HomeMy WebLinkAboutX2019-0012 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2019-0012
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 0 0 1 2 Project No : 2021-2018
y - Permit. Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
`p"�sxenx�+v' Combination Type - SFP Issued Date : 0110212019
Inspection Area: 4
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: 23 NARBONNE NB
Description: SFR TIO (E) 7 SO, INSTALL COMP. SHINGLE, CLASS 'B'
Legal Desc.: N TR 9589 LOT 30
Owner: DINELLE Contractor: DONE RIGHT ROOFING Architect:
Address: 1. CARMEL BAY DR : Address: 40055 RAVEN WOOD DR Address:^'
NEWPORT BEACH CA 92525 MURRIETA CA 92562 x.
Phone:. Phone: 951-813.5396 Phone: State Lie:-`
Applicant: LOPEZ MARCO
Address: 40055. RAVEN WOOD DR
MURRIETA CA 92562
Phone: " 951.813-5396
Code Edit: 2016
Type of Construction: VB
Occupancy Groups 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:
Building Permit Fee: $324.00
Plan Check Fee: $0.00
TOTAL FEE: $325.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Con State Lie:
Overtime Plan Ck: $0.00. -
Lie Expire:
Investigation Fee: $0.00
Bus Lie:
Record Management :. $0.00
Lie Exp Date:
Energy Compliance: $0.00
Worker's Compensation Insurance
CA Seismic Safety: $0.00
STATE COMP INS -
Disabled Access: $0.00
9221374
Hazardous Mat $0.00
11/1012019.
Building Green Fee : $1.00
TOTAL FEE: $325.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Con State Lie:
.1019430
Lie Expire:
1013112020
Bus Lie:
BT30065567
Lie Exp Date:
01/31/2020
Worker's Compensation Insurance
Carrier:
STATE COMP INS -
Policy No:
9221374
Expire:
11/1012019.
Building Setbacks Rear: /
Front: /
Left: /
Right: I
Use Zone: Parkinc SDac(
Excise Tax:
$0.00
Additional Fee :
$0.00
Grading Bonds Fee:.
$0.00
Grading PC Consultant:
$0.00
Grading Permit Fee:
$0.00
Grading PC Fee:
$0.00
WQ Insp. Fee:
$0.00
Electrical %:
Mechanical %:
Plumbing %:
$0.00
$0.00
$0.00
Planning Department -
Plan check Fee:
Fire Department
Engineer:
-s�
�
Address:
- m
Phone:
State Lic:
Designer.
-
Address:'
$0.00
.Phone:
$0.00
Special Conditions:
$0.00
Planning Department -
Plan check Fee:
Fire Department
Fair Share :
$0.00
SJH.Trans :
$0.00
In -lieu Housing Fee:
Fire Plan Rev
Public Works Department
-
Park Dedication :.
$0.00
PAN Plan Check:
$0.00
San Dist:
$0.00
NMUSD Feer
$0.00
Plan Check Fee: $0.00 Fee Due at Permit Issuance : $325.00
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�PU13LlO-WhDRKS APPROVAL:
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PLAN CHECK BY:
ARFIRGVAL TO ISSUE:
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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
Plan Check Fee: $0.00 Fee Due at Permit Issuance : $325.00
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�PU13LlO-WhDRKS APPROVAL:
a F
PLAN CHECK BY:
ARFIRGVAL TO ISSUE:
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OWNER -BUILDER DECLARATION
1 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) I have placed next to the applicable items)
(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 L) all of or L) 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
improved 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).
❑ 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.html.
Signature of Property Owner or Authorized Agent Dale
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700) of DJ'yisipn 3 of the Business and Prof ss s Code, and my license is in full force
and effect. License Class C- .� �/ License No / C7 1 �i '7 a Date ° L' t Contractor Signatures
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 ($100,000), 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:
: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 of the Labor Code, for th
oerformance 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. My workers'
rance carri nE�solicv number are: d-\ e E'1 n
Date
lame of Agent _ { rnone It
]I certify that, in the performance of the wor for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
iat, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
signature of Applicant �Y/ SJR -,vim--" <:_ � Da 2 '
)ECLARATION REGAR N ONSTRUCTION LENDING AGENCY r
hereby affirm under pen ty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 97, Civil Code).
ender's Name Lender's Address
iy 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 ofdinances and state laws relating to building construction.
I authorize representatives of this city or county to erilisr the above -identified property for inspection purposes.
DATE BY I I'EG ATONS OF CO 1OF NTCE E IANDDE OF FEDEAQMD RUDERAL I FOR OFFICE USE ONLY
PERMITEXPIRED V I SUBMITTED ASBESTOS NOTIFICATICIN TO • •" •a• ••
PERMITCANCELLED UEPA • • �• • • • + a e
PERMIT EMENDED 13AQMD • ° • . ° ° • °
PERMITFINAL �'QQ,� ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFIC4TE OF PROPOSED DEMOLI 10f� -
OCCUPANCY ISSUED SIGNATURE (�'� • ° .', • ••• ••• °:°
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