HomeMy WebLinkAboutX2019-2059 - PermitsCity of Newport Beach -Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII� COMB Permit. X2019-2059
100 Civic Center Drive, Newport Beach, CA 92660 x 2 9 1 9 2 0 5 9 Project No
a
Permit Counter Phone (949)644-3288
Inspection Requests Pbone-(949)644-3255
Combination Type - SFP Issued Date : 06128/2019
Inspection Area,,�4
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
,r
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 Sundaysf{�r`Holydays a
Job Address: 1949 PORT NELSON PL NB
-
Description: SFR - REROOF W/BORAL LTWT
TILE CRRC 0942.0085 40 SQ,
CL "A" TIO EXTG
Legal Desc.: N TR 7028 LOT 47
Owner: JOHNSON IVY & DAMON
Contractor:
OWNERIBLDR
Architect:
.=
Address: 1949 PORT NELSON PL
Address:
JOHNSON IVY
Address:
NEWPORT BEACH, CA 92660
O/B AUTH ATTACHED
Phone: 714-296-1821
Phone:
Phone:
State Lie:
....
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Applicant: JOHNSON IVY
Con State Lie:
OIB
Engineer
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Address: 1949 PORT NELSON PL
Lie Expire:
Address:
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,; ' �..
NEWPORT BEACH, CA 92660
Bus Lie:
+ ^ ^
Phone: 714-296-1821
Lie Exp Date:
Phone:
State Lie:
•
ao
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•
^ 0
Code Edit: 2016
Worker's Compensation Insurance
Designer.
m o
Type of Construction: VB
Carrier:
Address:
Occupancy Group: R3
Policy No:
Added /New sq.ft. Bldg: 0
Expire:
Phone:
•
, ° ^ ,. �, ^
Added /New sq. ft. Garage: 0
No of Stories: 2
Building Setbacks
Rear: I
Special Conditions:
No of Units: - 1
Front: I
f
•
Bldg Height: 0
Left: /
P
Bldg Sprinklers:
Right: /
°co
Flood Zone:
Use Zone: Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $17,000.00
Building Permit Fee: $324.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $0.00
Additional Fee:
$0.00
Plan check Fee : $0.00
Fire Inspection:
$0.00
Overtime Plan Ck: $0.00
Grading Bonds Fee:
$0.00
Fair Share : $0.00
Fire Plan Rev
$0.00
Investigation Fee: $0.00
Grading PC Consultant:
$0.00
SJH Trans ; $0.00
Demolition Fee
Record Management: $0.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee: $0.00
Building Dept Adm
$0.00
Energy Compliance: $0.00
Grading PC Fee:
$0.00
Public Works Department -
General Service
$0.00
CA Seismic Safety : $0.00
WQ Insp. Fee:
$0.00
Park Dedication : $0.00
Refund Deposit
$0.00
Disabled Access: $0.00
PAN Plan Check: $0.00
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %:
$0.00
San Dist: $0.00
Building Green Fee : $1.00
Mechanical %:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE: $325.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance :
$325.00
PROCESSED BY:
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
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)
action 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
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
,fessions 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
more than five hundred dollars ($500).
I, 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,
ainess 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
)rovements 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
)roved 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
)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:
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)
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
fessions Code, is, available upon request when this I submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
nature of PropWV.0 vner or Authorized Agent �G �L�— Date
)ENAED COAyT,RACTOR'S DECLARAT; N
)reby affirm Qnderpanalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
I eil%ct. License Class License No Date Contractor Signature
)RKERS' CQMP1&NSATION DECLARATION
INRZC: FAILUF& T09EBURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE
ITBF COMPENSS.71ON,UAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
i e*X affirm.Aq& ppnalty of perjury one of the following declarations:
. ..
i Rave 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
fbnance of the work for which this permit is issued. Policy No.
have and uirimiiitsin 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
frRrjce carriel. nd Policy number are:
pier • •'�, • Policy Number Expiration Date
of Agent
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
, 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 Date_
IECLARATION REGARDING CONSTRUCTION LENDING AGENCY
hereby 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).
ender's Name Lender's Address
ly 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 toentera Identified property for inspection purposes. ,yam
lionature of Prooertv Owner or Authorized Anent V x Print Prooedv Owner's or Authorized AOent's Name / 1 SAA L�hnfl
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY /
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
OEPA
PERMIT EXTENDED
QMD
PERMITFINAL
p
SBESTOS NOTIFICATION IS NOTAPPLICABLE TO
CERTIFICATE OF
OCCUPANCYISSUED
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