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HomeMy WebLinkAboutX2017-2547 - Permitsn�, va�r��� ' City of Newport Beach - Building Division `X2017-2547* COMB Permit: X20°1°Z;2547 4 100 Civic Center Drive, Newport Beach, CA 92660 Project No �, Permit Counter Phone (949)644-3288 -s.. ti Inspection Requests Phone (949)644-3255 Combination Type - BLDG Issued Date: 08/14/2017 , Inspection Area : 3 ° PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. ° ° ° , °' • ° m°°, ° Construction Hours: Monday -Friday 7:00 a.m. to 5:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays .... ®,,,, Job Address: 473 PROSPECT ST NB Description: SFR REPLACE UNDERLAYMENT AND INSTALL COMP SHINGLES W/ TEAR OFF 13 SQS Legal Desc.: TR772LOT8BLK24ALL(EXSWLY16FT&SELY47FT)THEREOFANDALL Owner: PFAFFMAN JOHN Contractor: MCCARTHY ROOFING INC Architect: ' Address: 473 PROSPECT ST Address: 625 W KATELLA AVE #29 Address: NEWPORT BEAQri CA 92663 ORANGE CA 92867 Phone: 949-294-6884 Phone: 714538-3330 Phone: State Lic: Applicant: ENRIQUEZ CARLOS Address: 625 W KATELLA AVE #29 ORANGE CA 92867 Phone: 714-538-3330 Code Edit: 2016 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 Construction Valuation: Building Permit Fee: $304.00 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: $305.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Con State Lic: 910068 Engineer: Lic Expire: 02128/2018 Address: Bus Lic: BT30068942 Lic Exp Date: 0413012018 Phone: Worker's Compensation Insurance Designer: Carrier: STATE COMP INS Address: Policy No: 9028472 Expire: 06/01/2018 Phone: 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: / $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 State Lic: Special Conditions: LIQUEFACTION AREA Planning Department - Plan check Fee Fair Share : SJH Trans: In -lieu Housing Fee: Public Works Department - Park Dedication : $0.00 PAN Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 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 Fee Due at Permit Issuance : $305.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: DECLARATION I �ereby affirmunder 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) a, .Ion 703:165: Vusiness 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 ie permit to Me 5 %igned 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 roiessions Code) or that he or she is exempt from Iicensure 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 dt Snore than Jive hendred dollars ($500). %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, lusthess andErpiessions 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 i1provements ag r" 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 yprpved for thepurpose of sale). a.lr es ownerpf 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 (lply(a an ovular ofgroperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I dam exempt frgWjicensure under the Contractors' State License Law for the following reason: ly WW%ignatuse 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 stmcturENtat 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 when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/c-alaw.html. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Ch ter 9 (com,(nencing with Secti 00) of Division 3 of the Business and Prgds�nd my license is in full force nd effect. License Class `39 License No j L3r) tn. D � r• ^I> Contractor Signatur VORKERS' COMPENSATION DECLARATION IARNING: 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 DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS 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 thr ance of the work for which this permit is issued. Policy No. BI 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' compensatior ranee c ier nd licy tuber are: q fl :arrier� Policy Number `�+a� y �-I% Expiration Date lame of Agent Phone # ]I 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 agree tat, if I should beco a subject to the worke ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Q ;ignature of Applican ,- < Ck IECLARATION REGARDING CONSTRUCTIO G 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 ly 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. I authorize representatives of this city or coun to enter L• ove- tified property for inspection purposes. signature of Prooertv Owner or Authorized Agent Print Property Owner's or Authorized Agent's N e Cor-i.,Y�nI"-P, Daki "dt Ii ACTION DATE BY DECLARATION OF-EBNIPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED PERMIT CANCELLED PERMITEXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED NOTIFICATION TO APPLICABLE TO