HomeMy WebLinkAboutX2019-2102 - PermitsCity of Newport Beach - Building Division 11IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII jlCOMB Permit: X2019-2102
100 ic Center Drive, Newport
E
..a vCounter PhBeach, CA 92660 X 2 5 1 9 2 1 9 2 Project No
Permit one (949)644-3288
"c Inspection Requests Phone (949)644-3255
Combination Type - MFP Issued Date: 0710512019
Inspection Area : 8
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`. 1220 PARK NEWPORT DR NB
Description: MFR -T/O BUR CAPSHEET, INST 114" DENS DECK & SIGNLE PLY PVC ROOF ESR -1157 CLASS "A" 31 SCIS, PARTIAL FLAT PORTION ONLY
Legal Desc.: N TR 6947 LOT 1 1^�. 1� /�
Owner: PARK NEWPORT LAND LTD Contractor: ADCO ROOFING INC Architect: I�t V t••. { =j®
Address: 201 FILBERT ST #700 Address:. 5743 CAHUENGA BLVD Address: R
SAN FRANCISCO. CA 94133 N HOLLYWOOD CA 91601 ....
Phone:
Applicant:.
BATIOFF
Address:
5743 CAHUENGA BLVD
Overtime Plan Ck:.
N HOLLYWOOD CA 91601
Phone:
818-505-9272
Code Edit: 2016
Type of Construction: V-BSPR
Occupancy Group: R21U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 4
No of Units : 1
Bldg Height: - 0
Bldg Sprinklers:.
Construction Valuation: $20
Building Permit Feer- $324.00
Plan Check Fee: $0.00
Con State tic:
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 :
$1.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Phone:
818.505.9272
Phone:
Con State tic:
560144
Engineer:
Lic Expire:
0313112021
Address:
Bus Lic
BT30068003
o s
Lic Exp Date:
07131/2020
Phone:
Worker's Compensation Insurance
Designer:.
Carrier:
BERKSHIRE HATHAWAY
Address:
Policy No:.
ADWCO26999
.•..
Expire:
0510212020
Phone:
Building Setbacks
Rear: /
Special Conditions:
$0.00
Front:
$0.00
oe o
Left: /
01"
$0.00
Right: /
O 0
Ilse 7nne: Parkina Soaces: 0
Fire Hazard Zone'. N
State Lic:
ogee
Planning Department-
Fire Department
a o
Additional Fee :
eee •
eeuee
$0.00
• e
o s
Grading Bonds Fee:
ae
Fair Share :
$0.00
Fire Plan Rev
e o
.Grading PC Consultant :
e
e e o
State Lic:
.•..
Oe
Grading Permit Fee:
a o
e r
$0.00
Building Dept Adm
$0.00
Grading PC Fee:
$0.00
oe o
01"
$0.00
WQ Insp. Fee:
O 0
00YEf
0e P
mommeo
PM Plan Check: $0.00
e
$0.00
Electrical %:
$0.00
moeaao
Mechanical %:
ooaae
o
$0.00
Plumbing %:
$0.00
oocoo�
o mm
o 0
c c o
ee..a
nano
$325.00
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
PM 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 F
mit Issuance :
$325.00
KSAPPROVAL:
PUBLIC WLKBY:
PLAN CHE
APPROVALTOISSUE:
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 iiy m(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 of, Icant 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 L) all of or U 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).
1, as owner of the property, am exclusively contracting with licensed Contractors toconstruct 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 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 Coop, Mpilable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
SJgnaturg of Propartf Owner or Authorized Agent Date
IIC"ED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sect! n 70 f Div' ion 3,gf the Business and Pro ss! ns Co e, an y tic se full force
aon affect. License Class License No Da 7 Contractor Signature
•ORIZERS' COMPENSATION DECLARATION
• • • S
RMINGaFA1LURE TOCN,.DA E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL R SUBJECT EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE
CbSTOPCOMPEN �A�ION DAMAGES AS PROVIDED FORIN SECTION 3]06 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I flab) affirm upder gralty of perjury one of the following declarations:
CSWave 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 the
t
Ice of the worKfor which this permit is issued. Policy No.
•..•. and willmaintain 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' compensation
r cc carrier and policy number are:
•.
fief ••+• Policy Number Expiration Date
Name 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 agrsi
that, if I should become subject to the ^w^oor^rke�rrs' compensatio provisio of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. --7
Signature of Applicant'LJ: Date^r G �9
DECLARATION REGA DING CONSTRUCTION LENDING AGENC /
I hereby affirm under p natty of perjury that there is a construction lending ency for the performance of the work for which this permit is issued (Section 3097, 3097, Civil Code).
Lender's Name Lender's Address
By 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 to enter thea ve-id ' ied p pe r inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Dat
ACTION DATE BY I DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL 11 FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED i 1 IIIA L -II SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED EPA
CEERTIFICATE OF ®'��V SIGNATED DEMOLIIC&NIS NOTAPP�ICJABL; TO
OCCUPANCY ISSUED —AR 4•]_IUn�_ PPPSrrr'CC//./ql]l \\
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