MAMINB: FAILURIPTO-SECNRE 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
CWaE COMPENSINION;'DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I.Vjq,bv affirm under penalty of perjury one of the following declarations:
I have and will maeltain 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
aarlismance of ttfe'worlt for which this permit is issued. Policy No.
. . . ..
Zand Will rr�eirtain 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
a carrier and policy number are:
Carrier Policy Number Expiration Date
me of Agent vnone ff
I certify that, in the performance o r #rich-[ it is issued, I shall not employ any person in any manner so as to become subject to the workers' comp 7
nsation aws of California, and agre
It, if I should become s bje 15,the wo Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �� �7
Inature of Applicant Dat
:CLARATION RE ONSTRUCTION LENDING AGENCY
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 3097, Civil Code).
rider'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 coun y ordpjanceran laws relating to building construction.
I authorize representatives of this city or coun�y ove- e ' ad property for inspection purposes. ��!'� f} p�
. +11 o nr ornn %f rn.,ner nr Ai ehnrlvcH Anon} I'� Print PmDertv Owner's or Authorized Aoent's Name\Z'1 A._N —" I f— Date
DATE I € LARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
.� I REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
I SUBMITTED
I EPA
TO
PERMIT EXTENDED AQM D
PERMIT FINAL A ESTOS NOTIFICATION IS NOT APPLICABLE TO
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