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HomeMy WebLinkAboutX2011-2901 - Permits�1,ro City of Newport Beach - Building Division IIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIpIIII /m4 100 Civic Center Drive, Newport Beach, CA 92660 II K_ Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 nAx�yy Combination Type - SFP Job Address: 28 ROYAL SAINT GEORGE RD NB Description: T/O TILE, INST PLYWOOD, 30# FELT, APPLY EAGLELITE TILE 55 SOS, CRRC #0918-0081 CLASS -,A-- Legal Desc.: N TR 7323 LOT 24 Owner: MORROW DONALD L Address: 28 ROYAL SAINT GEORGE RD NEWPORT BEACH, CA 92660 Phone: 714.668.6200 Applicant: PARAGON ROOFING INC Address: 16542 POTTER CIRCLE Bus Lic: HUNTINGTON BEACH CA 92627 Phone: 714.393-1950 Code Edit: 2010 Type of Construction: VB 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: Contractor: PARAGON ROOFING INC Address: 16542 POTTER CIRCLE HUNTINGTON BEACH CA 92627 Phone: 714.393-1950 Con State Lic: 726753 Lic Expire: 09/30/2020 Bus Lic: BT30066362 Lic Exp Date: 12/31/2019 Worker's Compensation Insurance Carrier: STATE COMP Policy No: 9034847 Expire: 03/19/2020 Building Setbacks Rear: / Front: / Left: / Right: / Architect: Address: Phone: Engineer: Address: Phone: Designer: Address: Phone: COMB Permit: X2011-2901 Project No : Issued Date: 12/02/2011 Inspection Area : 4 State Lie: State Lic: Special Conditions: REFL/EMIT - .17/.89 Construction Valuation_ $35 750 00 J e�na. ° Fire Hazard Zone : N g Permit Fee: BLHazardousMat $539.73 Excise Tax: $0.00 heck Fee: e Plan Ck: $0.00 $0.00 Additional Fee : $0.00 Planning Department - Plan check Fee Fire Department gation Fee: $0.00 Grading PC Consultant : $0.00 $0.00 Fair Share : $0.00 Fire Inspection: Fire Plan Rev $0.00 $0.00 Management : Compliance: $1.00 $0.00 Grading Permit Fee: $0.00 SJH Trans: $0.00 In -lieu Housing Fee: Demolition Fee smic Safety: $0.00 Grading PC Fee: $0.00 $0.00 Public Works Department - Building Dept Adm $0.00 d Access : $0.00 WO Insp. Fee: $0.00 Park Dedication : $0.00 General Service $0.00 ous Mat $0.00 Electrical %: P/W Plan Check: $0.00 Refund Deposit $0.00 Green Fee : $2.00 Mechanical %: $0.00 $0.00 San Dist: $0.00 Plumbing %: $0.00 NMUSD Fee: $0.00 $0.00 TOTAL FEE : $542.73 $0.00 Plan Check Fee: $542.73 Fee Due at Permit Issuance : $0.00 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION the reason(s)O papplicabletheitem(s) I hereby affirm under penalty of perjury ons Code: Anxc city orrc county that requires a permit to construct, a ter. improve, Idemolish, rrepair any structure prior to its issuance, lso requires the applicant for (Section 7031.5, Business and Profess) Y 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 an 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). portions of the work, and the structure is not intended or offered for sale (Section 7044, ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) p or personal property, Business and Professions are not mendeCode: The Co for sale, State Livens, thew dos o apply improvement n owner is ofwithrn one year oferty who, completion,Owner-Builde ffwill have the rbu den of proving that itpwas dnot built ored that e off improved for the purpose of sale). 0 I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does no 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 exes covet mpt from licensure under the Contractors' State License Law for the following reason:tion of p year sella signature below I halve built acknowledge that, --builder f it hasnotbelen constructed whichdence in its entirety by I ce sed contracto s. I r at least on understand that a copy of theapplicable law, Section 7044tof the Business and his permit, I cannot ega Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.hlml. Date Signature of Property Owner or Authorized Agent Date Contractor Signature I hereby affirm under penalty of perjury that I am licensed and cense INo ns of Chapter 9 (commencing with Code, and my license is in u force LICENSED CONTRACTOR'S DECLARATION Section 7000) of Division 3 of the Business and Profession and effect. License Class ORKERS' COMPENSATION DECLARATION AWFUL AND SHALL ARNINCOST F CO ILURE TTOION DAMAGES As PROVIDED FOR IN SECT ON 3706 'OF THE LABOR CODE, NTEREBTEAND ATTORNEY'S FEESAN EMPLOYER TO RIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E700,000), IN ADDITION TO I WG: FA I 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, or performance of the work for which this permit is issued. Policy No. I 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 compensa insurance carrier and policy number are: Expiration Date Carrier Policy Number Phone # Name of Agent n the th I certify I should becomet, Iesubject to thetworkers' for provlisIS issued, I ons of Section11not 3700 of the Laboany r Code,erson In any manner so as to l hall forthwith complybwith hose provis onse workers' compensation laws of California, an a Date_ nature of Applicant the work for which this permit is issued (Section 3097, C CLARATION REGARDING CONSTRUCTION LENDING AGENCY ivil Code). lending agency for performance areby affirm under penally of perjury that there is a construction Address ider's Name 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. the information I have provided is correct. I have read this application and city and county ordinances and state laws relating to building construction. I agree to comply with all applicable I authorize representatives of this city or county to enter the above -identified property for inspection Property Owner's or Authorized Agent's Name Date Prin0GERTfFTC47TGF f Property Owner or Authorized Agent f3ECitif2J4TtOM 111 11119PE131f(C€ IN(TN C01)E OF /-lrfr DFHf# Usk AMT r[.7on DA TF IIY F€DERALREGULATIONSPARTSfOFT1Tt€dL+.AND AOMOROL' £ 1403 ❑ istin&uTTrnA.'gW.eTO.q DffrK4TK1�YTO: PtRFP7 EPA PTCELUD El ❑ A0 iriC/tRON IS NOT MRLICAB E TO TENDED .AsB€STOS PROPOSEDDEMOUTiON. NAi n 1 1 7TGF /' ((dd S7€iNA1 UVE:ICYiSR)E.D