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HomeMy WebLinkAboutX2019-1820 - PermitsCity of Newport Beach : Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 1 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type -BLDG a 8 2 0 II COMB Permit: X2019-1820 Project No: Issued Date : 06/11/2019 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: 204 S BAY FRONT NB Description: SFR - TIO B.U.R. RE -INSTALL B.U.R. HOTMOP 9 SQ Legal Desc.: BALBOA ISLAND RESUB SEC 1 LOT 3 BLK 3(AND SELY1/2 LOT 2 BLK 3 Owner: KUPPERROBERTO. Contractor:. SUPERIOR ROOFING SYSTEMS Architect: Address: 204S BAY FRONT Address: 360 E 1ST ST 11701 Address: BALBOA ISLAND CA 92662 TUSTIN CA 92780 Phone: Phone: 866.783-4400 Phone: State Lica. Applicant: SUPERIOR ROOFING SYSTEMS Con State Lic: 865713 Engineer: Address: 360 E 1ST ST #701 - Lic Expire: 1013112019 Address: - TUSTIN CA 92780 Bus Lic ST30049644 Phone: 866-783-4400 Lic Exp Date: 01/31/2020 Phone: State Lia Code Edit: 2016 Worker's Compensation Insurance Designer.. Type of Construction: V -S Carrier: Occupancy Group: U Policy No: STATE FUND 1957583 Address: /New sq.ft. Bldg: 0 Expire: 0110112020 Phone: Added/New sq. ft. Garage: 0 cmAdded 0„y 41y No of Stories: Z Building Setbacks Rear: I Special Conditions: AE FLOOD ZONE No of Units :. 1 Front I LIQUEFACTION ARE Bldg Height: 0 Left: . Bldg Sprinklers' Right: I _ Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $7.000.00 Building Permit Fee: $324.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Feer $0.00 Additional Fee : $0.00 Plan check Fee: $0.00 Fire Inspection: $0.00 Overtime Plan Ck $0.00 Grading Bonds Fee: $0.00 Fair Share: $0.00 Fire Plan Rev $0.00 Investigation Fee:. $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Record Management : $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 - ... PAN 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 : $325.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $325,00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: 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 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 (_) all of or (_) 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 IIm roved for the purpose of sale). LJ 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 legall) 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 perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 on of the Business and Professto o rise is in full force and effect. License Class License No DatV Contractor Signature. WORKERS' COMPENSATION 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 ($700,000), 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: 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 )rmance 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. "y workers' compensa rance carrier and policy number are: of Agent Policy Number Expiration Date Phone # certify that, in the performance of work�for which this 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 agree t, if I should become subject to compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 9nature of Applicant Da CLARATION REGA G CONSTRUCT LENDING AGENCY Ireby affirm under penalty of perjury that here is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). - Ider's Name Lenders 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 bb half. J I have read this application and the information I have provided is Err ct'Is R I agree to comply with all applicable cityand county ordi a tate laws relating to building construction I authorize representatives of this city or cou�t� toe III���///AAAaaa I Rtified roperty for inspection purposes. nahrre of Prnnwrty Owner or AHthnrized Aoenf X ✓� �Print Prooertv Owner's or Authorized AGent's Name �� �i(/'' — v Date DECUMTION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE NOTIFICATION TO PERMIT EXTENDED` I // ,. UAQMD PERMITFINALBESTOS NOTIFI T19 APPLICABLE TO CERTIFICATE OF -�1 PROPOSED DEMIG OCCUPANCY ISSUED ! 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