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Home My WebLink AboutXC2023-0405 - PermitsCity of Newport Beach �E�ivvoRT Community Development Department - Build ng Dieision Newport Beach, CA C2660 100 Civic Center Drive, F'- Permit Counter Phone: (949) 718-1888 �., newportbeachca.gov/civic O�c;FoaN`" CombinationType- - Work Class - Repair COMB Permit : XC2023-0405 Ei�xc0 2 3 0 4 0 5�� II Plan Check No : Issued Date : 10/10/2023 Final Date: Permit Status: Issued Inspection Area :7 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 : 1501 WESTCLIFF DR Legal Desc : N TR 4225 BLK LOT 8 TR 4225 LOT 8 POR OF LOT (PAR Description: COMM RE -ROOF T/O FLAT REROOF INSTL NEW TORCH DOWN (850 SF) Owner: WESTCLIFF PROPERTIES LLC Contractor : ARCHITECTURAC O FI G SYSTEMS SYSTEMSNG INC BDA Architect 1600 DOVE ST STE480 Address : 1221 WEST COAST HWY, 225 Address Address : NEWPORT BEACH, CA 92660 NEWPORT BEACH, CA 92663 Phone: Phone : (949) 720-8166 Phone: (949)495-4200 State Lic: Con State Lic : 898367 Lic Expire : 06/30/2025 Applicant: ARCHITECTURAL ROOFING SYSTEMS INC Bus Lic BT30082358 Engineer: BDA PACIFIC ROOFING SYSTEMS Bus Lic Expire : 11/30/2023 P Address Address : 1221 WEST COAST HWY, 225 NEWPORT BEACH, CA 92663 Workers' Compensation Insurance Phone: Phone: (949) 495-4200 Carrier: CAROLINA CASUALTY INSURANCE COMPANY Policy No : BNUWC0158962 Designer Owner/Builder : W. C. Expire : 1/10/2024 Address Address : Phone: Phone: NO Construction Valuation : $13,220.00 Code Edition : 2022 Fire Sprinklers : NO Added/New/TI sq. ft. Bldg: 0 Type of Construction : V-B Fire Hazard Zone : 1 Alteration sq. ft. Bldg : Occupancy Groups : B,U No of Units : Added/New sq. ft. Garage : 0 Bldg Height : No of Stories : TOTAL sq. ft. : 0 Building Setbacks : Flood Zone : X Use Zone : MU-DW - Mixed -Use Dover/Westcliff PROCESSED BY: � — -- — — SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION o0 000 I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the relsen(s)d2dicalcd bsiow bythe cleckmark(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, remoll-h, Dr-ep3ir 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' Stala -icause Law (Chapter 9 (commencing with Section 7000) of Division 3 of the 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). 111, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portiin; of the wank, ul.d the atruclute 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 wl,o, through employee or personal e1ort, 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-Ruildor v ill have the burden of proving that it was not 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' 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, I cannot legally 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:l/ww .leginfo.ca.gov/colaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION --- I hereby affirm under penalty of erjury that I am licensed under provisions of Chapt r 9 (commencing with Section 7000) of DWlsi 3 of the Business and Pro es O o b, 4 my license is In full force and effect. License Class License No �� (� Date 4�/ //,i, /9 Z Contractor Signature NORKERS' COMPENSATION DECLA TION — — �`� VARNING: 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 ADDITION TO THE :DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY-5 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 IN ormance of the work for which this permit is issued. Policy No. 1I h ve 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 iI5urrance ,c�arrier1and policy number �r�-//�/; Amer t io k kie✓ M'(� if /LH��.(/ii" Policy Number _ �� (/ u% (�� ' S �j Expiration Date L �c( /J 7 Jame of Agent os -_ JI certify that, in the performance of th work r 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 agree �aL if I should become subj cl to t rk ' compe lion provisions of Section 3700 of the Labor Code, I shall forthwith comply With those provisions. / lignature of Applicant _ Date _(�� IECLARATION REGARDIN S O LEND G AGEN hereby affirm under penalty of perjury that there is a ons Ion lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). enders Name Lenders Address oy 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 ordina ads a laws relating to building construction. I authorize representatives of this city or county'to_entor t b a- a ti ie pr party for inspection purposes. Signature of Property Owner or Authorized A ant �) Print Property Owner's or Authorized A ct ACTION DATE BY DECLARATiON OF COMPL)XNCE WITjHLg9D&OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART a. FTI AND AQMD RULE 1403 EXPIRED I I I ❑ SUBMITTED ASBESTOS NOTIFICATION PERMIT EXTENDED QMD ERTIFIC ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO TE C CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY155UEO I SIGNATURE: Name