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Home My WebLink AboutXC2024-0132 - Permits�EwroRr City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: XC2U24-o132 p4 0 Community Development Depanment- Building Division X C 2 0 2 4 0 1 3 2 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: Permit Counter Phone: (949) 718-1888 Issued Date; 04/02/2024 u newporlbeachca.gov/civic Final Date: Cq</FORN�P Combination Type - - r .� II-,, -- -��-.- ... -� Permit status: Issued Work Class - Repair ;+_ j:: t"s Inspection Area : 8 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 O(Adok [ G/97'F Job Address : 600 ST ANDREWS RD, BUILDING D Legal Desc : A TR IRVINE SUB BLK 54 LOT 171 IRVINE SUB BILK 54 L Description: COMM REROOF OVERLAY POLYESTER FABRIC EMBEDDED IN ASPHALT EMULSION, RECOAT W/ COOL ROOF ACRYLIC ESR#2871 78 SOS Owner: CHURCH ST ANDREWS PRESBYTERIAN OF Contractor: HIGHLAND COMMERCIAL ROOFING Architect: - NEWPORT Address : 600 SAINT ANDREWS RD Address: 5105 HEINTZ ST Address NEWPORT BEACH, CA 92663 BALDWIN PARK, CA 91706 Phone: (949)574-2205 Phone: (626)856-2076 Phone: Con State Lie : 632551 State Lie Lie Expire: 07/31/2024 Applicant: ADVANCED PERMIT SERVICES INC Bus Lie: BT30083922 Engineer: Address: 24310 MOULTON PKWY, 0137 Bus Lie Expire : 03/31/2025 Address LAGUNA HILLS, CA 92637 Phone: (949) 207-3468 Workers' Compensation Insurance Phone: Carrier: AMERICAN CASUALTY COMPANY Owner/Builder : Policy No: 7011688782 Designer Address : W. C. Expire : 11/1/2024 Address Phone: Phone: Code Edition : 2022 Fire Sprinklers : YES Construction Valuation : $25,000.00 Type of Construction : I -A Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg: 0 Occupancy Groups : U No of Units : 0 Alteration sq. ft. Bldg : Bldg Height: No of Stories : 1 Added/New sq. ft. Garage: 0 , TOTAL sq. ft.: 0 Building Setbacks : .... Flood Zone : X Use Zone: PI - Private Institutions PROCESSED BY: SPECIAL CONDITIONS I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable ttem(s) 3eclion 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 is 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 ficensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of of more than five hundred dollars ($500). 11, 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 intended mattered for sale (Section 7044, 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 nprovemenls 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 pply to an owner of property who builds or improvesthereon, 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: y my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prim to completion of the improvements covered by this permit, I Cannot legall all a structure that I have built as an owrim-builder if it has not been constructed in its entirely by licensed Contractors. I understand that a copy of theapplicable law, Section 7044 of the Business and rofessions Code, is available upon request when this application is submitted or at the following Web site:htip.,Il w.leginfo.ca.govicalaw.titmi. ignature of Property Owner or Authorized Agent Date ICENSED CONTRACTOR'S DECLARATION / o hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7041 f pltrisjpn 3 of the Business and rofe�de, an 7 se is in full force nd effect. License Class License No Date 2� Ire Contractor Signature, i IORKERS' COMPENSATION DECLARATION ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TOME HUNDRED 7HOUSAHD DOLLARS (E100,000), IN ADOI ION TO THE DST OF COMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEE% 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 art ante 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 performance of the work for which this permit is issued. My workers' compensatio isurance carder and policy number are: anler Policy Number Expiration Date i9 of Agent _ JI certify that, in the performlofice of the work r wh h this permit is issued, I shall not employ any person in any manner sow to become subject to the workers' compensation laws of California, and agree hat, if I should become subj ct to p on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /' >ignalure of Applicant_ `. JtlG�i�✓r_ Date_ Z' z,(4— )ECLARATION REGARDING CONSTRUCTION LENDING AGENCY 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). -enders Name Lender's Address 3y my signature below, I certify to each of the following: 1 am the property owner or authorized to act on the owner's behalf. 1 have read this appowalion and the information I ave provided i I agree to Comply mth all applicable city and c my dinancos 7ndl,�alg,relating to building construction.I authorize repiesentatives of this city or coup y lcen a aboperty for inspection purposes.Signature of PropertyJoiner or Authorized Anent \�L" Print ProDertv Owners or Authorized Aaent's Name nale DATE BY DECLARATIONIONS OF COMT 61 LIANITLE 40A BODE OF FEDERAL FOR OFFICE USE ONLY ! P,rPHITCANCELLED I...IEPA RTPPVT FYTENDED MD PERN1T F'NAL UASBESTOS TIPI TION 15 NOT LIC BLE TO GERTIRAPTEOF �Z 1` PROPOSED: OLRI D('g1npNCy155UE1.' SIGNATURE: