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Home My WebLink AboutX2021-0696 - Permitsr City of Newport Beach - Building Division 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: X2021-0696 IIIIIIIIIIIIIIIIIIIUIIIIIIIIIIIIIIIIIIIIIIIIIIIN II Project No: Issued Date : 03/24/2021 Inspection Area: 1 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 03/24/2024 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: 5001 RIVER AVE NB Description: MFR- TIO COMP, INST DRIP EDGE METAL 1-LYR 50 YR SYNTHETIC FELT, GAF TITLE 24 COMP SHINGLES 19 SOS CLASS "A" Legal Desc.: RIVER SECTION LOT 12 BLK 50 ALL -INC BET SAME & HIGH TIDE LINE- -E INSPECTOR ` .�� Owner: WOOTERS DAVID S Contractor: R V ROOFING Architect: fE t�Yl Address: 20442 BAY VIEW AVE Address: 2133 ROOSEVELT AVENUE Address: NEWPORT BEACH, CA 92660 SAN BERNARDINO CA 92411 Phone: 949.500.1522 Phone: 909-213-2967 Phone: State Lic: Applicant: RAMOS VICTOR Con State Lie: 917291 Engineer: ® CONS I MON t,il"'"\!��' Address: 2133 ROOSEVELT AVENUE Lie Expire: 12/31/2022 Address: 5,-9 @6. i NOISE SAN BERNARDINO CA 92411 Bus Lie: BT30047470 Phone: 909-213-2967 Lie Exp Date: 03124/2022 Phone: State Lie: Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: STATE COMP Address: fig /A A "�'�� Occupancy Group: R3IU Policy No: 1948915 ®!N f_ Added /New sq.ft. Bldg: 0 Expire: 09/01/2021 Phone: ° Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: I Special Conditions: HAZARD REDUCTION ZONE No of Units: 2 Front: I Bldg Height: 0 Left: I Bldg Sprinklers: Right: / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: 914.800.00 Building Permit Fee: $343.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $0.00 Additional Fee: $0.00 Plan check Fee : $0.00 Fire Inspection: ° $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Investigation Fee: $0.00 Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WO Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access: $0.00 PAN Plan Check: $0.00 Grading Bond: $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 $0.00 /lumbing %: $0.00 $0.00 TOTAL FEE : $344.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $344.00 PROCESSED BY: / PUBLIC WORKS AP ROVAL: ZONING APPROVAL: ,iPLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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 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). 1, 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 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). 1 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 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 licensure under the Contractors' State License Law for the following reason: ly 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, 1 cannot legal) 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:hftp://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 Section 7000) Di ision9j the Business and Professions Code, a m jcgnse is in full force nd effect. License Class License No DContractor Signature — VORKER&rEOJ14PENSATION DECLARATION IARNING: FLUR!•1`0 SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE O$,T OF CO%PENS4TrON, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. - Rbyeby afff gfigfWer penalty of perjury one of the following declarations: �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 IN JF•iq m nce Gf tho>:ork for which this permit is issued. Policy No. �PFtav and • 111 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' compensator isuran a carrier and policy number are: • • • ` Policy Number Expiration Date of Agent Plify that/ in Qerformance of the 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 ie subject to the wg0jers',p,6tnpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ;iD itAile of ApptiMI rreby 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). 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 ordinances and state laws relating to building construction. I authorize representatives of this city or county to nter abov ntifled property for inspection purposes. //�� nature of Property Owner or Authorized Agent �'� Print Property Owner's or Authorized Agent's Name. 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