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Home My WebLink AboutX2020-0190 - Permitsr, = raUG", City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - SFP Illlillllfllllllllllllll0 IIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2020-01 Project No : Issued Date : 01122/2020 Inspection Area : 1 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: 128 VIA LIDO NORD NB Description: SFR TIO ROCK LAYER. INSTIL 10 SQ SPRAY FOAM ROOFING Legal Desc.: N TR 907 LOT 862 Owner: BOOTSMA JOHN Address: 128 VIA LIDO NORD NEWPORT BEACH CA 92663 Phone: Applicant: VISION ROOF SVCS Address: 49950 JEFFERSON ST #130-322 INDIO CA 92201 Phone: 760-600-6183 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: 2 No of Units: 1 Bldg Height: 0 Bldg Sprinklers: Construction Valuation: Building Permit Fee: $324.00 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: $325.00 PROCESSED BY: ZONING APPROVAL: Contractor: VISION ROOF SVCS Address: 49950 JEFFERSON ST #130.322 INDIO CA 92201 Phone: 760-600-6183 Con State Lic: 651509 Lic Expire: 07131/2020 Bus Lic: BT30065705 Lic Exp Date: 01/31/2020 Worker's Compensation Insurance Carrier: EMPL SVC GROUP Policy No: WC009578003 Expire: 1213112020 Building Setbacks Use Zone: 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: I Right: / 'arkina Soaces $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: Phone�O �1�+ G�1®nl®1SF CONSTR�1 State Lic: Engineer: Address: Phone: 00 Designer: Address: Phone: Special Conditions: HIGH DENSITY INSPECTOR 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 $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 : $325.00 F UELL^ WOFKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: API-ROVAL TC ISSUE: 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 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). ❑ 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 Iegall� sell 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 Professions Code, is available upon 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 D e LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisio s-of thR)Ef'8r 9 (commencing with Section 7 ))of 'v on 3 of the Business and Professi s Co , and m� license' full force and effect. License Class License Net �.y Da Contractor Signature WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUWECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000I, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I 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, for the p8¢prmance of the work for which this permit is issued. Policy No. lave 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' compensatiol ns rance carr�<r and pplicy n rn are: arner t n i " ad Policy Number Expiration Date Vame of Ag nt Phone # ❑1 certify that, in the performa ce f the work for whi t Is permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compens tion laws of California, and agre .hat, if I should become sub' t e w kers' comp anon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. (�I Signature of Applican Da r J o )ECLARATION REGAR CONSTRUCTION L NDING AGENCY hereby 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 de). -ender's Name Lender's Address 3y 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 constructs /'r�F/ I authorize representatives of this city or count to enter the above -identified property for inspection purpo s. 2 Signature of Property Owner or Authorized Ag n Print Property Owner's or Authorized Agent's Name /DateZ ACTION DATE DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED �.�SS EMITTED ASBES, OS NOTII-IrATI(1N'�O PERMITCANCELLED UEFA r PERMITEXTENDED /PERMITFINAL/ QMD CERTIFICATE OF ,l D010/_ PROPOS DDFTUA ASBESTOS NOTIF AT NOT APPLICAB TO OCCUPANCYISSUED MC SIGNALURE-J