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Home My WebLink AboutX2015-2726 - Permits (2)�g 4� City of Newport Beach - Building Division 111111111111111111111111111111111111111111111111111111 COMB Permit: X2015-272 �4 100 Civic Center Drive, Newport Beach, CA 92660 X 2 9 1 5 2 7 2 6 Project No 5, Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Issued Date : 09117/2015 Combination Type - MFP Inspection Area : 5 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. INSTALL OR VERIFY SMOKE(CARBON MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED Job Address: 426 AVOCADO AVE NB Description: Legal Desc.: Owner: Address: Phone: MFR REROOF W/CLS"A" COMP, TIO COMP (14 SQ) P M 210-50 PAR 1 UNIT 1 OF PROJECT LOCATED ON AP 469-094-13 TOGETHER SARDELtA PAMELA Contractor: OZONE ROOFING INC Architect: 426 AVOCADO AVE Address: 63 VIA PICO PLAZA # 433 Address: -� CORONA DEL MAR, CA 92625 SAN CLEMENTE CA 92672 Phone: 949-366-6597 Phone: , - _ tl A - State Lic: Applicant: OZONE ROOFING INC Address: 63 VIA PICO PLAZA # 433 SAN CLEMENTE CA 92672 Phone: 949366-6597 Code Edit : 2013 Type of Construction: VB Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 2 Bldg Height: 0 Bldg Sprinklers: Con State Lic: 866911 Lic Expire: 11/30/2015 Bus Lic: BT30049180 Lic Exp Date: 11/30/2016 Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9082989-2014 Expire: 12/2712016 Building Setbacks Rear: / Front: / Left: / Right: / Use Engineer: Address: Phone: Designer: Address: Phone: State Lic: Special Conditions: (426 & 426 112 AVOCADO) 0 Fire Hazard Zone : N Building Permit Fee: $204.00 Excise Tax: $0.00 Planning Department - Plan Check Fee: $0.00 Additional Fee : $0.00 Plan check Fee Overtime Plan Ck: $0.00 Fair Share Investigation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans Record Management: $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Disabled Access : $0.00 P/W Plan Check: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 TOTAL FEE: $205.00 PROCESSED BY: ZONING APPROVAL: Fire Department $0.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit $0,00 $0.00 aaaa 50.on $o.do $0.00 $0.00 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $205.00 PUBLIC WORKS 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 items) 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 ie 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 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 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, Wetness 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 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). 7 I am exempt from Iicensure under the Contractors' State License Law for the following reason: iy 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 legallt ell 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 'rofessions 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 .ICENSED CONTRACTOR'S DECLARATION �� hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sect n 700 ) of ivision 3 of the Busines d Prof' yeas C de a@c(�ny�licen a is in full force nd effect. License Class License No to I 1 Contractor Si a �� ( ✓ORKERS' COMPENSATION DECLARATION — ARNING: 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 ATTORNEY'S FEES. affirm under penalty of perjury one of the following declarations: have and will mai,ttain 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 Tmance 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: Policy Number ie of Agent certify that, ;n tha performance if tahould 5^^Com/e-subjecJ.tei uYl-e of Aool - nt /�— Date issued, I shall not employ any person in any manner so as to become subject to the worters'compensatir laws of California, and agre is of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ate hPmhv 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'; Name Lender's Address 3y my signature 6el%4, 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 tate laws r ating to building construction. I authorize representatives of this c' b(r county th I op rty for inspection purposes. Signature of Property Owner or Author'I d�RgenL n Print Property Owner's or Authorized Agent's Naiie f n Date Lb ACR(Nl nA7F RY LARAT✓ON OFCOMPU,4NCE WH CODE OF / a hUii UF}I[i r/Sk U T FECERdL REGLI4 TIO�NS PART 61 OF TITLE&I AMD AOWROLE 1403. PFFrarT YPIRFn ❑ ISIR"UfITFr✓?ASW-'iTnSNnTIt-fCATKINT!I:- ❑ EPA 443111 X,7fvfrT C"ICCLLEO PER14IT EXTEhL7ED ASBESTOS NOT✓HCARON IS NOT APPLICABLE TO P POSED CMC1[1TPON PCAiM77 R!'✓AL CER 7 �FTCATE C'F OCcUowJCY'ISSCiEJ SIGNAL 1