HomeMy WebLinkAboutX2021-0283 - Permitsiwr•ri. City of Newport Beach - Building Division *X2021-0283* COMB Permit: X2021
�! 100 Civic Center Drive, Newport Beach, CA 92660
� Project No
F y Permit Counter Phone (949)644-3288
i; Inspection Requests Phone (949)644-3255
Combination Type - MFP Issued Date :
Inspection Arearea :2021
5
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 02/10/2024 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:
4112 SHORECREST LN NB
Description:
Legal Desc.:
MFR *UNITS 4112, 4114 & 4116*
N TR 2758 LOT 2
REROOF W/CLS"A" COMP, TIO ROCK (23 SQS) ' I V� ����
Owner:
CHOY KIM
Contractor: SUPERIOR ROOFING SYSTEMS Architect:
Address:
951 SUMMIT DR
Address: 360 E 1ST ST 4701 Address:
LAGUNA BEACH, CA 92651
Phone:
Applicant:
SUPERIOR ROOFING SYSTEMS
Address:
360 E 1ST ST #701
TUSTIN CA 92780
Phone:
866-7834400
Code Edit : 2019
Type of Construction: VB
Occupancy Group: R21U
Added /New sq.ft. Bldg: 0
Added/New sq. ft. Garage: 0
No of Stories: 2
No of Units : 3
Bldg Height: 0
Bldg Sprinklers:
Construction
Building Permit Fee: $343.00
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: $344.00
PROCESSED BY:
ZONING APPROVAL:
TUSTIN CA 92780
Phone: 866-7834400
Con State Lie: 865713
Lie Expire:
1013112021
Bus Lie:
BT30062175
Lie Exp Date:
0113112021
Worker's Compensation Insurance
Carrier:
STATE FUND
Policy No:
1957683
Expire:
01/01/2022
Building Setbacks Rear: I
Front: I
Left: I
Right: I
Excise Tax:
$0.00
Additional Fee :
$0.00
Grading Bonds Fee:
$0.00
Grading PC Consultant:
$0.00
Grading Permit Fee:
$0.00
Grading PC Fee:
$0.00
WQ Insp. Fee:
$0.00
Electrical %:
$0.00
Mechanical %:
$0.00
Plumbing %:
$0.00
0
Phone: State Lie:
Engineer:
Address:
Phone: State Lic:
Designer:
Address:
Phone:
Special Conditions:
Fire Hazard
Planning Department -
Plan check Fee
Fair Share:
SJH Trans :
In -lieu Housing Fee:
Public Works Department -
Park Dedication :
$0.00
PNJ Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee : $0.00 Fee Due at Permit Issuance : $344.00
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 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).
❑ 1, 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,
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:htip://www.leginfo.ca.gov/calaw.htmi.
Signature of Prood, iy Owner or Authorized Agent Date
LICENSED C017TRACTOR'S DECLARATION
affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with SELcti 000) f Ision 3 o usiness and Professlop��UU d� n �n full force
and effect. License CIPss License No ate L ZI ntractor Signature //t: �
VIORKERS' COV..PENSATION DECLARATION
WARNING: FAILURE T) S?r'URE 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
COJT OF COMPENSATION, DnMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I 'iereb; affirm under penalty of perjury one of the following declarations:
111 hav= and win mPihtain 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
p,<im,r�ance of the work for which this permit is issued. Policy No.
`'ave and will mair.tuin 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'
rance carrier e-i po'icy number are:
of Agent
certify that, in the
, if I should bacon
iature of AoDIicA
Policy Number
Date
which this permit is issued, I shall not employ any person in any manner so as to become subject to the
Tlpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
compensation laws of California, and
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
3y my signature below, I certify to each of the following:
1 am the property owner or authorized to act on the property owner's behalf.
I have read this application and the information I have provideollorrect.
I agree to comply with all applicable city and county din and state laws relating to building construction.
authorize representatives of th' i r county to - n ifie property for inspection purposes.
signature of Prope Owner or Aut d Agent Print Property Owner's or Authorized Ag
ACTION DATE BY rDtCUARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED V I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED LIEPA
PERMIT EXTENDED
PERMITFINAL � 3K BESTOS NOTFICAT119,N IS PLICABLE TO
CERTIFICATE OF R POSE ITI�)Ir
OCCUPANCY ISSUED SIGNATURE: )� >
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