HomeMy WebLinkAboutX2018-3488 - Permitst1 City of Newport Beach - Building Division
a' 100 Civic Center Drive, Newpor+ 5each, CA 92660
- - Permit Counter Phone (P,1,,)e ;-3288
c). - Inspection Requests Phone .(949)644-3255
dui r.b Combination Type -CIP
Job Address:
Description:
Legal Desc.:
COMB Permit: X2018-3488
III��X 2 0 1 8 3 4 8 8�'1111
Project No
Issued Date : 11/1612018
Inspection Area : 7
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
lstruction 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
kST HWY NB
F OVER EXISTING CAP SHEET WITH FOAM COAT & TITLE 24 COATING 219 SCIS COOL ROOF #0770.0002
A NWLY 132 FT SELY 732.78 FT -EX NELY 150 FT
-Owner:
SMI HOTEL LLC
Address:
42 CORPORATE PARK STE 208
Record Management:
IRVINE, CA 92606
Phone:
$0.00
Applicant:
MARTINEZ LORENZO
Address:
777 S. LUGO AVE
Hazardous Mat
SAN BERNARDINO, CA 92408
Phone:
909-884-8505.
Code Edit: 2016
Type of Construction: V -A -SPR
Occupancy Group: R-1
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 0
Bldg Height:. 0
Bldg Sprinklers:
Construction Valuation:
Building Permit Feer $952.00
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 :
$4.00
TOTAL FEE: $956.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor:
BRASIL'S ROOF SERVICES
Address:
777 S. LUGO AVE
Fair Share :.
SAN BERNARDINO, CA 92408
Phone:
909-884.8505
Con State Lic:
907600
Lic Expire:
04/3012019
Bus Lic:
BT30065131
Lic Exp Date:
11/30/2019
Worker's Compensation Insurance
Carrier: CA INS CO
Policy No: 828992730101
Expire: 0512712019
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: /
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Architect
Address:
Phone: State Lic:
Engineer:
Address:
Phone: State Lic:
Designer:
Address:
Phone:
Special Conditions:
Hazard Zone: N
Planning Department -
Fire Department
Plan check Fee
$0.00
Fair Share :.
$0.00
SJH Trans:
• °
me•eoo
In -lieu Housing Fee:
• o
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check :
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Plan Check Fee : $0.00
• e
Fire Department
mm0000
$0.00
m
$0.00
e e
• °
me•eoo
o•eeee
• o
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$0.00
e o
•
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General Service
$0.00
ooemme
• o
$0.00
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oomoo
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Fee Due at Permit Issuance: $956.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:. l
r
Fire Department
$0.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
Fee Due at Permit Issuance: $956.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:. l
r
I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s)J, 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, p15u%t 116 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).
❑ 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,
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 ifwas not built or
improved for the purpose of sale). <'
13I, 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, Icannot 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 Coge, is available upon request when this application is submitted or at the following Web site:http://ww .leginfo.ca.gov/calaw.html. Date -
Signature of Ptopert90wner or Authorized Agent
LICENSED CONTVCTOR'S DECLARATION
I'h'e1e'bj affirm.IxWenpenalty of penury that I am licensed under provision f Chapter 9 (commencing with Section 70 O) of Division of the Business and Professi Znse, y license is in full force
and effect. License Class (rt —:3e License No O%iD 420 Date - - Contractor Signature
WORKERS' CdMPENSATION DECLARATION
V�j1RNIdG: FAILUN14TO"OURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRE THOUSAND DOLLARS ($700,000), IN ADDITION TO THE
COST OIYCOMPENSATION,9AMAGES AS PROVIDED FOR IN SECTION 0705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm
�U Nderpe natty of perjury one of the following declarations:
IPYYY
.I,lAe 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 the
Degformance of the work for which this permit is issued. Policy No.
ve and A maAain 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
insnrancR carrier and n'olicv number are:
Policy Number
Date
ne of Agent - - --
certify that, in the perfo ante o e or hich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' ompensation laws of California, and agre
if I should become su ect to r mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /
nature of Applicant /7Civil
CLARATION REG G CONSTRUCTION LENDING AGENCYIreby affirm and I alty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3 Code).
Ider's Name Lender's Address
my signature below, 1 certify to each of the following:
I am the property owner or authorized to act on the property owners behalf.
1 have read this application and the information 1 have proved Is torr t.
I agree to comply with all applicable cit and count rdin s an
-We'd
relating to building construction.
9 PY P Y Y � %�� py,Zte
r/
I authorize representatives of this city ar county to a abovy/ "a property for inspection purposes. / L ",eA � I. 1J f l l l
Print Prooertv Owner's or Authorized Agent's Nam
BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REQQLATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED ❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED EPA
PERMIT EXTENDED QMD
PERMIT FINAL %3 -� 9 SBESTOSN (FICA PPLICABLE TO
CERTIFICATE OF RO DE OL
OCCUPANCY ISSUED SIGNATURE:
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