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Home My WebLink AboutX2022-1131 - PermitsCity of Newport Beach - Building Division 1SW110* g'8,rr� 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Q ., �< Inspection Requests Phone (949)644-3255 Combination Type - SFP 111111111111111111111111111111111111111111111111111111COMB Permit: X2022-1131 x 2 8 2 2 1 1 3 1 Project No : Issued Date : 04/19/2022 Inspection Area : 2 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0411912025 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: 216 COLLINS AVE NB Description: SFR REROOF INSTAL 1 LAYER OF SYNTHETIC UNDERLAYMENT & ASPHALT SHINGLES 9 SQS CLASS B Legal Desc.: BALBOA ISLAND SEC 2 ELK 11 LOT 10 Owner: JANNSEN TERRY Address: 216 COLLINS AVE NEWPORT BEACH, CA 92660 Phone: Applicant: JH ROOFING Address: 2415 SANTIAGO ST SANTA ANA CA 92706 Phone: 714-402-6481 Code Edit : 2019 Type of Construction: V-B Occupancy Group: R3/U 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 Valuation: 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: Contractor: JH ROOFING Address: 2415 SANTIAGO ST SANTA ANA CA 92706 Phone: 714-402-6481 Con State Lic: 1008577 Lic Expire: 0313112024 Bus Lic: BT30071516 Lic Exp Date: 1113012022 Worker's Compensation Insurance Carrier: CLEAR SPRING Policy No: CWC00232300 Expire: 1012912022 Building Setbacks Use Zone: 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: / Architect: Address: Phone: Engineer: Address: Phone: Designer: Address: Phone: Special Conditions: Fire Hazard Zone : N State Lic: State Lic: $0.00 Planning Department - Fire Department $0.00 Plan check Fee : $0.00 Fire Inspection: $0.00 $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 $0.00 SJH Trans : $0.00 Demolition Fee $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 $0.00 Public Works Department- General Service $0.00 $0.00 Park Dedication : $0.00 Refund Deposit $0.00 P/W Plan Check : $0.00 Grading Bond: $0.00 $0.00 San Dist: $0.00 $0.00 NMUSD Fee: $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: GRADING APPROVAL: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjurythat I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed nextto 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 1e 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 'rofessions 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 of 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 nprovements 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 nproved 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 pply to an owl.er of p: operty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I am exempt from Iicensure under the Contractors' State License Law for the following reason: ly my lignature be'ow 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 911 a structure that I nave 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 'rufessions Code, is available upon request when this application is submitted or at the following Web site:http://www. leginfo.ca.gov/calaw. him]. lignature of Proderty Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjLqy that I ' am licensed under provisions of Chapter 9 (commencing with Section 70 ) of Ivi on 3 of the Business and Prof ns , and my I' e e is in full force nd edect. LiuensH Gass License No D 0,P'S'7 % Date 2-�¢ntractor Signature '` VORKERS' COMPENSATION DECLARATION IARNINI: FAILURE TO S�rURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THO S D DOLLARS ($100,000), IN ADDITION TO THE DST Or COMPEP:SATI )N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, ANn ATTORNEY'S FEES. hereJ; affirm under penalty of perjury one of the following declarations: I nave and WLIII'mointain 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 thI erformance of the work for which this permit is issued. Policy No. have 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 is Led. My workers' compensatior s ce car ier and policy number are: :arrier ustlz--c�r/�..�/N�7 Policy Number LibZ3L'30� Expiration Date (0 Z02_Z of Agent Phone # I certify that, in the performance of the wo for which this rmlt is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws o California, and agre tat, if I should become su ct to the wgr rs' compensati visions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions. L( lignature of Applicant `/ Date' / �9 2�J z )ECLARATION REG DIN ON U TION LENDING AGENCY hereby affirm under penalty of perj ry th t there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civi Code). ender's Name Lender's Address ly my signature below, I certify to eacR 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 providerip correct. I agree to comply with all applicable city and county ordinanc and state a I authorize representatives of this city or cekunty o enter tt ej bove-ide is relating to building construction. property for inspection purposes. Print Prooertv Owner's or Authorized Aeent's Name �'/ ✓Q� c=�r��s ACTION DATE BY ✓ SEC R ION OF IG IONS PPA PART OF TITLE E 40 AND AQMD RULECE WITH CODE OF PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMIT EXTENDED AQMD o PERMITFINAL CERTIFICATE OF OCCUPANCY ISSUED i�_i�is D~~ ESTOSNPTIFICATI (SNOT APPLI CE TO p ED DE �OUTIO SIGNATURE: FOR OFFICE USE ONLY