HomeMy WebLinkAboutXR2023-0742 - Permits�EWPOR� City of Newport Beach
4 X R 2 0 2 3 0 7 4 2 COMB Permit : XR2023-U 1 T2
o @ Community Development Department -Building Division
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No
Permit Counter Phone: (949) 644-3288 Issued Date : 0312112023
Inspection Requests Phone: (949) 644-3255 Inspection Area : 8
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Combination Type - SFP) "e+,t
Work Class - Repair
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 : 232 TUSTIN AVE I
Description: SFR REROOF. TEAR OFF (E) ROOF. APPLY
UNDERLAYMENT.
Owner: RUTAN ELSIE C TR
Address : 232 TUSTIN AVE
NEWPORT BEACH, CA 92663
Phone
Applicant: LEMUS ROOFING
Address: 2016 WALLACE AVE UNIT B
COSTA MESA, CA 92627
Phone: (949)735-2377
Owner/Builder:
Address :
Phone
Code Edition : 2022
Type of Construction : V-B
Occupancy Groups: U,R-3
Bldg Height:
Building Setbacks
Flood Zone
Use Zone:
PROCESSED BY:
Lie Expire :
10/31/20,
Bus Lie :
BT30077
Bus Lie Expire
: 12/31/20;
Workers' Compensation'.I
.. Carrier..: STATE COMPEL
Policy NO:
1845899
W.:C. Expire : ,
5/,27/2023
:- Fire Sprinklers
: NO
Front: 20, Side: 4, Side: 4, Rear: 10
X
R-1 - Single -Unit Residential
63
SPECIAL CONDITIONS:
OF GAF TIMERLINE COMPOSITION SHINGLES W/ 30# FELT
4G
(:.Architect
AVE UNIT B
Address:
CA 92627
Phone:
State Lie
Engineer:
Address:
rance
Phone:
.TION INSURANCE FUND
Designer:
Address:
Phone:
Construction Valuation : $11,500.00
Added/New/Tl sq. ft. Bldg : 0
1 Alteration sq. ft. Bldg :
1 z Added/New sq. ft. Garage: 0 • `° ° • °
TOTAL sq. ft.:
• •
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-,a a
3 6
•..Demo
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OWNER -BUILDER DECLARATION
-1 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 items)
action 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
e 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
afessions Code) or that he or she is exemptfrom 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
t more than five hundred dollars ($500).
-1 I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or `) portions of I.
lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through t
rlprovements are not Intended or offered for sale. If, however, the building or improvement is sold within one year of comp
nproved for the purpose of sale).
1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044,
ipply to an owner of property who builds or Improves thereon, and who contracts for the projects with a licensed Contractor
1 am exempt from licensure under the Contractors' Slate License Law for the following reason:
iy my signature below I acknowledge that, Except for my personal residence in which I must have resided for at leastone y
ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I un
'rofessions. Code, is available upon request when this application is submitted or at the following Web sim:hUp:8www.legm1
'rlgnature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700p) of
:nd effect License Class License No Date -6�"117"
work, and the structure is not intended or offered for sale (Section 7044,
)toyees' or personal effort, builds or improves the property, provided that the
on, the Owner -Builder will have the burden of proving that N was not built or
and Professions Code: The Contractors' State License Law does not
to the Contractors' State License Law).
to completion of the improvements covered by this permit, I cannot
that a copy of the applicable law; Section 7044 of the Business and
3 of the Business and Prof�Cadealyri-my, license is in full force
Contractor Signature �¢ !.\,�'Y I.
UORKERS' COMPENSATION DECLARATION I" '
IARNING: FAILURE TO SECUREWORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRGMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS (5100,000}, IN. ADDITION TO THE
DST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION C706 OF THE LABOR COeE,INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
I I have and will maintain a centricate of consent to self -insure for workers' compensation, issued by the Director of I dustrial Relations as provided for by Section 3700 of the Labor Code, for th
erformance of the work for which this permit is issued, Policy No.
have and will maintain wrorkars' compensation insurance, as required by Section 3700 of the Labor Code, for the
fence carter and policy number are:
Policy Number
Agent
of the work for which this permit Is issued. My workers'
Date
oerify that, in the performance of the work for which this permit is issued, I shell not employ any person in any manner syl as to become subject to the workers' componsation. laws of California, and
, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith domply with those provisions.
of
hereby affrm 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 Cade).
ender's Name Lender's 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.
I have repa4714'4pplication and the Information I have provided is Correct.
i. gree to Il Mply with all applicable dry and county ordinances and state laws relating to building construction.
• •l,authoria relussentatives of this city or coup�v to rater e a�yve-identi ied property for inspection purposes.
• • i5'i I tit l7_l_ �
'AC IeN DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
• • REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
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P�1(iV1T EXPIRE? • I
I U t SUBMITTED ASBESTOS NOTI FiCATtON TO
• • {(6ASSESTOS NOTIFICATION 15 NOT APPLICABLE TO
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