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HomeMy WebLinkAboutX2018-1689 - Permits1p City of Newport Beach - Building Division �r 100 Civic Center Drive, Newport Beach, CA 92660 t+* Permit Counter Phone (949)644-3288 -: Inspection Requests Phone (949)644-3255 Combination Type - BLDG IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�III� II COMB Permit: X2018-1689 x 2 0 1 6 1 6 6 9 Project No : 1338-2017 Issued Date : 0610412018 Inspection Area : 4 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. 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: 1201 SAND KEY NB Description: SFR- RE -ROOF 30 SQ. T/0 CALSHAKE. USE (E) SHEATHING. INSTALL 2 LAYERS 30# FELT, INSTALL EAGLE LITE TILE ESR 1647. 5.7 PSF Legal Desc.: N TR 6634 LOT 124 Owner: SULLIVAN SHANE Contractor: Address: 1201 SAND KEY Address: Energy Compliance: CORONA DEL MAR, CA 92625 CA Seismic Safety: Phone: Disabled Access : Phone: Applicant: GOETZ ANDREW Con State Lic: Address: 2855 E COAST HWY #234 Lic Expire: $0.00 CORONA DEL MAR CA 92625 Bus Lic: Phone: 949.673-3152 Lic Exp Date: Code Edit: 2016 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 Building Permit Fee: $304.00 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: $305.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: KASINGER ROOFING & WTRPRFING Architect 5342 TRAIL CANYON Address: MIRA LOMA CA 91752 Fire Inspection: 951-685-7430 Phone: 730243 Engineer: 12131/2018 Address: BT30022742 Park Dedication : 06/30/2019 Phone: Workers Compensation Insurance Carrier: STATE COMP Policy No: 3002535 Expire: 01/0112019 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: I $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Designer: Address: Phone: Special Conditions: Fire Hazard Zone: N Planning Department - Fire Department Plan check Fee Fire Inspection: Fair Share : Fire Plan Rev SJH Trans : Demolition Fee In -lieu Housing Fee: Building Dept Adm Public Works Department - Park Dedication : $0.00 PAN Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 State Lic: State Lic: Plan Check Fee: $0.00 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $O.OQ o 0 ooco� $305.00 0 Fire Department $0.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm oom.` General Service Refund Deposit •oouo Grading Bond: Plan Check Fee: $0.00 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $O.OQ o 0 ooco� $305.00 0 0 B cucoo e 0 oom.` •oocu 0 o •oouo cemccc oo©ooc c o o c o uoo ceoccc c 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 ie 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 Irofessions 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 of more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 nprovements 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 n roved 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 pply 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). ] I am exempt from licensure under the Contractors' State License Law for the following reason: ly 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, 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 Irofessions 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 Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and ProfeVions Code, and my license is in full force nd effect. License Class (f —9 License No Date \//, d/—/fI Contractor Signature)(,e, J.� YORKERS' COMPENSATION DECLARATION ix 'ARNING: 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 OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: I 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 th rformance of the work for which this permit is issued. Policy No. 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' compensatioi Is rance carrier and policy number are: c-- �/� merSTAT /- ;;r Policy Number Fao2S�J Expiration Date Z#i' ame of Agent Phone # ]I certify 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 agre lat, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. o ignature of Applicant �.�� �_ DattiL�'y—/o DECLARATION REGARDING C STRUCTI DING AGENCY tX 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). 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 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 tq. enter the above -identified party for inspection purposes. nature of Prooertv Owner or Authorized ADent �%r�aa�%��J Print Prooertv Owner's or Authorized ADent's Name1o"/% ACTION ...... Pt4VTT FINAL • COF ` ' OCCUpk1 NCV ISSUED • DATE I BY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 LJ I SUBMITTED ASBESTOS NOTIFICATION TO EPA QMD tJ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION _ FOR OFFICE USE ONLY