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HomeMy WebLinkAboutX2019-3286 - Permitsa City of Newport Beach - Building Division Ilillllllllllllllllllllllllllllllllll COMB Permit: X2019-3286 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 3 2 8 6 Project No Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - CIP Issued bate : 10/1612019 - Inspection Area : 7 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 r-! Job Address: 121 AGATE AVE NB w rhe_ Description: COMM RE -ROOF. GO OVER 1 (E) LAYER. 60 SQ COOL ROOF ACRYLIC SURFACING. ESR# 2871. CRRC# 0656-001 CLASS "A" ` SPECT®M Legal Desc.: BALBOA ISLAND RESUB SECTION ONE BLK 7 LOTS 12 13 AND 14 Owner: DMS Contractor: HIGHLAND COMMERCIAL ROOFING Architect: Address: 116 AGATE AV Address: 5105 HEINTZ ST Address: NEWPORT BEACH, CA 92663 BALDWIN PARK CA 91706 Phone: Phone: 626-856-2076 Phone: Applicant: HIGHLAND COMMERCIAL ROOFING Address: 5105 HEINTZ ST .Overtime Plan Ck: BALDWIN PARK CA 91706 Phone: 626-856-2076 Code Edit : 2016 Type of Construction: V -B Occupancy Group: B Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units : 0 Bldg Height:0 Bldg Sprinklers: Construction Valuation: $21, Building Permit Fee: $424.00 Plan Check Fee: $0.00 12/31/2019 .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 TOTALFEE: PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Con State Lie: 632551 Lie Expire: 12/31/2019 Bus Lie: BT30065840 Lie Exp Date: 01/31/2020 Worker's Compensation Insurance Carrier: STARR INDEMNITY Policy No: 1000001322 Expire: 12/01/2019 Building Setbacks Use Zone: Excise Tax: Additional Fee: Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WO Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: / Front: / Left: I Right: I �ardna Spaces $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee 0 Planning Department - IV® 0./® • Engineer: $0.00 e Address: e e esee Fire Plan Rev Phone: pp�ySt^a�tey�Li ' ®g� 4 H •e •co Designer: N Mtl��K0 ©e®•om Address: San Dist: me o NMUSD Fee: ooco Refund Deposit $0.00 m o e omeco Phone: o m o m $0.00 0 ommoo Special Conditions: FLOOD ZONE oomoo 000000 LIQ AREA 0 PRE -INSPECTION REQ mo o m o m c o o u m morn •moo Fire Hazard Zone : N Planning Department - Fire Department Plan check Fee: $0.00 Fair Share : $0.00 SJH Trans: Fire Plan Rev In -lieu Housing Fee: $0.00 Public Works Department - Park Dedication : $0.00 PAN Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 $0.00 PUBLIC WORK! PLAN CHECK B APPROVALTO Fee Due at Permit Issuance : $425.00 Fire Department $0.00 Fire. Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: .$0.00 $0.00 $0.00 Fee Due at Permit Issuance : $425.00 OWNER -BUILDER DECLARATION r 1. 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) (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 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 L) 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 improved 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 PrpQgljyQwner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION Marebyraffirm undarpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectire of i ision 3 of the Business and Pro ssio s ,rjaz d my license is in full force randeffect. Liceaaa Crass License No Da�' Contractor Signature ly 01ORMRS' COMPENSATION DECLARATION NARNING: FAILURE t0 SEOURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMLTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE CIT OFf OMPENSR7Td'N', QAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Mher0y, affirm uildgj penalty of perjury one of the following declarations: 3141awe and Lill 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 W1101flance of the work forwhich this permit is issued. Policy No. •h v; and wilt mynain 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' compensatiol ns ce carrier an policy number are: 'r �'Policy Number Expiration Date .. o •..• Vame of Agent Phone # :11 certify that, in the performance of the wo k 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 agre :hat, if I should become sub'ect t o mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 3ignature of Applicant DECLARATION REG RDING AGENCY hereby affirm under ilenalty o perju �t ere is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). -ender's Name Lender's Address 3y my signature below, I certify to Bad 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 vided is correct. I agree to comply with all applicable city and county o di s laws relating to building construction. I authorize representatives of this city or ce - eD 'edprape"rinspection purposes. 3ignature of Property Owner or Authorized Agoun Print Property Owner's or Authorized Agent's Name D • �(o' ACTION DATE BY DECIR F COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGU ART 61 OF TITLE 40 AND AOMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED LIEPA PERMIT EXTENDED 13AQMD PERMITFINAL ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCYISSUED I,Y10 4� SIGNATURE: rel W- m g N N �O =O L AZc V C6 UE Z m z° E- •c N= o ci pp << Z m � 1 1 oj�C) VJ O O� C-- aX� o 0 0�� Lz ami o C:c � c cW O Q U) >1 i O i] a o2 Q cc ccc�. %i 0 o� �Eca��� cn uj O pC:.m CU (D M0cu Q CO Q d% (D. Q 16r M O_ C ui w�pjt'z O°f o �� R .. «-� CL6 N > Q N �j (' Z - >+ ull 1 ! 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