HomeMy WebLinkAboutX2019-2108 - PermitsCity of Newport Beach -Building Division
100 Civic Center Drive, Newport Beach,. CA 92660
Permit Counter Phone (949)644-3288
_ Ay Inspection Requests Phone (949)644-3255
er ycT Combination Type MFP
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COMB Permit: X2019-2108
Project No :
Issued Date: 0710812019
Inspection Area : 8
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Construction Hours: Monday - Friday 7.00 a.m. o 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays
Job Address: 725 DOMINGO DR NB
Description: MFR- TIO WOOD SHAKE. REPAIR SHEATHING AS NEEDED. INSTIL 112 SQ COMP SHINGLES
Legal Desc.: N TR 5425 LOT 10
Owner: JAMBOREE MGMT CO
Address: 22982. MILL CREEK DR
LAGUNA HILLS CA 92653
Phoned°° O°O°
o m m
PCOf°C
Applicant: ROYAL ROOFING CONST INC
Adcl°ress: ° 172 rzASTiWNGETHORPE AVE
00"" PLACENTIA CA 92870
Phartap°°. 714-686-0015
0 o mm
eooeb o o
Cole Edit: ° °° 2016
Typao f Construction:° ° V -B
Occgpan8y Group? m ° • m ° R2
Ad4ecL/NbW sq.ft. Bldg: 0
Add6d /New sq. ft.,Garage: 0
Nomf Stories: o • 2
No<o7n11L ° °ORO
Bldg Height: ° C ° °..o
Bldg Sprinklers: ....
Building Permit Fee: $324.00
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 :
$3.00
TOTAL FEE: $327.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor:
ROYAL ROOFING CONST INC
Architect:
Address:
172 EAST ORANGETHORPE AVE
Address:
PLACENTIA CA 92870.
$0.00
Phone:
714-660-0015
Phone:
Con State Lie:
988169
Engineer:
Lie Expire:
1113012019
Address:
Bus Lie:
'BT30064091
$0.00
Lie Exp Date:
08/31/2019
Phone:
Worker's Compensation Insurance
Designer:
Carrier:
TRAVELERS COMPANY
.Address:
Policy No:.
WC018978001
Expire:
12131/2019
Phone:
Building Setbacks
Rear: /
Special Conditions:
Front: /
$0.00
WQ Insp. Fee:
Left: I
Park Dedication :
$0.00
Right: I
Refund Deposit
State Lie:
State Lie:
INSPECT®
Excise Tax:
$0.00
.Planning Department -
Fire Department
Additional Fee :.
$0.00
Plan check Fee :
$0.00
Fire Inspection:
$0.00
Grading Bonds Fee:
$0.00
Fair Share.:
$0.00
Fire Plan Rev
$0.00
Grading PC Consultant:
$0.00
SJH Trans :
$0.00
Demolition Fee
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
$0.00
Building Dept Adm
$0.00
Grading PC Fee:
$0.00
Public Works Department -
General Service
$0.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
P/W Plan Check:
$0.00
Grading Bond:
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
Plan Check Fee:
$0.00
Fee Due at Permit Issuance:
$327.00
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).
❑ 1, 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
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
ap ly 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 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 Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html. ....
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 7QM of Division 3 of the Business and Professions Code, and r4Jicard:e is in full force -
and effect. License Class License No Date Contractor SignaturEV /J eew s' i!'
INORKERS'COMPENSATIONDECLARATION •••°•
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 (iJ lT0;0001,JN ADDITION.TO TdIE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
•• s
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 wtabor imance of the work for which this permit is issued. Policy No. Code,.for dhl
Yanoeo,
' ' . '.'
nd 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 wor6rs' cormpensatior
arrier and policy number are:"'.:....
,arrier Policy Number Expiration Date......
Vame of Agent
Phone# "..
❑1 certify that, in the performance of the work 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 agree
:hat, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
Date 7— Zl'
CLARATION REGARDING.00NSTRUCTION LENDING AGENCY
msby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Ider's Name Lender's 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 behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of this city or county jo enter theabove-identified property for inspection purposes.
nature of Prooertv Owner or Authorized Acent J�/�/ta [/&t tear, - ej- Print Property Owner's or Authorized Agent's Name
ACTION DATE BY /I DECLARATION 01 I REGULATIONS PARTO610 OF 40 AND AQMD RULECE WITH CODE OF FOR OFFICE USE ONLY
PERMIT EXPIRED
PERMITCANCELLED
PERMITEXTENDED
SUBMITTED ASBESTOS NOTIFICATION TO
NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF - r' d j."-, PROPOSED PROPOSED
OCCUPANCYISSUED SIGNATUR
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