HomeMy WebLinkAboutX2021-1470 - PermitsCity of Newport Beach - Building Division
a'+
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
.. p,..
Inspection Requests Phone (949)644-3255
Combination Type - BLDG
IIIIII�IIIIIIIIIIII�III�IIIIIIII�IIIIIIII� II COMB Permit: X2021-1470
x 2 0 2 1 1 4 7 e Project No:
Issued Date : 06/09/2021
Inspection Area : 2
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 06/09/2024 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: 301 CORAL AVE NB
Description: SFR T/O SHAKE ROOF. REPLC WOOD SHEATHING AS NEEDED. INSTIL 15# FELT. INSTALL 17 SQ COMP SHINGLES
Legal Desc.: BALBOA ISLAND SEC 3 LOT 34 BILK 15 AND LOT 35 BILKIS
Owner:
COHEN ROBYN S
Address:
301 CORAL AVE
NEWPORT BEACH, CA 92662
Phone:
Applicant:
J D CLARK ROOFING
Address:
15569 ROLLING RIDGE DR
CHIL HILLS CA 91709
Phone:
909-636-9057
Code Edit: 2019
Type of Construction: V-B
Occupancy Group: R3/U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 1
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation:
Building Permit Fee: $343.00
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
Contractor:
J D CLARK ROOFING
Address:
15569 ROLLING RIDGE DR
CHIL HILLS CA 91709
Phone:
909-636-9057
Con State Lie:
416967
Lie Expire:
01131/2022
Bus Lie:
BT30047826
Lie Exp Date:
07/31/2021
Worker's Compensation Insurance
Carrier: STATE COMP
Policy No: 9073636
Expire: 0611812021
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: /
Front: /
Left: /
Right: I
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
II TOTAL FEE: $344.00 Plan Check Fee
are asa
e e o
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
0
Architect:
Address:
Phone: p State Lie:
ay Engineer: ® Cot
Address: Sraiu(�TJ®AV
Phone: State Lye` f q r®/��
Designer:
Address: ON S'q rCJ/ �
Phone: R®^ �'! Y%s
Special Conditions: HIGH DENSITY
Fire Hazard Zone : N
Planning Department -
Plan check Fee
Fair Share:
SJH Trans :
In -lieu Housing Fee
Public Works Department -
Park Dedication :
$0.00
PAN 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:
$0.00 Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$344.00
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
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
LJ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of i
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of comf
improved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044,
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor
❑ 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)
sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I ur
Professions Code, is available upon request when this application is submitted or at the following Web site:http://Www.legin
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7090) o
and effect. License Class License No Date _&/�
COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL
DST OF COMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affir Inder penalty of perjury one of the following declarations:
work, and the structure is not intended or offered for sale (Section 7044,
ployees' or personal effort, builds or improves the property, provided that the
on, the Owner -Builder will have the burden of proving that it was not built or
and Professions Code: The Contractors' State License Law does not
to the Contractors' State License Law).
prior to completion of the improvements covered by this permit, I cannot
stand that a copy of the applicable law, Section 7044 of the Business and
Date
13 of the Business and Pro ssions � d my license is in full force
Contractor Signature
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE
J I h e and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director o Industrial Relations as provided for by Section 3700 of the Labor Code, for
mance of the work for which this permit is issued. Policy No.
71 hive 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'
Isur ce carrierandpolic�7nrumber,
1. t" 7 v Policy Number Expiration Date
lame of Agent n Phone #
certify that, in the performance of
, if I should become subje/cctJ�aH//!FT��f��
latureof Aoolicant rr`.Le'_
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
compensation provisions of Section 3700 of the Labor Code, I shall forthwith, comply with those provisions.
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for
ender's Name Lenders Address
ly my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property ownZenfifie,
I have read this application and the information I have providedct
I agree to comply with all applicable city and county ordman laws relating to building construction.
I authorize representatives of this city or county ter property for inspection purposes.
lionature of Prooerty Owner or Authorized AD ent Print Pmuerty Owner's
ACTION
DECLARATION OF WITH CODE OFDATE BY I REGULATIONS PPAT061 OF TITLE 40 AND AQMD RULE AL FOR
Date
this permit is issued (Section 3097, Civil Code).
ONLY
Date
PERMITEXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO
•�S • �', + ••
• ' d' • "' 4�.•r ••••
`
PERMITCANCELLED
EPA
� •� «•°iy• r M 4 ••• • •• •••�•
* * 4 • • + : ' • s
• • •�• •• ---
PERMIT EXTENDED
QMD
PERMIT FINAL
tAASBESTO5 NOTIFIIO OT LICABLE TO
CERTIFICATEOF
ROPOSED DE of nO
•
OCCUPANCY ISSUED
, A
lot1/"
,
SIGNATURE:
••• s•:
�'� . •• •«•
• e`'��� v�
ss•
• •�• a i D °°
�' °si • e• T �� • e•�
s eo °j•