HomeMy WebLinkAboutX2019-0568 - PermitsCity of Newport Beach - Building Division Jill COMB Permit: X2019-0568
6 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 0 5 6 a Project No
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
:.Combination Type - SFP Issued Date : 02121/2019
Inspection Area : 4
No of Stories:
3
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
1
Bldg Height:
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
Bldg Sprinklers:
Job Address:
11 NAPOLI NB
Flood Zone:
X
P/W Plan Check:
Construction Valuation: $85.000.00
- Description:
SFR TIO (E).69 SQ, INSTALL WOOD SHINGLE, PART OF A CLASS W ASSEMBLY, REMOVEIREPLACE 1 SQ OF B.U.R.
$324.00
- Legal Desc.;
N TR 9861 LOT 10
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management':.
$0.00
Owner
ALLRED DEAN
.Contractor:
MCCORMACK ROOFING ENERGY
Architect
$0.00
Address:
11 NAPOLI
Address:
1260 N HANCOCK #108
Address:
$0.00
NEWPORT BEACH, CA 92660
$4.00
ANAHEIM CA 92807,`
Phone
.Phone:
714-777-4040.
Phone: State Lie:
Applicant:
MC CORMACK ROOFING ENERGY
Con State Lic:
643700
Engineer:
Address.
1260 N HANCOCK #108
Lie Expire: -
0613012020
Address:
ANAHEIM CA 92807
Bus Lie:
BT30064748
Phone:
714-777-4040 -
Lie Exp Date:
1013112019
Phone: State Lie:
�.
ria
t+
.Code Edit:
2016
.Worker's Compensation
Insurance
Designer.
;
Type of Construction: VB
Carrier:
EMPLOYEE SVC GRP
Address:
4 1
Occupancy Group: R31U
Policy No: -
WC900085108
Added /New sq.ft. Bldg: 0
Expire:
1213112019
Phone:
- Added /New sq. ft. Garage: 0
No of Stories:
3
No of Units :
1
Bldg Height:
0
Bldg Sprinklers:
N
Public Works Department-
Flood Zone:
X
P/W Plan Check:
Construction Valuation: $85.000.00
San Dist:
Building Permit Fee:
$324.00
$0.00
Plan Check Feer $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 ;
$4.00
TOTAL FEE : $328.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Building Setbacks Rear: / Special Conditions:
Use Zone:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Front: /
Left: /
Right: I
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
0
Planning Department -
Fire Hazard Zone : N
Plan check fee:
Fire Department
Fair Share
Fire Inspection:
SJH Trans :
Fire Plan Rev
In -lieu Housing Fee:
Demolition Fee
Public Works Department-
. Park Dedication :
$0.00
P/W Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Plan Check Fee: $0.00 Fee Due at Permit Issuance :
sPUBLIC WORKS APPROVAL:
0
'.PAN CHECK BY:
APPROVAL TO ISSUE:
o�o cc a�¢ vun o•
s o 0
u OG c6 � 9
UO,u 3fi. 04G u � OGG OOG
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$328.00
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:
Plan Check Fee: $0.00 Fee Due at Permit Issuance :
sPUBLIC WORKS APPROVAL:
0
'.PAN CHECK BY:
APPROVAL TO ISSUE:
o�o cc a�¢ vun o•
s o 0
u OG c6 � 9
UO,u 3fi. 04G u � OGG OOG
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$328.00
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).
0 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
Im 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:
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. 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.htmi.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of p ryth I am licensed under provisions o Chapt r y.(�gmr�encing with Section 7000) of Divisi of the Business and of 'o o e, and my f ens in II fo
and effect. License Class � % 8 License No �� ,/U 3 DaC - Contractor Signa re
NORKERS' COMPENSATION DECLARATION
FARMING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T OUSA DOLLARS ($100,000), IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 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
erf rmance of the work for which this permit is issued. Policy No.
have and will. mB(ain 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
Isurance carrier an p6 Cy number are:
;arrierfc 1 Poh umb� /I Expiration Date
lame of Agent �a rt Phone #
]I certify that, in the performance of the work for which this permit is issued, I hall 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 Feguryth
' compensation provisio coon 3700 o the or Code, I shall forthwith comply with those provisions.
ignatureof Applic t
IECLARATION REG GTR CTION LENDING NCY
hereby affirm under enally ot 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 ordinanc d state laws relatin to bui ing construction. /
I authorize representatives of this city or co n eabove-identified property ection pur
inature of Property Owner or Authorized A t er' or Authorized Agent's Na
\CTION DATE BY DECLARATHD OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATION PART 61 OFTITLE 40 ANDAQMD RULE
PERMIT EXPIRED
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