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HomeMy WebLinkAboutX2019-2661 - PermitsCity of Newport Beach -Building division III'' ,,II''II II'' Ipp ''IIII ''fi�tt IIIIIIII I� II I P�IIII�ltlllliUl�Ull►,°IIIII COMB' Permit: X2019-2661 9 Q(3 civic Center Drive, Newport Beach, CA 92660 ll��l X 2 g 1 9 2 6 6 Project No Permit Counter Phone (949)644-3288 4 Inspection Requests Phone (949)644-3255 Issued Date: 08/26/2019 Combination Type - MFP Inspection Area : 5 PERMITS EXPIRE ISO DAYS AFTER ISSUANCE CAR LAST VAL10 INS ECTIOM to 6 3 and Saturday from 8•13 .m. to :00 p.m. No oi* on Sundays Or,iifOfidays Construction Hours: Monday Friday 7.-00 a.m. p.m- Job Address: 603 BEGONIA AVE NB MFR REMOVEIREPLACE (E) 18 SQ OFB.U.R, CLASS 'B' MIN. Description:. Legal Desc_: CORONA DEL MAR BLK 629 LOT 3 Owner SCHILLER THOMAS Contractor. PREFERRED ROOFING Architect 3419 VIA LIDO #161 Address Address: 429 PANORAMA DR 92654 Address: NEWPORT BEACH CA 9 State Lic: LAGUNA BEACH CA Phone: Phone: 949-600-5911 ' TR C-r ' ICJ lN Applicant: PREFERRED ROOFING Con State Lic: Expire_ 902112 08/31/2021 Engineer. Address: N ESE .� Address: 3419 VIA LIDO #161 NEWPORT BEACH CA 92663 Lic Bus Lic: BT3112021 2 ON State Lic: Phone: 949-600-5911 Lic Exp Date: 09/30/2019 Designer - Code Edit: 2016 Workers Compensation Insurance STATE COMP Address: ®• • � Y Type of Construction: VB Carrier. Policy No: 9062137 Occupancy Group: R3/U Expire: 08/16/2020 Phone: Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 Building Setbacks Rear / Special Conditions: p No of Stories: 2 Front:: I ` No of Units : 2 Left: / Bldg Height:. 0 Right: 1 Bldg Sprinklers: N Use Zone: Parking Spaces: 0 Fire Hazard Zone: N Flood Zone: X Construction Valuation: $8,500.00 Building Permit Fee: $324.00 Excise Tax $0.00 $0.00 Planning Department - Plan check Fee : $0.00 Fire Department , Fire Inspection: $0.00 Plan Check Fee: $0.00 Ck: $0.00 Additional Fee: Grading Bonds Fee: $0.00 Fair Share : $0.00 $0.00 Fire Plan Rev Demolition Fee $0.00 overtime Plan Investigation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans: In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Record Management: $0.00 Grading Permit Fee: 9 $0.00 $0.00 Public Works Department - General Service $0.00 $0.00 Energy Compliance: $0.00 Grading PC Fee: WQ Insp. Fee: $0.00 Park Dedication: $0.00 Refund Deposit P Grading Bond: $0.00 CA Seismic Safety: $0.00 P/V11 Plan Check: $0.00 Disabled Access : $0.00 $0.00 Electrical %: $0.00 San Dist: $0.00 $0.00 Hazardous Mat Building Green Fee: $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 Plan Check Fee: Fee Due at Permit Issuance : $325.00 TOTAL FEE : $325.00 ©4$0.00 y a a a PUaBLI4 1o1P R m ° C �RF4 rPPROVAL: PROCESSED BY: PLAN CHECK BY: ZONING APPROVAL: °Al✓PIOW Td7©ISSUE: GRADING APPROVAL: ° 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 items) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, _�; irrrprove, 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 doilars ($500). III i ❑ 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). ❑ 1, 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). ❑ 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 year prior to completion of the improvements covered by this permit, I cannot legal) sell a structure that I have !,built as an owner -builder if it has not been constructed in its entirety, by licensed contractors. 1 understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is availableupon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Da LICENSED CONTRACTOR'S' DECLARATION I hereby affirm under penalty of perjury that i am licensed under provisions of Chapter 9 (commencing with Section 700) isio 3 of the Business and Profes ions o and my license is in fu[i force and effect. License Class License No Date' Contractor Signature WORKERS' COMPENSATION DECLARATION JVARNING FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND�SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN TIES D CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR iN SECTiOW37W OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 1 have 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 )e ormance of the work for which this permit is issued. Policy No. for th 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. M workers' com e nsurance carrier and number are: Y p nsatior carrier 11_ n _ e w PnTik, K*f. /-) O9 ie of Agent certify that, in the pi if I should become Date — :F Phone # for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ia, and ag Signature of Applicant DECLARATION REGAL"ING�',TMION LENDING AGENEr 1 hereby affirm under penalty of perjury that there is a construction lending agency for the Dat performance of the work for which this permit is issued (Section 3097, Lender's Name Civil Code Lender's Address By my signature below, I certify to each of the following: . ty owner's behalf. am the property owner or authorized to acjha 1 have read this application and the informaided is correct. agree to iI comply with all applicable city andces and state laws rel to building construction. i authorize representatives of this city or co,nhnvve-ide for "W predoperty inspection purposesSignature of Property Owner or Authorized AgenPrint Property Owner's or Authorized Agent's ACTION DATE' BY DECLAWTION OF COMPLIANCE WITH CODE OF FEDERAL Na a FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE l 1403 ., C. PERMIT EXPIRED I SUBMITTED ASBEST CS NO-!FICATiGN TO PERMIT CANCELLED PERMITEXTENDED D "EPA QMD PERMITFINAL'a) CERTIFICATE [ Q/( i ASBESTOS NOIFI fIS NOT APPLICABLE TO OF P POSED D I OCCUPANCY ISSUED SIGNATURE: III