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Home My WebLink AboutXR2023-0116 - Permits�EWP City of Newport Beach o .. Community Development Department- Building Division r y 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 °g4cenN`P newportbeachca.govfnspections Combination Type - SFP Work Class - Re -roof 111111111111111111111111111111111111111111111111111111 JillCOMB Permit : XR2023-0116 Plan Check No: Issued Date : 01/18/2023 Inspection Area : 1 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 : 5000 RIVER AVE Legal Desc : N TR 31.62 BLK LOT 31, Description: SFR REROOF W/MODIFIED BITUMAN 10 SQ CL "A" T/O;BUR - ESR-2018 " Owner: RALPH DELISIO "" Contractor : Brizuela Rooflng System Architect Address : 5000 RIVER AVE ` Address :. 3930 2nd Ave --Address NEWPORT BEACH, CA 92663 Jos angeles, CA 90008 Phone : (949) 227-0771 Phone : (310) 853 9001 Phone Con State°Lic : 919282 State Lic Lic Expire : 07/31/2024 Applicant: Brizuela Roofing System Bus Lic : BT30073457 - Engineer Address : 3930 2nd Ave Bus Lic Expire : 01/31/2024 Address Jos angeles, CA 90008 Phone: (310) 853-9001 Workers' Compensation Insurance Phone: Carrier: 'STATE COMPENSATION INSURANCE FUND " Owner/Builder : .= Policy No: 9298072 Designer Address : '. W. C. Expire : 5/12/2023 Address : Phone: Code Edition : 2022 Type of Construction : V-B Occupancy Groups: R-3,U Bldg Height: Building Setbacks Flood Zone Use Zone : PROCESSED BY Front: 5, Side: 3, Side: 3, Rear: 10 X R-1 - Sin le -Unit Residential Fire Sprinklers: """"'NO Fire Hazard Zone NO No of Units : _1 No of'Stories : 1 ° ° Construction Valuation Added/New/Ti sq. ft. Bldg Alteration sq. ft. Bldg : Added/New sq. ft. Garage: TOTAL sq. ft. : `� DON I RUCTION NOISE SPECIAL CONDITIONS: lrf,qqHE WEEKEND I a ai: � F LL a! 3 l ° 0 0 ° . yaw°a ° OWNER -BUILDER DECLARATION Z- I hereby affirm under penalty 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 requiresthe applicant for the permit to file a Sig Red statement that he or she is licensed pursuant to the provisions of the Contmctofs' Stale License Law (Chapter 9 (common bing with Section 7000) of Division 3,of the Business and Professions Code) or that he or she is exempt from UeensUre and the basis for the alleged axemptioR Any violation of Section 7031.5 by any applicant for a permit subjectG'the applicant toa oivil penaityo€ not more than five hundred donate ($500). I, as owner of the property, or my employees with wages as their sole compensation, will dp:(_)all of or U portions of he work, and'ther structure is not intended orofEered'for sale (Section 7044-; Business and Professions Cone: The Conractors' State License Law does not apply to an owner of property who, throughemployees er 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-Buitdorwi have the burden ofproving that it not built or Improved for the purpose of sale). Q 1; as owner of. the property,. am exclusively contracting with licensed Contractors to construct the protect (Section 70441 Business and Professions Codas The Contractors' State License Law does not apply to an ownerof property who builds or Improves thereon, and who contracts for the projects With a licensed Contractor pursuant to the Contractors' State License Law). El 1 am exempt from licensure underthe Contractors' State License Lawforthe 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 legal) . ProfessioSell a ns Code, is.re that I ava 1 blaupoh request when thisave built as an owner -builder it thas riot applications submitted ore n Constructed tn its et the Folloty by ✓ing `Web site: Up:/lwww.legi ctors. I fo.caL o that a copy of rite-tipplicable taw, Section 2044 of the Business and. fO.Ca.90Y/Caiaw.htmt Signature of Property Owner or Authorized. Agent. Date. LICENSED CONTRACTOR'S DECLARATION I I hereby aHimt under penalty of perjury that tam licensed under previsions of Chapter 9 (Commencing with Section 7000) of giviskin 3+of the Business and Prole " ions C .,-and&s ' n full force: and effect. License class 4 s � Ltcense.No e?I Y Date ntractorSlgnatum WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE wORKW COVERSATION COVERAGE la UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL: PINES UP TO ME HUNDRED THOUSAND DOLLARS (StDD;SDD]; IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AVW%V=U FOR IN SECTION :3T0S OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES: hereby affirm under penalty of pdijury oho of the following declensions: 13 I have and Mil n1diniallrCa±ceZtiliCdt9 of consent to self.insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of theLaborCarte, .for IN ones of the worl4forwhiCh-thts paiiitit is Issued. . Policy No. ve and will m 'cR�theY •rp4ensation insurance, as required Section 3700 of the Labor Code. for the. performance of the work for which this. perm is Issued, My Workers` compensator surartce Cartier n� �r are! q y �7 Carrier ��'�• • Polic Number ( ( Expiration Dale S/� Z-� 0 L� Name of Agent: ' •' ..... Phone:IT I certify that, in the p$rm"Snce" kt Work for 'ch this permit is issued, I shall not employ any person ,n any manner: so as to became subject to the workers' compensatio laws of Cal' mia.. and agre that, it I should becomr� ttoj¢ too Qt ers' m do provision of Section 3700 of the Labor Code, I -shall forthwith comply With those provisions. p Signature Of Applican Date�� Z DECLARATION REGARDING CTION LEND04CrAMNCY h hereby affirm under penalty: of perjury that theca Is a construdlon lending agency forthe performance of the workfor which this permit is issued (Section 3097,. Civil Code). Lender's Name... - _ Landers:Address y my signature: below, I certify to each of the following:: I am the property owner orau twrized to act on the propertyowner's behalf. I have read this application and the information I have prokided is correct' I agree to comply with all applicable, Cityam county, d oncas late elatin building construction. j r (authorize representatives DE this city or COUn t the ab a U d propa or inspection purposes. i to- r 2d Si nafUYa ofi PlO Dwnef Or Authorized A nt PYini P€d a owner'5 or AuthofizatiA anF5 Name G' ✓ LL1Y` (ZL�ai'C. ..Date. ACTION .DATE BY ECtARATIONOF COMPIIEWITH CODE OF FEDERAL FOR. OFFICE USE ONLY EGU. 010.710NSPART 6I OF TFTLE 40 AND AQMD RULE 1403 PERMIT EXPIRED LJ I SUBMI TIED ASBOTOS NO-nFICATION TO PERMIT CANGEtLE4 DEPA PERMITEXFENDED QA4M:D' .PERMIT FINAE. 'Z^1 —Z 12 AS&ESTg5 N&)T�ATT t PUCASLE T. CERITUICATEOF cJ PROPOSEDN OCCUPANCY ISSUED .SIGNATURE, I