HomeMy WebLinkAboutX2019-1867 - Permitsh
City of Newport Beach - Building Division
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100 Civic Center Drive, Newport Beach,CA 92660
$0.00
Permit Counter Phone (949)644-3288
Phone:
Inspection Requests Phone (949)644-3255
$0.00
Combination Type - SFP
��IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII �� COMB Permit: X2019-1867
x 2 9 1 9 1 6 6 7 Project No :
Issued Date : 06/13/2019
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: 1845 PORT WESTBOURNE PL NB-�
Description: SFR TIO (E) 36 SQ WOOD SHAKE, INSTALL CLASS "B" WOOD SHAKE, PART OF A CLASS "A" ASSEMBLY • -
Legal Desc.: N TR 6622 LOT 65
Owner: NELSON AMARALICYNTHIA
Address: 1845 PORT WESTBOURNE PL
NEWPORT BEACH, CA 92660
Phone
Applicant:
LUKE ROOFING INC
Address:
26081 MERIT CIRCLE#125
$0.00
LAGUNA HILLS CA 92653
Phone:
714-612.8806
Code Edit: 2016
Type of Construction: VB
Occupancy Group: R31U
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
Lie Expire:
Overtime Plan Ck:
$0.00
Investigation Feer
$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 :
$2.00
TOTAL FEE: $326.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor: LUKE ROOFING INC
Address: 26081 MERIT CIRCLE#126'
LAGUNA HILLS CA 92653
Phone: 714-612-8806
Con State Lie:
672569
Lie Expire:
06/30/2021
Bus Lie:
BT30036360
Lie Exp Date:.
07131/2019
Worker's Compensation Insurance
Carrier:
STATE NATIONAL INS
Policy No:
CWC71949-1001
Expire:
01/0112020
Building Setbacks
Use Zone:
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: I
Parkina Spaces
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee
0
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
Fire Hazard
Planning Department -
Fire Department
Plan check Fee
$0.00
Fair Share
$0.00
SJH Trans
Fire Plan Rev
In -lieu Housing Fee:
$0.00
Public Works Department -
Park Dedication :
$0.00
PMI Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:.
$0.00
State Lic:4:
�crsze¢os�
State Lie: ;-•
N
$0.00 Fee Due at Permit Issuance : $326.00
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PUBLIC WORKS AP<<RGSV�LF
PLAN CHECK BY:• ° • - ` �._•`E.�-
APPROVAL 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
$0.00 Fee Due at Permit Issuance : $326.00
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PUBLIC WORKS AP<<RGSV�LF
PLAN CHECK BY:• ° • - ` �._•`E.�-
APPROVAL TO ISSUE:"
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OWNER -BUILDER DECLARATION
1 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
ie 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
Irofessions 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
got 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,
lusiness 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
nprovements 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
nproved 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
Poly 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).
J I am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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 Iegall�
ell 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
'rofessions 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
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 of Division 3 of the Business and Pro ions Code, a II force
nd effect. License Class License No Date l;- / Contractor Signatu
VORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND RS (E100,0001, IN DITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
31 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
eyprmance of the work for which this permit is issued. Policy No.
41 have and willntain 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' compensatioi
nsurance carrier a d olicy number
;arrier %Z7 - of N bar Expiration Date
Name of Agent Phone #
:1I certify that, in the performance of the work f ich this permit 10 sued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
.hat, if I should become su'act to the rs' cc pensation pro ' I ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. yy�r
Signature of Applicant Dalk C -13;- 1 P
)ECLARATION REGAPbING CONSTRUC O N _AG Y
hereby affirm under p alty of perjury that I Are is a construdtin' ding agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
-ender's Name Lender's Address
3y 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 count ances state I s relating to building construction.
I authorize representatives of this city or cou o er the abo a t a property for inspection purposes.
Signature of Property Owner orAuthorized A Print Property Owner's or Authorized Agent's Nam OSAw.t tanks f p e `- / 3-)7
ACTION DATE BY rj TION OMPLI NC ITH CODE OF FEDERAL FOR OFFICE USE ONLY
REG TIONS RT 610E LE 40 AND AOMD RULE
PERMIT EXPIRED
U I SUBIAITED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
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