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HomeMy WebLinkAboutX2019-1004 - Permitsa City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII� COMB Permit: X2019-1004 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 1 0 0 4 Project No : 1511-2018 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - SFP - Issued Date : 04/0812019 Inspection Area : 2 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: 300 GRAND CANAL NB Description: SFR REROOF W/ STANDING SEAM METAL ROOF (ESR#2048) CLASS "A" TIO SHAKE (10 SQS) Legal Desc.:. N TR 742 LOT 1 emp '4 Owner JOHN ERMATINGER Contractor WINKLE CUSTOM HOMES Architect: d j Address: 5 MERRY LN Address: 416 112 ORCHID AVE Address: $ .� CORTE MADERA CA 94925 CORONA DEL MAR CA 92625 Phone: Phone: 949-873-3125 Phone: State Lica. Applicant: SKENDERIAN TODD Con State Lia 992007 Engineer. Address: 1100 S COAST HWY, #316 lir Expire: 03131/2020 Address: - - LAGUNA BEACH CA 92677 Bus Lia BT30055137 $0.00 e o m Phone: 949-715-5461 Lie Exp Date: 0513112019 Phone: State Lia •+• Code Edit: 2016 .Worker's Compensation Insurance Designer: Ommm Type of Construction:. VIS Carrier: STATE FUND Address: ° Occupancy Group: R31U Policy No: 9122252 In -lieu Housing Fee Hazardous Mat Added/New sq.ft. Bldg: 0 Expire: 01/1012020 : Phone: o°°°°e Added /New sq. ft. Garage: 0 Park Dedication : $0.00 .... No of Stories: 2 Building Setbacks Rear: I Special Conditions: Electrical %: - No of Units : 1 Front: 7 - o m o • • ° Bldg Height: 0 Left: I $0.00 m Bldg Sprinklers: Right: I Flnnd 7nne- I Ise 7nne- Parkinn Rnacea n Fire Hazard 7nne - N c o 0 0 0 Building Permit Fee: $324.00 Plan Check Fee:. $0.00 - II TOTAL FEE: $325.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Excise Tax: Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Plan check Fee: Record Management: $0.00 $0.00. Energy Compliance:' $0.00 Grading PC Consultant: CA Seismic Safety: $0.00 $0.00 Disabled Access: $0.00 In -lieu Housing Fee Hazardous Mat $0.00 $0.00 Building Green Fee : $1.00 II TOTAL FEE: $325.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Excise Tax: $0.00 Planning Department - Additional Fee : $0.00 ` Plan check Fee: Fire Inspection: Grading Bonds Fee: $0.00. Fair Share `.. $0.00 Grading PC Consultant: $0.00 SJH Trans $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee General Service Grading PC Fee: $0.00 .Public Works Department- WO Insp. Fee: $0.00 Park Dedication : $0.00 - PAN Plan Check: $0.00 Electrical %: $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Feer $0.00 Plumbing %: $0.00 Plan Check Fee $0.00 Fee Due at Permit Issuance : $325.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: 0 0 moo•ao 0 0 00000 0 00000 ooammo • m c o 0 0 0000 o •• 0 0 Fire Department coo m $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 : $325.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: 0 0 moo•ao 0 0 00000 0 00000 ooammo • m c o 0 0 0000 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 requiresthe 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 (_) 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 im 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 nor. 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, -I cannot legallt 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.htmi. 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 Sectio 7 9) of Ivision 3 of th mass and Prof ss n de, and my lice s is in full force and effect. Liceaw.Glass License No Det Co tra for Signature WORKERS' COMPENSATION DECLARATION 4AR44INO.FAILUR97DSECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TH SAND DOLLARS ($100,000), IN ADDITION TO THE COST OF eOMPENSATL(*,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. penalty of perjury one of the following declarations: 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 a of N vllgrIt for which this permit is issued. Policy No. ]�Me and wilhmath(ain 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' suranoe career and policy number are: .... 3rrigr. Policy Number Expiration Date I artily that, in the per "e f the work for whit this permit is issued, I shall not employ any person in any manner so as to become subject to the w ers' compensation laws of California, and Should ItEfc9gie}�, 'ecTtt e workers' compo n ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. areby affirm under penaltol f 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 I have read this application a the information dd hE I agree to comply with all apPlicable city and cQd(rt1 I authorize reprosentativ is ci or count ,f DATE I BY EXPIRED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED owners behalf. ed is correct :es and stte laws relating to building construction. al ove--ide,�l Hi d property for inspection purposes. Print Prooertv Owner's or Aut ION OF COMPLIANCE WITH CODE OF FEDERALI FOR OFFICE ND DNS PART 61 OF TITLE 40 AAQMD RULE I SUBMITTED ASBESTOS NOTIFICATION TO IS NOT APPILICABLE TO L6]