The URL can be used to link to this page

Home My WebLink AboutX2021-2191 - Permits1r City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2021-2191 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 2 1 9 1 'iai' Permit Counter Phone (949)644-3288 Project No `,. ?5 Inspection Requests Phone (949)644-3255 �'a<Ir<�ug`` Combination Type - MFP Issued Date : 08/18/2021 Inspection Area : 1 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0811812024 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: 122 35TH ST NB z Description: MFR T/O (E) CAP SHEET & INSTALL 2 LAYERS OF TORCH 20 SQ CL A Legal Desc.: NEWPORT BEACH CITY BLK 34 LOT 14 0 Owner: VENNUM BARBARA H Address: 122 35TH ST Contractor: LEE ROOFING OF COSTA MESA INC Architect: 0 Address: 1730 POMONA AVE #10 Address: Z NEWPORT BEACH, CA 92663 Phone: COSTA MESA CA 92627 Z '. Phone: 949-642-7222 Phone: Cn State Lic: Applicant: LEE ROOFING OF COSTA MESA INC Address: 1730 POMONA AVE #10 Con State Lic: 349686 Engineer: > _ Lic Expire: 0613012022 Address: `- COSTA MESA CA 92627 Bus Lic: BT30063872 - Phone: 949-642-7222 Lic Exp Date: 07/31/2022 Phone: State Lic: ��p�. • • - Code Edit 2019 Worker's Compensation Insurance Designer: ® ® Type of Construction: V-B Carrier: CALIFORNIA INS CO Address: > z� � ° • �d • • ...... ° m Occupancy Group: R3/U Policy No: 4683503601 ° ° o Added /New sq.ft. Bldg: 0 Expire: 01/01/2022 Phone: CD • Added /New sq. ft. Garage: 0 '" • ° ° ° No of Stories: 2 Building Setbacks Rear: / Special Conditions: ® ; ° ° ° ° ° ° • ° ° No of Units : 2 Front: I '-4 Bldg Height: 0 Left: / -. ° • ° ° ° Bldg Sprinklers: N Right: I Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N ° ...... 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: Excise Tax: $0.00 Planning Department - Additional Fee : $0.00 Plan check Fee: Grading Bonds Fee: $0.00 Fair Share Grading PC Consultant : $0.00 SJH Trans Grading Permit Fee: $0.00 In -lieu Housing Fee Grading PC Fee: $0.00 Public Works Department - WQ Insp. Fee: $0.00 Park Dedication : $0.00 PAN Plan Check: $0.00 Electrical %: $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 Plan Check Fee • B° Fire Department oaaea 000•o• $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 $0.00 Fee Due at Permit Issuance : $352.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: I 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, 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, 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). LI 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 70G and effect. License Class License No Date WORKERS' COlhPENSATION DECLARATION ✓DARNING: FAILUREQ®6icu RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL DQgT QFCOMPENSATIQFf, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. and Professions Code: The Contractors' State License Law does not to the Contractors' State License Law). to completion or the Improvements covered by this permit, I cannot that a copy of the applicable law, Section 7044 of the Business and Date isi 3 of the Business and essioYAND e a nse is in full force Contractor Signature a AND CIVIL FINES UP TO ONE HUNDREProf.OLLARS ($1D0,000), IN ADDITION TO THE affirm %(%rpEnalty of perjury one of the following declarations: •e and will maintain 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 nce of the wort for which this permit is issued. Policy No. .. and will mai•ltain 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' compensa' a carrier aM,po licy number are: policy Number Expiration Date Agent • Phone # that,JrS thB*Rertormance of the wo f whi this permit is issued, I shall not employ any person in any ould b6ComA subject �3 the wor ers' om nsation provisions of Section 3700 of the Labor Code, I shall httu re of Appfnt iea CLARATION REGA DI G C NSTRUCTION &RNDING AGENCY rreby affirm under penal erjury that there is a construction lending agency for the performance of the work for wl Ider'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 co t. I agree to comply with all applicable city and county ordinance st a laws relating to building construction. I authorize representatives of this city or county to eJlt§Q' pte -i i3tified property for inspection purposes. signature of Property Owner or Authorized Agei ACTION I DATE I BY 1403 PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED o as to become subject to the workers' compensation laws of California, and agre comply with those provisions. [� Date this permit is issued (Section 3097, Civil Code). lertv Owner's or Authorized Aoent's Name WITH CODE OF FEDZfRAL I FOR OFFICE USE ONLY 61 OF TITLE 40 AND AQMD RULE ASBESTOS NOTIFICATION TO TO orvsb,, ;fbo,, n�-\