HomeMy WebLinkAboutX2022-0730 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
w Permit Counter Phone (949)644-3288
. q Inspection Requests Phone (949)8=44-3253
Combination Type - CIP
*X2022-0730* COMB Permit: X2022-0730
Project No :
Issued Date:
Inspection Area : 7
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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 idays
Job Address:
4250 BIRCH ST NB
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Description:
COMM REROOF APPLY POLYURETHANE FOAM & ACRYLIC COATING OVER (E) BUR CL "A" 36 SQ (1") MAX POLYURETHANE 6 # MAX ESR 2132
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Legal Desc.:
P BK 45 PG 25 PAR 2g-1�
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Owner:
BENI INVESTMENTS LLC Contractor: STONE ROOFING Architect:
Address:
17122 MARINA VIEW PL Address: 730 N CONEY AVE Address:
d
HUNTINGTON BEACH, CA 92649 AZUSA CA 92702
Phone:
Phone: 626/969-6515 Phone: State Lic:
Applicant:
STONE ROOFING Con State Lic: 159149 Engineer:
Address:
730 N CONEY AVE Lic Expire: 05131/2022 Address:
AZUSA CA 92702 Bus Lic: BT300
Phone:
6261969-6515 Lic Exp Date: Phone: State Lic:
Code Edit :
2019
Worker's Compensation Insurance
Designer:
Type of Construction:
V-BSPR
Carrier:
ARCH INS CO
Address:
Occupancy Group:
A2
Policy No:
ZAWC19401705
Added /New sq.ft. Bldg:
0
Expire:
10/01/2022
Phone:
Added /New sq. ft. Garage:
No of Stories:
0
1
Building Setbacks
Rear: I
Special Conditions:
No of Units :
0
Front: I
Bldg Height:
0
Left: I
Bldg Sprinklers:
Y
Right: I,�
Flood Zone:
X
Use Zone:
Parking Spaces:
0 Fire Hazard Zone
: N
Construction Valuation:
$17,707.00
°...
Building Permit Fee:
$385.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $0.00
Additional Fee :
$0.00
Plan check Fee : $0.00
Fire Inspection:
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 : $0.00
Building Dept Adm
o$e.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
.o10.08.
Disabled Access :
$0.00
PAN Plan Check : $0.00
Grading Bond:
' $O.ba
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 : $386.00
Plan Check Fee
: $0.00 Fee Due at Permit Issuance :
$386.00
PROCESSED BY:
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s)
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any s$ucture.. priorto 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 (_) 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).
❑ 1, 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 legall,
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.html.
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 7000) of Division 3 of the Business and Professions Cod Ji n s in full force
and effect. License Class License No Date /.3ItI IRS Contractor Signature
WORKERS' COMPENSATION DECLARATION /
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOU ND DOL RS I$100, ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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
rm nce of JV.v%ork for which this permit is issued. Policy No.
ave and 411, mi.ntain 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' compensa
g'4*e carrier and policy number are:
rier' Policy Number Expiration Date
ie of Agent
certify that.0J4, Qerformancce- of the work
if Mshould becomE subject t thew ers'
"ure of Applicant:
affirm under penalty of
nlvm.. ..
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
I provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. -
Date /1n 72
. r_vury
is a coTerruction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Address
y my slgnaturb"Ovq I certify to each oiTSe following:
"tarn the propertyowner or authorized to act on the property owner's behalf.
"Mave reacfttliD application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinances and state la
I authorize representatives of this city or county to erVeyfhe yPr.ir�entifiRe
ACTION
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
3 to building construction.
for inspection purposes.
Print Prooertv Owner's or Authorized Aaent's Name
DATE BY I REGbIRATION TIONS T6 OL TITNLITH CODE OF LE 40 AND AQMD RULE AL
1403 ____J
I SUBMITTED ASBESTOS NOTIFICATION TO
IS NOTAPPLI¢AVLE TO
FOR OFFICE USE ONLY