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HomeMy WebLinkAboutXR2022-3257 - Permits�eWPo?T City of Newport Beach II II IIII II IIIII IIIIIII IIIIIIIIII III II II COMB Permit : XR2O22-3257 D� @ Community Development Department- Building Division X R 2 n 2 2 3 2 5 7 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No Permit Counter Phone: (949) 644-3288 Issued Date : r Inspection Requests Phone: (949) 644-3255 Inspection Area : 2 c9r.rroaN�P newportbeachca.gov/inspections Combination Type - SFP Work Class - Re -roof PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THA*V YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NgVVORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 39 LINDA ISLE Legal Desc : N TR4003 BLK. LOT 3 Description: SFR REROOF W/ STND WT TILE 5.7 PSF 32 SQ CL "A" ESR-1647 T/O TILE* II OFF CAP SHEET ON FLAT ROOF INSTALL BUR 6 SQ CL "A" Owner: ROBERT ELLIOTT Address : 39 LINDA ISLE NEWPORT BEACH, CA 92660 Phone Applicant: TG ROOFING AND ROOF REMOVAL Address : 960 N ENTERPRISES ST ORANGE, CA 92867 Phone: (714)637-1530 Owner/Builder : Address : Contractor: TG ROOFIPGIZD ROOF RE �AL Architect Address : 960 NN RPRISES STc� ORA CA 92867 Address �- Phone : , (714) 637-1530 Phone Con State Lie : 657689 o State Lie Lie Expire : 12/31/2022 Bus Lie: BT30080251 Engineer: Bus Lie Expire : 12/31/2023 Address Workers' Compensation Insurance Phone: Carrier: STATE FUND Policy No : 1976314 Designer: W. C. Expire: 7/1/2023 Address : Phone: Phone: Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $41,610.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 Occupancy Groups : R-3,1_1 No of Units : 1 Alteration sq. ft. Bldg : Bldg Height : No of Stories : 2 Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 0 Building Setbacks : Front: 10, Front: 25, Side: 4, Side: 4 Flood Zone : AE, 8 FT; X Use Zone : R-1 - Single -Unit Residential PROCESSED BY: fi , SPECIAL CONDITIONS: 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) 3ecilon 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 to 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 700©) of Division 3 of the Business and °rofessions Code) or that he or she is exempt from licensors and the bass for the alleged exemption. Any violation of Section 7031.5 by any applicant for apermit subjects the applicant to a civil penalty of of more than five hundred dollars ($500), "1 1, as owner of the property, or my employees with wages as their solo compensation, vid do L) all of or (_,) portionsofthe work, and the structure is not intended or offered for sale (Section 70", rusfness 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 sate. 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). 3 1, 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 poly 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), I I am exempt tram licensure under the Contractors' State License Law for the following reason:--_--_ ly my signature below I acknowledge that, except for my personal residence in;whlch I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally all astructure that I have built as an oumar-buildor if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 ofthe Business and "rofessions Code, is available upon request when this application is submitted or at the following Web site:http:lhvAw.leginfo.ca.govlcalaw.html. Ifgnalure of Property Owner or Authorized Agent Date .ICENSEA CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) t fJ' siorc =Ili Ina Business and Professio a ri y license is in full force nd effect. License Class License No Date G l L Contractor Signature VORKERS' COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRiID THOUSANO DOLLARS (5700,000), IN AUDITION TO THE DST OF COMPENSATION, RAMADES AS PROVIDED FOR W SECTION 3706OF THE LABOR CODE, INTEREST, Me ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 7 I 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, for Its hormance of the work for which this permit is issued. Policy No. ___ ova 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' compensatior ns once carrier and policy number are: ,.artier Policy Number Expiration Date \lame of Agent Phone # :11 certify that, in the performance of 1 e work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agraR hat, if I should become subject a or :bmpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature or ApplicanC,Jf/6Z Z,S �2— DECLARATION REGARDING CONSTR CTION LIETWING AGENCY' hereby affirm under penalty of perjury that there is a construction landing 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 partly 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 comity or man and state lays relating to building construction. I authorize representatives of this city or can ty to an Ids 'hed party for inspection purposes. Signature of Property Owner or Authorized A an -- - Print Property Owner's or Authorized Agent's Namsft/P f� L4 C- AS�C� jCnpate Z �s ACTION RATE gY , DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOROFFICE USE ONLY $ RFGULAUONS PART 51 OF TRLF 40 AND AQMD RULE i i4D3 PERMIT EXPIREt7 I SURDAI r, ED AS3CSTOS'IOTIFICA.TtnN TO PERMIT EXtENbED LI 'QN• D PERMITOWL A$8ESTO5 NOTIFICA NCIT APPLtC.ABL£ TO CERTRflCAi`£'Of .30.�L3 PROPOSED DEMO N OCCUPANCY ISSUED SRGNATP M. Z