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HomeMy WebLinkAboutX2019-2432 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIII�IIIIIIII�IIIIIIIIIIilllllll� COMB Permit: X2019-2432 $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 $0.00 Fire Plan Rev 100 Civic. Center Drive, Newport Beach, CA 92660 X 2 9 1 9 2 4 3 2 - Project NO Permit Counter Phone (949)644-3288 In -lieu Housing Fee: $0.00 Building Dept Adm .Inspection Requests Phone (949)644-3255 ". $0.00 Public Works Department - _ Combination Type - SFP - Issued Date : Park Dedication : $0.00 Refund Deposit :2019 Inspection Area 5 Area PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. $0.00 Grading Bond: 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: 724 POPPY AVE NB $0.00 Description: SFR PARTIAL REROOF TIO WOODSHAKE AND REPLACE W/ WOOD SHAKE CLASS A ROOF ASSEMBLY 6 SCIS ONLY NMUSD Fee: Legal Desc.: N TR 673 BLK B LOT 3 $0.00 .$0.00 Owner SECRETAN FRANK Contractor: T & G ROOFING & ROOF REMOVAL Architect $0.00 Address: 724 POPPY AVE Address 4228 E TOWNSEND AVE Address: $325.00 CORONA DEL MAR, CA 92625 ORANGE CA 92867 Phone: Phone: 714-637-1630 Phone: State Lica- ° •mm Applicant: T & G ROOFING & ROOF REMOVAL - Con State Lic: 657689 Engineer. Address: 4228 E TOWNSEND AVE Lic Expire: 12/31/2020 Address: •� ° ° ORANGE CA 92867 Bus Lic: BT30065122 Phone: 714-637-1530 Lic Exp Date: 1113 012 01 9 Phone: State Lic n ° • e ° o Code Edit: 2016 Worker's Compensation Insurance Designed °•mmm �em °°° Type of Construction. V -B Carrier: STATE FUND Address: Occupancy Group: R31U Policy No:. 1976314 o mmc o Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 1 - No of Units: 1 Bldg Height: 0 Bldg Sprinklers: Building Permit Feer $324.00 Plan Check Fee: $0.00 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 TOTAL FEE: $325.00. Expire: Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant: Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: 07101/2020 Rear: I Front: / Left: / Right: / 'arking Spaces: 0 Phone: Special Conditions: VHFHSV Fire Hazard Zone : N m cmmmmo $0.00 Planning Department - Fire Department $0.00 Plan check Fee : $0.00 Fire Inspection: $0.00 $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 $0.00 SJH Trans : $0.00 Demolition Fee $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 $0.00 Public Works Department - General Service $0.00 $0.00 Park Dedication : $0.00 Refund Deposit $0.00 PM Plan Check : $0.00 Grading Bond: $0.00 $0.00 San Dist: $0.00 $0.00 NMUSD Fee: $0.00 $0.00 .$0.00 $0.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $325.00 PROCESSED BY: U PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: so OWNER -BUILDER DECLARATION W ., 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) .ction 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 rfessions 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). - 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, 3iness 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 Ay 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 1 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 ifessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. nature of Propertiy0dwner or Authorized Agent Date TENSED COWfUCTOR'S DECLARATION f•Y� Oelpp Y perjury P P (commencing re6 affirm u d E alt of er'u that I am licensed under provisions of Chapter 9 commencin with Section 70 f o 3 of the Business and Profes ons a ense is in full force I �er,ff��r�ct., License Class License No Data Contractor Signature )AXORS' COMPENSATION DECLARATION fNINCW. FAILUREO%'FftRE 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 n•OFOOMPENSAiIQI11,D MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. reby affirm ued%r p8nalty of perjury one of the following declarations: 6444 and A9ill Maintain a certificate of consent to self -insure for workers' compensation, grmance of thework for which this permit is issued. Policy No. issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for and wyl;rngiypin 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' carrier and pOicy number are: 'arljgr_ ` • • • Policy Number Expiration Date lame of Agent • •' • Phone # ]I certify that, in the perfor/nance of the work which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' ompensation I ws of California, and agre, iat, if I should become sudfect to tthhe.workers' co pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Iignature of Applicant ✓ Dat _� IECLARATION REGA DING CONSTRU LENDING AGENCY hereby affirm under p natty of perjury th there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 , Civil Code). ender's Name Lender's Address ly my signature below, I certify to each of the following: 1 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. 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