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Home My WebLink AboutX2019-3315 - Permitsu City of Newport Beach - Building Division IIIIIIIIIIIIIIillll�lllllllllllllllilllllllllllll COMB Permit: X2019-3315 _ ,t rJ 160 Civic Center Drive, Newport Beach, CA 92660 �. X 2 0 1 9 3 3 1 5 Project No: 0791-2018 �. � Permit Counter Phone (949)644-3288 v : Inspection Requests Phone (949)644-3255 'e''cra.�r�`A Combination Type - SFP Issued Date : 10/1812019 Inspection Area : 8 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: 20231 ORCHID ST NB Description: SFR - REROOF W/30 YR SHINGLES 22 SO CL"A", TIO EXTG **CHANGE OF CONTRACTOR** w E INSPECTOR P CCI'®®R Legal Desc.: N TR 1500 LOT 14 ' Y V Owner: BARNES -MILLION KATHRYN L Contractor: OWNERIBLDR Architect: Address:. 4771 FIORE BELLA BLVD Address: Address: LAS VEGAS, NV 89135 Phone: Phone: Phone: State Lie: Applicant: BARNES -MILLION KATHRYN L Can State Lie: OIB Engineer: Address: 4771 FIORE BELLA BLVD Lie Expire: Address: LAS VEGAS, NV 89135 Bus Lie: ° Phone: 702-289-8282 Lie Exp Date: Phone: State Lie: ...... Code Edit: 2016 Worker's Compensation Insurance Designer. 0 °COOO° 8000°�; Type of Construction: VB Carrier: Address: o ° Occupancy Group: R31U Policy No: Added /New sq.ft. Bldg: 0 Expire: Phone: C 0 Added lNew sq. ft. Garage: 0 o 0 0 o m e a C 0 0 No of Stories: 1 Building Setbacks Rear: I Special Conditions: No of Units: 1 Front: l Bldg Height: 0 .Left: I C o o Bldg Sprinklers: Right: / ° ...... Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone: N ccc coo c u Construction Valuation: $0.00 o v Building Permit Fee: $0.00 Excise Tax: $0.00 Planning Department- c oo c c o one Fire Department oEob Plan Check Fee: $0.00 Additional Fee: $35.00 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 WO Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 P/W Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $35.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $35.00 PROCESSED BY: PUBLIC WORKS AP VAL: ZONING APPROVAL: PLAN CHECK : GRADING APPROVAL: APPROVAL 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) lection 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 (_) all of or U 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 np�jved for the purpose of.salp). „ ,. n LPaIa 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). 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 wheq this apps' on is/�ubmitted or a following Web www.ieginfo.ca.gov/calaw.html. of Property Owner or Authorized Agent \� / rub �j��p�/� Date>C®� ` 20 LT_ JCENSED CONTRACTOR'S DECLARATION P hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force nd effect. License Class License No Date Contractor Signature VORKERS' COMIDENSATION DECLARATION �PWIV ?AILURE TQ 3 URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE OST OFF OMPEN$A IU MAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm un89r*penalty of perjury one of the following declarations: 111* Have and wil 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 erformance of thew"I for which this permit is issued. Policy No. JI h50e and w%maiptain 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' compensatior 19urar1cp carrier aiRd andQBlicy number are: !�r8er' Policy Number Expiration Date •: �e i• •cy that, in. • tie 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 agrer I! i should bwme subject t�o ttF a workers' compensation provisions of Section 3700 of the Labor Cade, I shall forthwith comply with those provisions. p nature of Applfc2lil�� Y�1 it'LO/l Date IF CLARATION REG DING NSTRUCTN LENDING AGENCY :reby affirm under enalty of perjury that t ere is a construction lending agency for the performance of the work for which this permit is issued (Section 3 , Civil Code). 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 applicable city and county ordinances and state laws relating to building construction. 1 authorize representatives of this city or county to .,jhe,ebove-i�ified property for inspection purposes. nature of PrODerty Owner or Authorized Agent .(h /Zt .L_. a/f Print Property Owner's or Authorized Agent's Name rCl�t P J� ACTION - DATE BY ( DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITCANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF II- -I•I OCCUPANCYISSUED LJ I SUBMITTED ASBESTOS NOTIFICATION TO UASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION