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HomeMy WebLinkAboutX2019-2502 - Permits��tit'1r City of Newport Beach -Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2019-2502 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 2 5 0 2 Project No All 000 Permit Counter Phone (949)644-3288 'z Inspection Requests Phone (949)644-3255 Combination Type - MFP Issued Date : 08/08/2019 arr.�a Inspection Area : 2 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: 218 COLLINS AVE NB Description:. MFR TIO (E) 21 SQ, INSTALL COMP. SHINGLE, CLASS 'Er Legal Desc.: BALBOA ISLAND SEC 3 BLK 11 LOT 19 _ Z Owner: COUSE ROBERT Contractor: JH ROOFING Architect:. Address: 5508 E BARWICK DR Address: 190 B COSTA MESA ST Address: - CAVE CREEK AZ 85331 COSTA MESA CA 92627 U) Phone: Phone: 714-402.6481 Phone: State Lic: Applicant: JOEIJH ROOFING Con State Lic: 1008577 Engineer: spy 1 1 Address: 190 B COSTA MESA ST - Lic Expire: 10/3112019 Address: COSTA MESA CA 92627 Bus Lic: BT30060846 Phone: 714.402.6481 Lic Exp Date: 1 013112 01 9 Phone: State Lic: Code Edit: 2016 Worker's Compensation Insurance Designer: is Type of Construction: Carrier STATE COMP Address: .yy Occupancy Group: R3/U Policy No: 9145801 Added /New sq.ft. Bldg: 0 Expire: 10/29/2019 Phone: Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: I Special Conditions: LIQUEFACTION AREA - No of Units: 2 Front: I Bldg Height: 0 Left: I - Bldg Sprinklers: Right: (- p Flood Zone: X Use Zone: Parking S aces: 0 Fire Hazard Zone : N Construction Valuation: $9.800.00 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 Fee: $0.00 Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Record Management : $0.00 Grading Permit Fee: $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 : $1.00 Mechanical %: $0.00. NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $325.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $325.00 ®a PROCESSED BY: LVRRK9 APPRQVALa i ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: � APPROVAL TO ISSUE: e o 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) 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 ie 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,pasis 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).•P''a.a b ` ", .` I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 n 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' Stale License Law does not p ly 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: 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 legall) 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.html. signature of Property Owner or Authorized Agent Dat .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perj�l„q that I am licensed under provisions of Cpter 9?ommencing with Section 700 ) o� Via' n 3 of the Business and Profes Ions de, and I� nse is in full force nd effect. License Class 9 License No 00� %�% Date d` b' Contractor Signature OZ S YORKERS' COMPENSATION DECLARATION 'pRNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREDTH SA DOLLARS ($100,000), IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0106 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, hereby affirm under penally 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 th erfWnance of the work for which this permit is issued. Policy No. and will m in 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 II number are:tA ., le of Agent . `r — — t-, certify that, in the performance of the "yy c for which if I should become subject to the wows' compen5 iature of Applicant 7Z Date ermit is issued, I shall not employ any person in any manner so as to become subject to the workers' provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. my signature below, I certify td�eac of the following: I am the property owner or authh 'zed to act on the property owner's behalf. I have read this application and the information I have provided' correct. I agree to comply with all applicable city and county ordinanc and stat a I authorize representatives of this city or count nter t ave -Id f' nature of Prooertv Owner or Authorized Aaent Al ACTION PERMITEXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED DATE I BY is relating to building construction. property for inspection purposes. Print Propertv Owner )N OF COMPLIANCE WITH CODE OF FEDEI NS PART 61 OF TITLE 40 AND AQMD RULE REO A5BESiOSM10•TIpawCATION m - OTIFICATIO IS OTAPPLIC B TO rACLI,lQid ••• ••. i a • FOR OFFICE USE ONLY i MA of California, and