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Home My WebLink AboutX2015-2726 - PermitsCity of Newport Beach - Building Division *X2015-2726* o4 4 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - MFP COMB Permit: X2015-2 Project No: Issued Date : 09/1712015 Inspection Area : 5 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. INSTALL OR VERIFY SMOKE/CARBON MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRAD Job Address: 426 112 AVOCADO AVE NB Description: MFR REROOF W/CLS"A" COMP, T/O COMP (14 SQ)�''' 4VPECTO�11! Legal Desc.: P M 210-50 PAR 1 UNIT 1 OF PROJECT LOCATED ON AP 459-094-13 TOGETHER Owner: SARDELLA PAMELA Contractor: OZONE ROOFING INC Architect: Address: 426 AVOCADO AVE Address: 63 VIA PICO PLAZA # 433 Address: CORONA DEL MAR, CA 92625 SAN CLEMENTE CA 92672 State Lic: Phone: Phone: 949-366-6597 Phone: Applicant: OZONE ROOFING INC Con State Lic: 866911 Engineer: Address: ' Address: 63 VIA PICO PLAZA # 433 Lic Expire: 11/30/2015 SAN CLEMENTE CA 92672 Bus Lic: BT30049180 Phone: State Lic: Phone: 949-366-6597 Lic Exp Date: 11/30/2015 Code Edit : 2013 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: STATE FUND Address: Occupancy Group: R3/U Policy No: 9082989-2014 Phone: Added /New sq.ft. Bldg: 0 Expire: 12/2712015 Added /New sq. ft. Garage: 0 Building Setbacks Rear: / Special Conditions: , No of Stories: 2 No of Units : 2 Front: / ' Bldg Height: 0 Left: I Bldg Sprinklers: Right: / Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Flood Zone: Construction Valuation: $e 300.00 Building Permit Fee: $204.00 Excise Tax: $0.00 Planning Department - $0.00 Fire Department Fire Inspection: $0.00 Plan Check Fee: $0.00 Additional Fee : $0.00 Plan check Fee : Fair Share : $0.00 Fire Plan Rev $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Grading PC Consultant : $0.00 SJH Trans : $0.00 $0.00 Demolition Fee Building Dept Adm $0.00 Record Management: $0.00 Grading Permit Fee: $0.00 $0.00 In -lieu Housing Fee : Public Works Department - General Service $0.00 Energy Compliance: $0.00 Grading PC Fee: WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 CA Seismic Safety: $0.00 PM/ Plan Check : $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Electrical W $0.00 San Dist; $0.00 $0.00 Building Green Fee : $ Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 To L FEE: $205.00 Plan Check Fee : $205.00 Fee Due at Permit Issuance : $0.00 PUBLIC WORKS APP VAL: PROCESSED BY: ZONING APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: GRADING APPROVAL: OWNER -BUILDER 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 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 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 ProD,r:y Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I'mr=-S; affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing withe ion ) i i n oft us ass and Profes Ions ode, s is in force and effect. License ;lass License No J Contrac r Sigg4fu 61MRKERS' CON!IDENSATION DECLARATION NARNING: FAILURE 177 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 COLT OF COMPENSA.IJL, J'nMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ;Iereby affirm under penalty of perjury one of the following declarations: 1 have and v,i'! 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 th( 5,1- rinitive of the work for which this permit is issued. Policy No. 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' carrier and policy number are: ie of Agent certify that, in the performance of the work for .Rref become sytpLer�SQ theuererk'e7 o a re of Ican 1 �\.�/ _ Policy Number Expiration Date issued, I shall not employ any person in any manner so as to become subject to the is of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. -reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (�n 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 ordin at€"�wa Rating to buil g c truction. -4uthorize representatives of this city or countyioen e� th ab tiff¢d pro rty for in ecto umoses. of Property Owner or Authori.Ted•Agent— !r Ae`7"d DATF RY I PFRWFTFyPrR.Fd) I I 17%'ilvirT i dPicaLED / 1 1 PCr7117FT Fli CERTIFrCATECF OCCUDANCF,SSLOE6 Owner's or Authorized Agent's Name FEDERAL REGULATIONS PART 6f OF TITLE40 AND A0111417 RULE 44-03. ❑ 1 vinmTTfDASTYSTo4; NOT1T/C4Tw)m7O: ❑ EPA ❑ 440ME 13 ASBESTOS N0II191CAWNLSNOTAPPL1CABLE7O PROPOSED DEMOLITION. 51C,NA f UHL. of California, and UA2T