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HomeMy WebLinkAboutX2014-2583 - PermitswrgQ - City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 .m u n"eenrxh Combination Type - SFP llllllllllllllllllllllilfiiillllllllllllllllllll Job Address: 20051 ORCHID ST NB $0.00 Overtime Plan Ck: Description:SFR - REROOF WITH 30# FELT, CERTAINTEED COMP SHINGLES, CL"A", 26 SQS, TEAR -OFF EXISTING Inspector Area: 3 Legal Desc.: N TR 1499 LOT 27 $0.00 Owner: WOOLFOLK CLIFFORD & BARBARA TRUST Contractor: GUARANTEED ROOFING SERVICE Address: 325 VISTA BAYA Address: 4380 LARKSPUR ROAD COSTA MESA, CA 92627 $0.00 RIVERSIDE CA 92504 Phone: 949436-0487 Phone: 951-218-6738 Applicant: CASTRELLON VINCENT Con State Lic: 895126 Address: 4380 LARKSPUR ROAD Lic Expire: 04/3012015 RIVERSIDE CA 92504 Bus Lic: BT30048437 Phone: 951-218-6738 Lic Exp Date: 09/30/2015 Code Edit : 2013 Type of Construction: V -B Occupancy Group: R3/U Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 1 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Flood Zone: X Building Permit Fee: $309.00 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 Fee Increase: Fee: $0.00 Additional Fee : $0.00 Hazardous Mat : $0.00 Building Green Fee: $1.00 TOTAL FEE: $310.00 PROCESSED BY: ZONING APPROVAL:. GRADING APPROVAL: Worker's Compensation Insurance Carrier: STATE COMP Policy No: 1949613 Expire: 03/01/2015 Building Setbacks Excise Tax: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: / Front: / Left: / Right: / $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee COMB Permit: X2014-2583 Project No : Inspection Requests Phone (949)644-3255 Issued Date : 09/09/2014 Architect: Address: Phone: State Lic: Engineer: Address: Phone: State Lic: Designer: Address: Phone: Special Conditions: 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 Zone :N $0.00 $0.00 $309.00 Fee Due at Permit Issuance : $1.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. INSTALL OR VERIFY SMOKE/CARBON MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED o c cooccc c c 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 $0.00 $0.00 $309.00 Fee Due at Permit Issuance : $1.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. INSTALL OR VERIFY SMOKE/CARBON MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED o c cooccc c c 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 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 U all of or U 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 trgppperty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not appirto 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). 0e u• h @MFexempt•from li ensure under the Contractors' State License Law for the following reason: By my signature -bale" 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 legalh Stf', ILStdlcture that I hate 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 Q.rpWgions Code, Is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Si nature of Pro .;t 4Dcaner or Authorized Agent Date MINSED COPh1 RFtCTOR'S DECLARATION I:lefebyeffirm urdeapenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0 of Division 3 of the Business and Professio o and my license is in full force an*d efthct. LicArys .QAss License No Date Contractor Signature ' koilF ii COMPENSATION DECLARATION NARNING: FAILURE TASEBURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUW ECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF SOMPENSAT IION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Nerebyeffirm and a rf enalty of perjury one of the following declarations: ❑ I have and U16ro ntain 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 gem' "anpe of the work forwhich this permit is issued. Policy No. he a 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 ira ce carrier and policy number are: ner Policy Number Expiration Date ne of Agent Phone # certify that, in the performance of the work 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 :, if I should become suu¢ject t the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. R G nature of ApplicantlC �It Date DECLARATION REGAR NG C NSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury that there 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 y 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 pro IIII d is correct. 1 agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county o n er th" above -identified property for inspection purposes. II ignature of Property Owner or Authorized Agent _ Print Property Owner's or Authorized Agent's Name\i v.A�MT /fB1G� At'Tf W DATF I RV PFRAJIT PERAMTEWTENDED PERMITTim CEATIFJCATEOF OCCUP NCY;SSLOED l OFT17LEAOAND ©€SllftulTTrr7ASfIrsTOSxnnrff'dTh7Nrff:- e_❑ EPA NOT APPLICABLE TO 1-UDr O1_HC1 fA'k OTPLF