HomeMy WebLinkAboutXR2024-5510 - Permitsa��WPoRr City of Newport Beach
@ Community DE velopment Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
~ n' Permit Counte Phone: (949) 718-1888
U sa S
<.. newponbeach a.gov/civic
Combination Type - SFP
Work Class ADDITION/ALTERATION
11IIIIIIIIIIII111111111111111111111111111111111111111111I jj COMB Permit : XR2024-5510
Plan Check No :
Issued Date : 0612112024
Final Date:
Permit Status: Issued
Inspection Area : 1
PERMITS EXPI E 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTIO RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address : 472 62ND ST Legal Desc : N TR 772 BLK 22 LOT 9 TR 772 LOT 9 BILK 22 ALL (EX
Description : SFR RE -ROOF, T/O (E) ROOF, INSTALL DENSDECK & 60-MIL WHITE PVC. ESR 4676, is sj,
Owner: THERESA C
Address : 120 TUSTIN
NEWPORT
Phone
Applicant: CESAR NORIE(
Address : 515 S BROAD"
SANTA ANA, C)
Phone : (714) 227-3875
Owner/Builder :
Address :
Phone
Code Edition : LUuz"
Type of Construction : V-B
Occupancy Groups: R-3
Bldg Height:
Building Setbacks
Flood Zone:
Use Zone:
PROCESSED BY:
EN
Contractor: OCEAN ROOFING
Architect:
#C145
Address : 515 S BROADWAY
Address
;H, CA 92663
SANTA ANA, CA 92706
Phone: (714)486-2404
Phone:
Con State Lic : 976999
State Lic
Lic Expire : 11/30/2025
q
Bus Lic: BT30066921
Engineer:
,y
Bus Lic Expire : 04/30/2025
Address
92706
Workers' Compensation Insurance
Phone:
Carrier: INSURANCE COMPANY OF THE WEST
Policy No : WVE506745401
Designer:
W. C. Expire : 9/20/2024
Address
Phone:
From: 5, Front: 5, Side: 3, Side: 3
X
R-1 - Single -Unit Residential
SPECIAL CONDITIONS:
Fire Sprinklers : NO
Construction Valuation :
$28,000.00
Fire Hazard Zone : NO
Added/New/Ti sq. ft. Bldg :
0
No of Units : 1
Alteration sq. ft. Bldg :
0
No of Stories : 2
Add/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' 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
ie 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).
I, 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 70",
;usiness 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, 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).
1 am exempt from licensure under the Contractors' State License Law for the following reason:
-y 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 legalll
ell a structure that 1 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:http://w .leginfo.ca.govlcalaw.htmi.
signature of Property Owner or Authorized Agent Date
.ICENSED CON TRACTOR'S DECLARATION
hereby affirm undal penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 f i io 3 f the Business and Professlo ede, an license is in full force
nd cffe-,t. Licenss Clcss License No Date (J0 Contractor Signature
JORKERS' CCMPcXSATION DECLARATION
XRMAG: 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 ($100,0001, IN ADDrrION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION $706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
heleby'affirm under penaltyof perjuryone of the following declarations:
J 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.
edormanoe of the work +or which this permit is issued. Policy No.
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'
rcnce carrier and pc Ii cy number are:
Policy Number
of /.gent _
Date
I certify that, in the perrormance 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 Caiifomia, and agre
Ial, if I should become subje the workers stpensalion provisions of Section 3700 of the Labor Code, I shall forthwith comply With those provisions. 1
ignature of Applicant _ I i Dale- O} tlf d
DECLARATION REGA DING C STRUCTION E DING AGENCY —j-`
hereby affirm under penaltyof pe jury 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 Lenders Address
y 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. ` p I t q „
I have read this application and the information I have provided is correct. I vVI
I agree to comply with all applicable city and county ordinances and slate laws relating to building construction.
I authorize representatives of this city or county to en B�reagove-iad property for inspection purposes.
icnature of PrODerty Owner or Authorized Agent Y,, 1 A ( Print Prooenv Owner's or Authorized ADent's Name) DataX U� I
ACTION I DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXTENDED
LJAQM D
PERMIT FINAL
CERTIFICATEOF
'7 �/
/ • 01.
ASBESTOS NOT CATION 15 NOT APPLICABLE TO
ROPOSED DEMOLI q��11
OCCUPANCY ISSUED
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