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Home My WebLink AboutXR2023-3194 - Permits�WPORT City of Nav+putt �3each I11IIIpIIIIII 111111111111p111111111p11111111111111111111 COMB Permit: XR2023-3194 CFy r` i 9 Corlmuni;y Dtve,opment 0epartment - Building Division X R 2 0 2 3 3 1 9 4 100 Ciwr C3ntar Drive, Newoort Beach, CA 92660 Plan Check No Pen nit Counter Phone: (949) 718-1888 Issued Date : 1110912023 u g S _ newportheachca.gov/civic Final Date: Combination Type - Permit Status: Issued Work Cla3s - Fepah Inspection Area : 2 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 : 111 BAY FRONT E Legal Desc : A TR BALBOA ISLAND SEC 5 BLK 4 LOT 8 BALBOA ISLAND Description: SFR RE -ROOF 8 SQ, R/R UNDERLAYMENT AS NEEDED, INSTAL WOOD SHAKE SHINGLES (ICC-ESR-2867) Owner: BUSBY JAMES STEELE TR Address : 2205 LAGUNA CANYON RD LAGUNA BEACH, CA 92651 Phone : Applicant: BRANDI RUPPERT Address: 1529 W Orangewood Ave Orange, CA 92866-2423 Phone: (714)538-3780 Owner/Builder : Address : Contractor Address : SCHILLER ROOFING 1527 W ORANGEWOOD AVE ORANGE, CA 92868 Phone : (714) 538-3780 692490 11/30/2025 BT30082372 Con State Lic Lic Expire Bus Lic : Bus Lic Expire 08/31 /2024 Workers' Compensation Insurance Carrier: AMERICAN ZURICH INSURANCE COMPANY Policy No: WC112583003 W. C. Expire : 12/31/2023 Architect Address Phone: State Lic Engineer: Address Phone: Designer Address Phone: Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg Occupancy Groups : U,R-3 No of Units : 2 Alteration sq. ft. Bldg : Bldg Height: No of Stories : 1 Added/New sq. ft. Garage: TOTAL sq. ft. Building Setbacks : Front: 5, Side: 4, Side: 4, Rear: 5 Flood Zone : X Use Zone : R-BI - Two -Unit Residential, Balboa Island PROCESSEDBY: - NO CONSTRUCTION WORK SPECIAL CONDITIONS: ON SATUR6AYS $20,788.00 0 0 0 OWNER -BUILDER DECLARATION , I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed nest to the applicabls 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 -As issuance, -al; a r3q,iires thN 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 d of too 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 irtenned'ornffNre.1 fcT sale (Secton 7.)44, Business and Professions Cade: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, DOI& or Improve- Troferty, 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 theta -,den of ?romnq that it was no, 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' Stale 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 legalli 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:liwww.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of ggryyry that 1 am licensed under provisions of hapler 9 (commencing with Section 7000) f D'vision 3 of the Business and Prof ions Code, nd y titan a is in full force and effect. License Class (. 'S License No �2y a Date B I 9 2 Contractor Signal NORKERS' 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 1f 100,0001, IN ADDITION TO THE :OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS Fees. hereby affirm under 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 th. terformance of the work for which this permit is issued. Policy No. R have 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 nsurance c�rr�rier,,and policy numbed' �7 -arrier ////Lz'�L �n L(��f Policy Number L S J 3 % Expiration Date Jame of Agent Phone k certify that, in the performance of the work for whj h this permit is issue , I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agrE if I should m u ' ,ct to the wo _ re c - e sation proviso lion 3700 of the Labor Code, I shall forthwith Comply with those provisions. lature of App ant a Date hereby affirfi under Venally 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). -enders Name Lender's Address By my signature below. I certify to each of the following: I am the property owner or authorized to act on the px9perty owner's behalf. I have read this application and the informationph6v provided is cc ct. I agree to comply with all applicable city an5AunXordinances a sta a uildin truction. I authorize representatives of this city or ant e b tiff r pection purposes. Date Signature of Property Owner or Authonze A ant Pnnt Property Owner's or Authorized Agent's Namd ACTION DATE BY DECLA TI OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED 15UBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED DEPA PERMIT EXTENDED _LJAQmo PERMIT FINAL /Z /2 J, ^��- l.. ASBESTOS NOT (CATION IS NOT�CABLE TO CERTIFICATEOF ` j '7 V rPROPOSED; c TION OCCUPANCY ISSUED SIGNATURE: