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Home My WebLink AboutX2022-0268 - Permits�y�.x•nck City of Newport Beach - Building Division E h 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 v Ar Inspection Requests Phone (949)644-3255 Combination Type - MFP ��IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII �� COMB Permit: X2022-0268 X 2 0 2 2 0 2 6 8 Project No : Issued Date :0113112022 Inspection Area : 1 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0113112025 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: 1323 E BALBOA BLVD NB Description: MFR - TIO EXISTING COMP. INSTAL 1 LAYER 30# FELT. INSTALL 25 SQ COMP SHINGLE Legal Desc.: BALBOA TR EAST SIDE ADD BLK 22 LOT 9 POR OF LOT AND T 7 R 10 SEC 2 POR NO Owner: COLLINS JAMES B Contractor: D & J ROOFING INC Address: 2025 W BALBOA BLVD #2A Address: P.O. BOX 8788 NEWPORT BEACH, CA MAMMOTH LAKES CA 93546 Phone: Phone: 760-937-5636 Applicant: D & J ROOFING INC Con State Lic: 886300 Address: P.O. BOX 8788 Lic Expire: 101M12022 MAMMOTH LAKES CA 93546 Bus Lic: BT30038799 Phone: 760-937-5636 Lic Exp Date: 03/3112022 Code Edit: 2019 Worker's Compensation Insurance Type of Construction: V-B Carrier: ESG Occupancy Group: R3/U Policy No: WC010974903 Added /New sq.ft. Bldg: 0 Expire: 12/31/2022 Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: / No of Units : 4 Front: / Bldg Height: 0 Left: I Bldg Sprinklers: Right: / Flood Zone: Use Zone: Parking Spaces: 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 ArchitecMZNSTr., Address: // h(UIC Ph�o'"nye: �e Ytga�rlPq/�� Ehdress: r" Y6� ' V Address: ®� 7 Phone: Designer: Address: Phone: Myte Lic: Special Conditions: HIGH DENSITY Excise Tax: $0.00 Planning Department - Additional Fee : $0.00 Plan check Fee Grading Bonds Fee: $0.00 Fair Share: Grading PC Consultant : $0.00 SJH Trans : Grading Permit Fee: $0.00 In -lieu Housing Fee: Grading PC Fee: $0.00 Public Works Department - WQ Insp. Fee: $0.00 Park Dedication : $0.00 P/W Plan Check : $0.00 Electrical %: $0.00 San Dist : $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $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 : $352.00 PROCESSED BY: %-Y` 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 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 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 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 U 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). 111, 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 Iicensure 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 lega1I1 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 0 Q), 'vi i of the Business and Profe 1 o e, and my li a se is in fu farce and effect. License Class License No Dat U Contractor Signatur NORKERS' 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 THOUSAND DOLLARS I$100,0001, IN 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: 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, forth 7e rmance of the work for which this permit is issued. Policy No. ha 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' compensatio rance carrier and policy number are: ier Policy Number Expiration Date ie of Agent Phone # certify that, in the performance of the work for whic thZ�� , I shall not employ any person in any manner so as to become subject to the workers' compensation law of alifornia, and agre if I should become subjjee(Qt\�0\' a rkers' compe Rection 3700 of the Labor Code, I shall forthwith comply with those provisions. Iature of Applicant /\\�� Date X V I ( �� G •� AOArinu ovr_noro r_ nn TonnTinAl I cM i In nncslnv rT Ireby 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). 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 ws relating to building construction. I authorize representatives of this city or county1p, ppt r $a pbove-identi ie propertylor inspection purposes. n of Property Owner or Authorized Aqent (-A \VA K Y /'V`Q rM J 1 ( ) —2rint Propertv Owner's or Authorized AD DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND A( RULE PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO - .. PERMITCANCELLED DEPA PERMITEXTENDED QMD PERMITFINAL CERTIFICATE OF OCCUPANCY ISSUED 5' _ ��?i J^ SBESTOS NOTIFICATION 15 NOT APPLICABLE TO PROPOSED DE ION SIGNATURE: