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HomeMy WebLinkAboutX2021-2050 - PermitsCity of Newport Beach - Building Division E r 100 Civic Center Drive, Newport Beach, CA 92660 ' Permit Counter Phone (949)644-3288 r.. .� Inspection Requests Phone (949)644-3255 Combination Type - BLDG COMB Permit: X2021-2050 IIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Project No: Issued Date : 08/04/2021 Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, PROJECTS MUST BE COMPLETED BY 0810412024 OR PERMIT WILL BE INVALID 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: 1701 ORCHARD DR NB Description: SFR - TIO (E), INSTIL 32 SQ COMP SHINGLE. INSTIL SYNTHETIC UNDERLAYMENT. REPLACE SHEATHING AS NEEDED Legal Desc.: Owner: WILKINS JEREMY Address: 1701 ORCHARD DR NEWPORT BEACH CA 92660 Phone Applicant: CERTIFIED ROOFING SPECIALISTS Address: 9281 LARKSPUR DR WESTMINSTER CA 92683 - Phone: 714-323.7481 Code Edit : 2019 Type of Construction: V -B Occupancy Group: R31U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 1 Bldg Height:. 0 Bldg Sprinklers: Construction Building Permit Fee: $351.00 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 Hazardous Mat $0.00 Building Green Fee : $2.00 TOTAL FEE: $353.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: CERTIFIED ROOFING SPECIALISTS Address: 9281 LARKSPUR DR Fair Share : WESTMINSTER CA 92683 Phone: 714-323.7481 Con State Lic: 956843 Lie Expire: 01/31/2023 Bus Lie: BT30053068 Lie Exp Date: 11/30/2021 Worker's Compensation Insurance. Carrier: STATE COMP. INS Policy No: 1949902 Expire: 1210112021 Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: / Front: / Left: / Right: / king Spa $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 Architect: Address: Phone: State Lie: Engineer: Address: Phone: State Lie: 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 Plan Check Fee : $0.00 ... e`b'Que al PerWfltIssu8fit:e,:° ° $353.00 o • ••• • o .v ce G£ O- •• U O d 6 O PUBLIC WORKS`APPRbVAL: • ' ` ` PLAN CHECK BY: _ O O U O• U "f APPROVAL TO ISSUE: •e `° ` °• 00 OGU O U Ury` UOi U40 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 Plan Check Fee : $0.00 ... e`b'Que al PerWfltIssu8fit:e,:° ° $353.00 o • ••• • o .v ce G£ O- •• U O d 6 O PUBLIC WORKS`APPRbVAL: • ' ` ` PLAN CHECK BY: _ O O U O• U "f APPROVAL TO ISSUE: •e `° ` °• 00 OGU O U Ury` UOi U40 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 items) (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 (_) 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 legal) 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 Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000D of Division 3 of the Business and Profusions C a, a y license is in full force and effect. License Class License No Date '4-}f Contractor Signatuf�. WORKERS' COMPENSATION DECLARATION WARNING: 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty 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 p ormance of the work for which this permit is issued. Policy No. DI ave 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 insur nce carrier and policy number are: r SMI COIF 2M5 NftJ Policy Number t4ygy0a-ary Expiration Date Name of Agent Phone # ❑1 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 that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant `U' Da O p -y-21 DECLARATION REGA CONSTRUCTION LENDING AGENCY I hereby affirm under pena ty o perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners behalf. 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