HomeMy WebLinkAboutX2020-1677 - PermitsCity of Newport Beach - Building Division
T
100 Civic Center Drive, Newport Beach, CA 92660
ti Permit Counter Phone (949)644-3288
i " s Inspection Requests Phone (949)644-3255
Combination Type - CIP
COMB Permit: X2020-1677
Project No: 0117-2020
Issued Date: 07/23/2020
Inspection Area : 7
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0712412023 OR PERMIT WILL BE INVALID
Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 am. to 6:00 p.m. No work on Sundays or Holidays
Job Address: 3363 VIA LIDO NB
Description: COMM INSTALL NEW TPO ROOFING SYSTEM OVER EXISTING CAP SHEET ROOF CRRC # 0676-0001 30 SQS
Legal Desc.: TR 1117 LOT 4 AND 5 ALL -INC FOR OF ALLEY ADJ-
Owner:
FAINBARG ALLAN
Address:
129 W WILSON ST #100
COSTA MESA, CA 92627
Phone:
949-722-7700
Applicant:
PREMIER ROOFING/BLDG CO INC
Address:
17601 NORWOOD PARK PLACE
TUSTIN CA 92780
Phone:-
714-573-0155-
Code Edit: 2019
Type of Construction: V-B
Occupancy Group: B
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 1
No of Units: 0
Bldg Height: 0
Bldg Sprinklers:
Valuation: $17,922.00
Building Permit Fee: $363.00
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: $364.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor:
PREMIER ROOFINGIBLDG CO INC
Address:
17501 NORWOOD PARK PLACE
TUSTIN CA 92780
Phone:
714-573-0155
Con State Lie:
634404
Lie Expire:
12/3112021
Bus Lie:
BT30058009
Lie Exp-Date:
01/3112021-
Worker's Compensation Insurance
Carrier: REDWOOD FIRE
Policy No: PRWCO23259
Expire: 10/28/2020
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: I
Front: I
Left: I
Right: /
larkinc Spaces
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee
Architect:
Address:
l-y
V
Phone:
State Lie: Z
Engineer:
W
Address:
>
I
Phone:-
-State Lic: - C
Designer:
Address:
Phone:
-�
Special Conditions:
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
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $364.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE: QWN/y
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 amexempt 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 applican' 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
Tot more than five hundred dollars ($500).
1, 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 far safe (Section 7044,
3usiness 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
mprovements 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
mproved 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
IppIY 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 underthe Contractors' State License Law forthe following reason:
3y my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one yearpnorto Completion of the Improvements Covered by this permit, I cannot legalf
:ell 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
'rofesslons Code, is available upon request when this application is submitted or at the following Web site:http:f/www.leginfo.ca.gov/calaw.html.
>ignatum of Pr3;x.rty Owner or Authorized Agent Date
-ICENSEE) S^P'TRACTOR'S DECLARATION '
het --by affirm under penalty of perjury that I am licensed under provisions Of Chapter 9 (commencing with Section 7000) f Division 3 of the Business and Profession
ana nlirPn�P ��'� fud iffect.-Ucalnse Class _ NJ License No lo34L1 ri Date 23 '2MO Contmctor and if force Signature -
YORKERS'COMPENSATION DECLARATION
r�PNING FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SURDECT AN MPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS J$100,000J, M ADDITION TO THE
OST OF COMPEHSA71014, DAMAGESAS PROVIDED FOR IN SECTION 37050F THE LAaOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm Littler penalty of perjury one of the following declarations:
t have and -vill maintain a certificate of consent to self4nsum for workers' compensation, issued by the Director of Industrial Relations as provided for by Section $700 of the Labor Code, forth
arjo:mance 07 the work for which this permit is issued. Policy No.
31 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' compensation
sum ncpe� c�a'rrier Pod policy number are:
arrer O&.,k1Lr I✓1bJrghGQ $oIU♦-,gS Policy Number Pt-W C6;4-50I Expiration Date 10.15.7.0"L0
ame of Agent 1. 161f;g(ca Phone#__ NllP.3r3p•53a)
�I certify that, in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agrex
at, if i should become subject to the workers' compensation p visions 0€ . ion 3700 of the Labor Code, I shall forthwithcomplywith those provisions,
gnature of Applicant wDate^
ECLARA770N REGAr<uING as I ttWET OfTLEf�ING AGENCY
lereby affirm under penalty of perjury that there is a construction tending agency for the performance of the work forwhich this permit is issued (Section 3097, Civil Code).
order's Name Lender's Address
I 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 county ordinances and state laws relating to building Construction.
I authorize representatives of this city or county to ent 'den ified orgpe�pection purposes-
-Huck-
w rlupuriy wwrler or Aumonzed Age gtG+ry Print Pro party Ownel's or Authorized Agent's Name I Vk�it o ` "' �'" Date 12a
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMO RULE
1403
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