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Home My WebLink AboutX2016-1270 - PermitsCity of Newport Beach - Building Division 111111111111111111111111111111111111111111111111111111 COMB Permit: X2016-1270 p� ra 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 6 1 2 7 e Project No Permit Counter Phone (949)644-3288 a r Inspection Requests Phone (949)644-3255 Combination Type - SFP Issued Date : Area : 2016 ' esa,n Inspection Area 3 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. . . INSTALL OR VERIFY SMOKEICARBON MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED Job Address: 2630 VISTA DEL ORO NB Description: MFR - REROOF GARAGE FLAT ROOF W/28# GLASS BASE FELT, ROLLED GRANULAR, TORCHED MOD BITUMEN, 6 SQS Legal Desc.: N TR 6996 LOT 38 Owner: GEORGE BLAIR Contractor: OWNER/BLDR Address: 2630 VISTA DEL ORO Address: GEORGE BLAIR NEWPORT BEACH, CA 92660 Phone: 949-697.1524 Phone: Applicant: GEORGE BLAIR Con State Lic: O/B Address: 2630 VISTA DEL ORO Lic Expire: NEWPORT BEACH, CA 92660 Bus Lic: Phone: 949-697-1524 Lic Exp Date: Code Edit : 2013 Type of Construction: VB Occupancy Group: U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units : 5 Bldg Height: 0 Bldg Sprinklers: Flood Zone: X Worker's Compensation Insurance Carrier: Policy No: Expire: Building Setbacks Rear: / Front: / Left: / Right: I Use Zone: Architect: Address: Phone: Engineer: Address: Phone: Designer: Address: Phone: Special Conditions: Construction Valuation: $2,200.00 Building Permit Fee: $110.00 Excise Tax: $0.00 Planning Department - Plan Check Fee: $0.00 Additional Fee : $0.00 Plan check Fee Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share Investigation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans Record Management: $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Disabled Access: $0.00 PIW Plan Check : $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 TOTAL FEE : $111.00 PROCESSED BY: ZONING APPROVAL: State Lic: State Lic: ICI 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 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $111.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO 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 if thi property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Businesn and Prcfrrs'ons 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 a nents 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 I. nprovel for the pLrpw a of sale). 4 I, a 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 a&E;, -loan 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). CC.'++ I am exemoL frorn, 1(oensure under the Contractors' State License Law for the following reason: Ey 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 legall) sell a structure the' I h2ve 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 subrjtted or at the following Web site:hftp://w .leginfo.ca.gov/calaw.html. Sigl,aturaofPrope,ty Owner orAuthorized Agent i< % [ /!/wT4,e_— Dat,_ .. g./g'OIio LICENSED CONTFACTOR'S DECLARATION 1 Y.a:ct7 affirm Lrd9; penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Licerss Class License No Date Contractor Signature WORKERS' CCr.1?_NSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for thl performance of the work for which this permit is issued. Policy No. ❑1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatior nsurance carrier and policy number are: Policy Number Agent Date ify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. of Applicant Date/`_'i ItGLAKAI IUN KtGAKUING GUNS I KUG NUN LCNUINU AGENCY hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ender's Name Lender's Address y my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this t for inspection u/la- 20I (y city or county en �r��jjhe above=d�e�ntifie`ld pr—operty purposes. // ig nature of Property Owner or Authorized AgentW`Kd�L `V'�` Print Property Owner's or Authorized Agent's Name �L$�Ct,lYt- L71PilJr Date ACTIlH,I nATF By DECLARATION OFCOr11PIJAIICE*7TM CODE OF t LPN UFNLL USi IJPIH.T FEDERAL REGUL4TIONS PART 81 OF Ti TLE W AND AOMD ROLE 140. PFRh4rT FXPIRFn ❑ rsrrnurTrrDasrrsT�sNnnrrrnTrrtN7t7 EPA Qar4GTOSNO71RCA170NPSrVCTRPPUCASLETO C'EWLMON. PE,1t,fIT CAPICLLtLD PERIAFT EM'EhOED JJ$PED PCfiMtTr"r!'JAL J CERTIFTCATECF QCCUDANCkiSsUELI SJ U-