HomeMy WebLinkAboutX2019-2980 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X20,9-2980
100 Civic Center Drive, Newport Beach, CA 92660 x 2 0 1. 9 2 9 6 0 Project No
6_000"
Permit Counter Phone (949)644-3286
' �' 1 f R t Ph 949 644 3255
- 4l nspec ion eques s one ( ). -
Building Permit Fee:
$324.00
Plan Check Fee: $0.00
Issued Date :
er
Combination Type - MFP
$0.00
Record Management:
$0.00
:2019
Inspection Area 3 '
Area
$0.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
$0.00
Disabled Access :
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 Holiday§
Job Address:
4208 PATRICE RD NB
Building Green Fee :
Description:
MFR REROOF W/CLS"A" COMP, TIO COMP (27 SQS)
Legal Desc.t
NTR5783LOT4
FM
Owner:
LEFEBVRE Contractor: ROYAL ROOF CO Architect:
INql,
Address:4
WEYMOUTH CT Address: 6831 SUVA ST Address:
Worker's Compensation Insurance
NEWPORT BEACH, CA 92660 BELL GARDENS CA 90201
Phone
Applicant: ROYAL ROOF CO
Address: 6831 SUVA ST
BELL GARDENS CA 90201
Phone: 323-331-8468
Code Edit: 2016
Type of Construction: VB
Occupancy Group: R21U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units: 4
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation: $10.5
Building Permit Fee:
$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
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Phone:
323-331.8468
Phone:
State Lic:
Con State Lic
432352
Engineer:
Lic Expire:
06/3012021.
Address:
Bus Lic:
BT30064712
Lic Exp Date:.
1 0131/2 01 9
Phone:
State Lic
Worker's Compensation Insurance
Designer:
Carrier:
EMPLOYEE SERVICE GRP
Address:
Doom.
Policy No:
WC47586020
Expire:
0610112020.
Phone:
Building Setbacks
Rear: I
Special Conditions:
Front: /
o o
Left: /
o°°°°°
Right: /
Use Zone: Parking Spaces:
0
Fire Hazard Zone : N
0
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
a $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:
$0.60
Public Works Department
-
General Service
$0.00
WQ Insp. Fee:
$0.00.
Park Dedication :
$0.00
Refund Deposit
$0.00
P/W 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
Fee Due at Permit Issuance:
$325.00
PUBLIC WORKS APPROVAL
PLAN CHECK BY:
APPROVAL TO ISSUE:
1
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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 requires the applicant for
is 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
'rofessions 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
of more than five hundred dollars ($500).
7 I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or `) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Iusiness 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
nprovements 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
nproved for the purpose of sale).
1 1, 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
pply 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).
7 I am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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
ell 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
'rofessions 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
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions Chapter 9 commencing with Section 7j10 of D'visi n 3 of the Bus! as and Profe�g�Or>�Codg, and rqy I'I,cense 's in full force
nd effect. License Class r 73 '�1 License No �I D tcs �/� I l Contracto ignature '�\1�'��h VNt t
I/ORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CR INAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
OST OF COMPEN%AIIQa, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm Upn(jgr 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 IN
e oini9nce oPtb9 ivA for which this permit is issued. Policy No.
and will -maintain 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'
comer ani . icy number are:
yG1�
PolicyNumber ��'c�� 1,00a—QK Expiration Date
L.o�r • • • Phnne 0
Ice of the work for which ((F�Is permit is issued, I shall not employ any person in any manner so as to become subject to the
to the workers`compensdttOn provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions
r
of
ItgltiY'afFirm umdeepsinalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued
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 a 1lca le city and county ordinances and state I s relating to building construction.
I authorize representatives o Is city or county tgVnter the above-igerLtified operty for inspection purposes.
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 63 OF TITLE 40 AND ACLMD RULE
1403
PERMIT EXPIRED I I I U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY ISSUED
compensation laws of California, and
Date OCi J L'K I A
Civil Code).