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HomeMy WebLinkAboutX2019-2066 - Permitswn City of Newport Beach- Building Division COMB Permit: X2019-2066 IIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIII� II 100 Civic. Center Drive, Newport Beach, CA 92660 X 2 0 1 9: 2 0 6 6 Project No E 9 Permit Counter Phone (949)644-3288 "su Inspection Requests Phone (949)644-3255 r'.rs,rr70,,� Combination Type - MFP Issued Date: 07/0112019 Inspection Area : 4 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: 26 VIENNA NB Description: MFR (UNITS 26,28,32) REROOF T10 MIRS VISTA SHAKE AND REPLACE WI CERTAINTEED ARCADIA CLASS "A" ASPHALT SINGLES 83 SCIS Legal Desc : TR 9859 LOT 1 UNIT 12 OF PROJECT LOCATED ON AP 461.121.07 TOGETHER e/r�'•. Owner KEYSTONE PACIFIC PROP -Contractor: GREATER PACIFIC ROOFING INC Architect: Address. 16775 VON KARMAN #100 IRVINE CA 92606 Address: 1580 E EDINGER AVE UNIT Address: SANTA ANA CA 92705 Phone: 949-833-2600 Phone: 949-836-1966 Phone: It be: ° °O Applicant: GREATER PACIFIC ROOFING INC. Con State Lie: 621368 .Engineer: Address: 1580 E EDINGER AVE UNIT F Lie Expire: 0613012021 Address: SANTA ANA CA 92705 - Bus Lie: BT30063584 a°• Phone: 949-836-1966 Lie Exp Date:. 0613012020 Phone: State Lie: Code Edit 2016 Worker's Compensation Insurance Designer. 9090 ° o Type of Construction: VB Carrier: CALIFORNIA INSURANCE Address: u aococ� Occupancy Group: R21U Policy No: 4600150101 ©ono. Added /New sq.ft. Bldg: 0 Expire: 0610112020 Phone:. Added /New sq. ft. Garage: D - No of Stories: 2 Building Setbacks Rear: I Special Conditions: No. of Units : - 4 Front: - Bldg Height: 0 - Left: / Bldg Sprinklers: - - - Right: / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $71.789.00 Building Permit Fee: $324.00 Excise Tax: $0.00 - - Planning Department - Fire Department Plan Check Fee: $0.00 Additional Fee : - $0.00 Plan check Fee: $0.00 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share:. $0.00 Fire Plan Rev $0.00 Investigation Feer $0.00 Grading PC Consultant: $0.00 SJH Trans ; $0.00 Demolition Fee Record Management: $0.00 Grading Permit Feer $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00- Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access ; - $0.00 PAN Plan Check :. $0.00 Grading Bond: $0.00 Hazardous Mat ..$0.00 Electrical %: $0.00. San Dist: $0.00 Building Green Fee : $3.00 Mechanical %: $0.00 NMUSD Fee: $0.00 - $0.00 . Plumbing %: $0.00 $0.00 TOTAL FEE : $327.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $327.00 ' PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: - PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE:�- 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) action 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 Aessions 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 t 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, siness 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 orovements 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 oroved 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 ply to an owg&O 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 exempCffdrM licensure under the Contractors' State License Law for the following reason: �A•y }ignatuhe 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 legal) I afstructurafhat 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 )feseions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. (nature of PrQperty Owner or Authorized Agent :EpISED EOf11RACTOR'S DECLARATION srbby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 0) of ivisio 3 the Business and Profe ns C Ie, and my license is in full force 9tiect. Irdgr gtlass License No Date / Contractor Signature - 941<ERS' COMPENSATION DECLARATION hfUQII0: 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 STV COMPENSATION,•DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. kffff ?taby affirm under penalty of perjury one of the following declarations: 11 have a4S411 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 formance M1110 work for which this permit is issued. Policy No. 1,have 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' compensatio ;arrier Policy Number V ' Q / ^^7-'Z/ Expiration Date Jame of Agent Phone # k_ 7 Q ? ✓ 0&12 :1I certify that, in the pert rmance the rk for hich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' c mpensation laws of California, and agre hat, if I should become s bject the r rs' ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant y/ Dat _ )ECLARATION REG DI NS CT LENDING NCY hereby affirm under enalty of perjury that there is a constru ion lending agency for the performance of the work for which this permit is issued (Section 309 Civil Code). -ender's Name Lender's Address 3y my signature below, I certify to each of the following: I am the property owner or authorized to act on the property o er's behalf. I have read this application and the information I have r d is correct. 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