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Home My WebLink AboutXR2023-2894 - Permitsagwvok City of Newport Beach 11111111111111111111111111111111111111111111111111111111 II COMB Permit : XR212' .2894 Community Development Department- Building Division X R 2 0 2 3 2 8 9 4 n100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: Permit Counter Phone: (949) 718-1888 Issued Date : 10/1312023 _—" newportbeachca.gov/civic Final Date: 11/08/2023 Combination Type - SFP Permit Status: Final Work Class - Re -roof ONLINE Inspection Area : PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 20401 UPPER BAY DR Legal Desc : Description : Tear off (E) asphalt shingle roof and install Marlarkey Windsor shingles in Midnight Black over one layer of GAF tigerpaw underlay. ESR 3150 5:12 pitch Owner: Address Phone Applicant : Pope Roofing Inc dba Western Roofing Systems Address : 1440 S. State College Blvd suite 4b Anaheim, CA 92806-5722 Phone: (714)778-6294 Owner/Builder: Address : Phone Code Edition: Type of Construction Occupancy Groups: Bldg Height: Building Setbacks Flood Zone Use Zone : PROCESSED BY: SPECIAL CONDITIONS: Contractor : Architect Address : Address Phone: Phone: Con State Lic : State Lic Lic Expire Bus Lic : Engineer: Bus Lic Expire : Address Workers' Compensation Insurance Phone: Carrier : Policy No : Designer W. C. Expire: Address Phone: Fire Sprinklers : NO Construction Valuation : $23,700.00 Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 No of Units : 1 Alteration sq. ft. Bldg : No of Stories : Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 0 OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractors' Stale 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 licensors 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 U of the the is portions work, and structure 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). ❑ 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 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 licensors under the Contractors' Slate 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, 1 cannot legal) 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 Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: 111 have and will maintain a certificate of consent to self -insure for workers' issued by compensation, the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for IN performance of the Work for which this permit is issued. Policy No. ❑I have and will maintain Workers' compensation insurance, as required by Section 3700 of the Labor Code, for the the for performance of work which this permit is issued. My workers' compensator insurance carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # ❑I certify that, in the performance 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 laws workers' compensation of California, and ogre that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I forthwith shall comply with those provisions. Signature Of Applicant Date DECLARATION REGARDING CONSTRUCTION LENDING AGENCY _---- I 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). Lender's Name Lenders Address By my signature below, 1 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 enter the above -identified property for inspection purposes. Si nature of PropertyOwner or Authorized Agent Print Pro partyOwner s or Authorized Agent's Name Date ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED El I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED DEPA PERMIT EXTENDED QM�A D PERMIT fINAL 2 I—�'2/ T--r IJ ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: