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HomeMy WebLinkAboutX2019-1092 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIII�III�IIIIIIIIIIIIIIIIIIIIIIIIIIIII o 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9. Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 vyRv b Combination Type - MFP 1 0 9 2 COMB Permit: X2019-1092 Project No Issued Date: Inspection Area : 2 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: 218RUBY AVE NB Building -Permit Fee: $324.00. Excise Tax: ` $0.00 Description:. MFR -TIO COMP SHINGLE. INSTIL 7/16" OSB, 30# FELT. 16 SQ COMP SHINGLE .Legal Desc.: BALBOA ISLAND SEC 3 BLK 10 LOT 19 Pian Cheek Fee: (12:00 Owner: BOLTON RUTH Contractor: PACIFIC CREST ROOFING Architect:. Address: 4337 BEL AIRE DR Address: 25402 GALLOP CIR Address: O�MM v Ian Ce ... LA CANADA, CA 91011 LAGUNA HILLS CA 92653 $0.00 Fair Share : Phone: - Phone: 949-916-5393 Phone: State Lic: Applicant: PACIFIC CREST ROOFING .Con State Lic: 986602 Engineer: - Address: 25402 GALLOP CIR Lic Expire: 0913012019. Address: Demolition Fee LAGUNA HILLS CA 92653. Bus Lic: BT30053727 - Grading Permit Fee: Phone:. 949-916-5393 - Lic Exp Date: 0413012020. Phone: .State Lic:,, e Building Dept Adm $0.00 Energy Compliance: $0.00 Code Edit: -2016 Worker's Compensation Insurance Designer: Type of Construction: V -B Carrier: STATE COMP Address: $0.00. Occupancy Group: .... R3/1.1 Policy No: 9070054 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access: Addod PNewsq.ft. Bldg: m 0 Expire: 08/29/2019 Phone: P/1N Plan Check: Added /Neuesq. ft. Goroge:m 0 Grading Bond: $0.00 No cf,5eriei;: ° 2 Building Setbacks Rear: 1 - Special Conditions: FLOOD ZONE A01 No of Uf),t5 : ° 2 Front: / LIQUEFACTION AREA Bldgm o ®i9 ht m m mg Left: / $1.00 Mechanical %: Bldg Sprinklers: _ ° ° Right: / $0.00 flood Zmne:m o ... Use Zone: Parkino Snares, 0 Fire Hazard 7nne N TOTAL FEE PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Plan Check Fee: $0.00 Fee Due at Permit Issuance : $325.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: Building -Permit Fee: $324.00. Excise Tax: ` $0.00 Planning Department- Fire Department Pian Cheek Fee: (12:00 Additional Fee: $0.00 Plan check Fee: $0.00 Fire Inspection: $0.00 O�MM v Ian Ce ... $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Investigation Feeg .... m $0.00 Grading PC Consultant:. $0.00 SJH Trans : $0.00 Demolition Fee Record Managemeiii:� ° $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department- General Service $0.00 CA Seismic Safety: $0.00. -. WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access: $0.00 P/1N Plan Check: $0.00 Grading Bond: $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 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Plan Check Fee: $0.00 Fee Due at Permit Issuance : $325.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: 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 he 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 3rofessions 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 iot more than five hundred dollars ($500). 1, as owner of the 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, 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 m roved 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). I am exempt from licensure under the Contractors' State License Law for the following reason: 3y 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 legally 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 Date LICENSED 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 Prfessions Coe my license is in full force and effect. License Class License No Date Contractor Signatur NORKERS' COMPENSATION DECLARATION VARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOSAND DOLLARS ($100,000), IN ADDITION TO THE :OST 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: —11 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 9f tDgubor Cogq,°fpr thi 0 once of the work for which this permit is issued. Policy No. S.II Ale 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. dAyxcodcers' compensatioi nsura a carrier and policy number are: _ G :. ° 0.00 'arr' Policy Number 7 /y o /'7 ���� Expiration Date z Jame of Agent Phone # -�5S ' fi/ S"Y4Z , 00 ' :11 certify that, in the performance of the o for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation Iavjs qJ Californij,%91g1 agree hat, if I should become subject to th rs'•co_ m _pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. c� • t� • • ° signature of Applicant/ Date / —5 �! •O )ECLARATION RE INGON LENDING AGENCY l • • • • • • ° ° hereby affirm under penalty of Pry hat 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 • ° 3y my signature below, I certify to each of the following: .... I am the property owner or authorized to act on the property owners be I have read this application and the information I have provided is c e I agree to comply with all applicable city and county ordinances ate laws relating to building construction. I authorize representatives of this city or count to enter the v -Identified roperty for inspection purposes. Signature of PropertyOwner or Authorized Agent Print PropertyOwner's or Authorized Agent's Nam /01 O I Date ACTION DATE BY CLA ION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE I SUBMITTED ASBESTOS CERTIFICATE OF q77 LUASBSTOSNOLIITO .I I (CABLE TO OCCUPANCYISSUED Z7 ��l