HomeMy WebLinkAboutX2019-2228 - PermitsCity of Newport Beach Building Division I IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IICOMB Permit: X2019-2228
n V 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 2 2 2 8 Project No:
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
"xy�zyyx�' Combination Type :-SFP Issued Date: 07/17/2019
Inspection Area : 1
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 an Sundays or Holidays
Job Address: 522 W OCEAN FRONT NB
Description: SFRTIO (E) 24 SQ, INSTALL BORAL #1647 CEDARLITE 600 (5.9psf), CLASS'B'MIN. '� • --- -
Legal Desc.: EAST NEWPORT TRACT BLK 10 EAST FOR OF LOTS 1617 & 18
Owner: DAVIS Contractor:. SHELLEY STEPHEN ROOFING CO Architect:
Address: 524 W OCEANFRONT Address: P 0 BOX 1286 Address: e
NEWPORT BEACH, CA 92661 SAN CLEMENTE CA 92674 . -rinm WORK �L .
Phone: L v
Applicant: SHELLEY STEPHEN ROOFING CO
Address: P 0 BOX 1286
SAN CLEMENTE CA 92674
Phone: 949-292-2942
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: N
Phone: 949-292-2942
Con State Lic:
525478
Lic Expire:
09130/2020
Bus Lic:
BT30003303
Lic Exp Date:
03/31/2020
Worker's Compensation Insurance
Carrier:
STATE COMP INS FUND
Policy No:
1137303
Expire:
06101/2020
Building Setbacks
Rear: /
$0.00
Front: /
-
Left:
Grading Bonds Fee:
Right: I
Use
0
Phone: N® 4d®NR B F1L84
Engineer: -
$0.00
Address:
$0.00
^yg`,,�D ®�/�e
Phone: ®N SAM fkE) `7 v7
�g SAM
ems_
$0.00
Planning Department -
Designer:
$0.00
Address:'.
$0.00
Phone:
$0.00
Special Conditions: LIQUEFACTION AREA
Fire Hazard Zone : N
Construction Valuation: $26,500.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Building Permit Fee: $324.00
Excise Tax:
$0.00
Planning Department -
General Service
$0.00
Plan Check Fee: $0.00
$0.00
Additional Fee :
$0.00
Plan check Fee :
$0.00
$0.00
Overtime Plan Ck:
$0.00
Grading Bonds Fee:
$0.00
Fair Share :
$0.00
Investigation Fee:
$0.00
Grading PC Consultant:
$0.00
SJH Trans:
$0.00
Record Management:
$0.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
$0.00
Energy Compliance:
$0.00
Grading PC Fee:
$0.00
Public Works Department -
CA Seismic Safety:
$0.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Disabled Access :
$0.00
PAN Plan Check:
$0.00
Hazardous Mat
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Building Green Fee:
$2.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$0.00
TOTAL FEE: $326.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Fire Department
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
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 : $326.00
_ a ` VUB' tC W DRYS APNtOVAL:
O bF.b Ob i 6
40 O O
PLAN CHECK BY:
a o o �tYiFfjO oA -T(I) ISSUE:
b i i s
boy, co om c c Ecc ccb
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 theapplicable 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
he 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
lot 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,
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
Tiprovements 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
reproved 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.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 Sectiolfis70 0) of Division 3 of the Business and PrEfe�sions a m I segs 1 ull force
. and effect. License Class License No Dat ContractorSigna �rSC/--1�
WORKERS' COMPENSATION DECLARATION
WARNING: 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.
I 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 the Labor Code, for th,
perf ance of the work for which this permit is issued. Policy No.
I have and aintain 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' compensatior
insurance carri a policy nuer re:
Carrier To' umber Expiration Date
Name of Age Phone #
I certify that, in the performance of a 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
that, if I should becomes ject tot ionp ov' 'ons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant._ j7_12 -1Z 7
-.
Ireby affirm under p.Analty of perjury that there is a conettlEtion 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 rater a e-idq�tt'ljied p,ppeity for inspection purposes.sp/�
nature of Prooertv Owner or Authorized AGe .i Print Property Owner's or Authorized Aqent's Nam
ACTION
PERMIT EXPIRED
PERMITCANCELLED
PERMIT EXTENDED
DATE BY DECLARATION OF COMPtfANCE WITH CODE OF FEDEI
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
I SUBMITTED
PERMITFINAI0-3o-4 rl V ASBESTOSS!'NOTIFICATION NOT APPL ABLE TO
CERTIFICATE OCCUPANCYISSUED
SIGNATURES MOOT .•
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