HomeMy WebLinkAboutX2022-0564 - Permitsw r City of Newport Beach - Building Division
" ..T 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
c.. - Inspection Requests Phone (949)644-3255
Combination Type - SFP
*X2022-0564* COMB Permit: X2022-0564
Project No :
Issued Date 02/25/2022
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 02/25/2025 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 Sunda r Holidays
Job Address: 401 MORNING STAR LN NIS
Description: SFR T/0 (E) 38 SQ, INSTALL COMP. SHINGLE, CLASS'B'
i TOP
Legal Desc.: N TR 4224 LOT 173
Owner: OHLIG LISELOTTE Contractor: ADAM'S ROOFING INC Architect:
Address: 24812 BUCKBOARD LN Address: 3435 SOUTH SILVER SPUR Address:
LAGUNA HILLS, CA 92653 SANTA ANA CA 92704
Phone: Phone: 714-965-0245 Phone: State Lic:
Applicant: ADAM'S ROOFING INC
Address: 3435 SOUTH SILVER SPUR
SANTA ANA CA 92704
Phone: 714-965-0245
Code Edit : 2019
Type of Construction: V-B-SPR
Occupancy Group: R3/U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 1
No of Units : 1
Bldg Height: 0
Bldg Sprinklers: Y
Flood Zone: x
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 :
$1.00
TOTAL FEE: $352.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Con State Lic: 524341
Lic Expire:
06/3012022
Bus Lic:
BT30078082
Lic Exp Date:
0212812023
Worker's Compensation
Insurance
Carrier:
STATE FUND
Policy No:
1300240
Expire:
03/01/2023
Building Setbacks
Rear: /
Front: /
Left: I
Right: /
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Engineer
Address:
Phone:
Designer
Address:
Phone:
Special Conditions:
Planning Department -
Plan check Fee
Fair Share
SJH Trans
In -lieu Housing Fee:
Public Works Department -
Park Dedication :
$0.00
P/W Plan Check :
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
State Lic:
Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
° o
ea
•
m •
e
p•••eo
m
e
•e
e e
e
• •
o e•
mm
e
• e
•
m •
•
•e
e e o
mm o
•
•mm
O
m O
OOmOo
mmOOJ
�
mo•emo
d
E O O
•
O
O O
em
eo•e•o
•o
•
o c
c
•
mme•
m
mo
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee : $0.00 Fee Due at Permit Issuance : $352.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
6
OWNER -BUILDER DECLAKAI wry
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(:) indicated below by the checkmark(s) have placed next to the applicable item(:)
;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
;he 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 legally
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 Cod9,09 available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Date
Signature of Propmv dwner or Authorized Agent
Mari SED CONTRACTOR'S DECLARATION
ihereb�'affirm Qq�f penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000). f Ivisl 3 of the Business and Professionsd and ticense is in full force
Vcteffapt. Licen %e Class License No Date Contractor Signature apt.
WORKERS' CQMPg4SATION DECLARATION
%WARNIItJAILUREjq SECLRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($i00,0001, IN ADDITION TO THE
QOST,oJ COMPENSATION, aAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
IA"ahy affirm 461der S%nalty of perjury one of the following declarations:
' 95i°ave and wild .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 t
p ance of the work for which this permit is issued. Policy No.
have and v7ip piairQain 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' compensatloi
d'r9PIQe carrierand policy number are:
C2r}i>sl' Policy Number Expiration Date
Phnne #
ne of Agent
certify that, in the performance of the rk for which this armit is issued, I shall not employ any person in any manner so as to become subject to the workers' compZ�Z
California, and agree
I. if I should become subject to the wor rs' compensa n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant ���s�%e Date
CLARATION REGAgD NG CONSTRUCTION LENDING AGENCY
�reby affirm under p€nalty 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).
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 owners behalf.
I have read this application and the information I have provided 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 toe r e above-i ntified property for inspection purposes.
(nature of Pro erty Owner or Authorized Agent ` Print Property Owner's or Authorized Agent's Name Date
:TION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED LJ SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED EPA
PERMIT EXTENDED iyrviu
PERMITFINAL -13.22 BESTOS NOTIFICATION I NOTAPP ABLE TO
CERTIFICATEOF PR POSED DEOI,TI
OCCUPANCYISSUED GNATURE• \/
0 a
cn
'CIO —
K
(D,�
m
c� CD
y �.�
9, 0 m
c3
A 0.�
w
o
n- o
o
o—o
N
0.0
C
O
Cr ^
C
CD (a 7
��y
m
w_a
3QQ
o
Qom
N
k
�Qw
y
am
C (D
a
�K O Q
3
O o
N
o CD
W n
rt (%
(D (D
X.
N
O 3
0 cc
p•
7 CD
?.
.yi• 7�' 3
CD N n,
'00 3
N N w
C
C.0 (G a
CD
�O.
n•w O O(=O
N
'V N O(D
•PN
_ N N
ONNwo3
ir
and
_
cCLCD
� m
C '.O 's
w g
N (D S O
N.
n'
CT1 O
��
Q
C 6
a 0 � 6
w N
i (w7 X
.. `[
Cr
O.
a 0.3
(D
CD
W'".
m
S
rtM
Cr,C—.N
O
a
w W
O
CD
a G
COD
p
�'N"4•Q
N (�
(3n
N
mN
a D
(D
C)
CnQn
y .�
°�3�
N
=mco
CD
CD Q
v m
m
w ri
ZL
CD :3
w m
Q
m
o<
4
CL
c°
m�
3.
3
m
y cn
0 0
`
w(Dcy
woo
mnmm
<o
o
Ns�;O
(D3
_�
N
-� N
(D w
(D 7 7
T. O
S.g
mww
w
3
Qzm
3wwm
o
0
00
N
CD
0 d S
N 3 on
N
N 7 �_•
CL CDP
CD
0 C 0
O'
(O CL 3
m O �
W
7 a
C
(D N
00
o
o°
to C)
m Q O a
7 0-
3 O
R w n
Ci O' --
N 3 (O
O-s
-.O
O,
0
O (D
w
O N
C
O•
w
'O —
N
N
M
N
N
y O
N N Q N
'O
w N
O N
C C
p�
= Q CD W
7
(O
�1 n a
S
N
3
m
O O
O w
:0,c
N N
y
c
V
o m
�� �o
w m_ o
o m
CD
I
CD p
j. N w
'O
(D
CD
X
(D 3
O
w w
N
d
�w
o
nO
N
OCD
Q
y
3 0
(A
w�
N
p
C
C.N CD.o-.N
CD
5-10
N
N
(D a N
Q
CD
to
TI n w
CL
(D
N
O S
Oa, m
(�D (D
N N
(D
7 o N
N .w•.
O 3
N N
n�
CD
Cl)
Qw
CD
w 0
N N
N O
61 w
7
0
C
Q. N
=)m
to c
N C'
N
w
N
3
0
CD
w
Q
O
w
6
O
7
O
7
X
a
0
Q
CD
0
O
V1
3
c
cr
(D
r-
(D
N
(D
Q
0
N
O O
-O 3 cD
,�3 z
O c D
3 n
7 c (D
N
?
U%
o
O
ti
CD
O
n
v
m
(OD
ICI
3
V
m
m
O
z
71 0
04 b
Z
mox
mW
O
D
A
mods,
dry
"v
o °
e
0 >
O
(D
O
DEW
�:
CZD
A vI
Z
OO
;
za)
y
CD
Z Z
P.
d
CD
O
Z
N
ox�yx
v
io
OD
a
m
N