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Home My WebLink AboutXR2023-1233 - Permits�EwaoRr City of Newport Beach Community Development Department- Building Division X R 2 0 2 3 1 2 3 3 COMB Permit : XR2023-1 233 n100 Civic Center Drive, Newport Beach, CA 92660 Platt Check No: Permit Counter Phone: (949) 718-1888 U f! r" t Issued Date : 05/11/2023 S newportbeachca.gov/civic Cq</cORN�P Combination Type - SFP h i t...% i 9...= 1J d f1 Inspection Area : 5 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 : 4530 ROXBURY RD Legal Desc : N TR 3357 BLK LOT 15 Description: SFR REROOF REMOVE (E) BUR AND INSTALL 3PLY BASE W/ BUR 7 SOAURES OVER ADU _ Owner: LARAINE TANZER Contractor: MIKE VOGT ROOFING Architect Address : 4530 ROXBURY RD Address : 2658 VISTA ORNADA Address NEWPORT BEACH, CA 92625 NEWPORT BEACH, CA 92660 Phone: (949) 903-1 B23 Phone: (714)736-6422 Phone: Con State Lie : 1064773 State Lie Lie Expire : 03/31/2024 Applicant : MIKE VOGT ROOFING Bus Lie : BT30072008 Engineer: Address : 2658 VISTA ORNADA Bus Lie Expire: 05/31/2023 Address NEWPORT BEACH, CA 92660 Phone: (714) 736-6422 Workers' Compensation Insurance Phone: Carrier: STATE COMPENSATION INSURANCE FUND Owner/Builder: Policy No: 9273545 Designer Address : W. C. Expire: 3/26/2024 Address Phone: Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $7,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg: 0 Occupancy Groups : U,R-3 No of Units : 1 Alteration sq. ft. Bldg : Bldg Height: No of Stories: 1 Added/New sq. ft. Garage: 0 TOTAL sq. ft. 0 ... Building Setbacks : Front: 15, Side: 6, Side: 6, Rear: 6 Flood Zone : X Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area) PROCESSED BY: SPECIAL CONDITIONS: I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) Indicated below by the checkmark(s) I have placed next to the applicable item(s) Section 7031-5, Business arid Professions Code: Any city or county that requires a permit to construct, alter, improve, dernolish, or repair any structure, prior to its issuance, also requires the applicant for he 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 ticensure 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 lot more than five hundred dollars ($500), 11, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Iusiness 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 clprovements are not intended or offered for sale, if, however, the building or improvement is sold within one year of completion, the Ownar-Builder will have the burden of proving that it was not built or mproved for the purpose of sale). 11, 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 oply 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), 1 1 am exempt from licensure under the Contractors' Stale 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 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 it it has not boon constructed in its entirety by licensed contractors. I understand that a copy of theapplicable law. Section 7044 of the Business and 'rofesslons Code, is available upon request when this application is submitted or at the following yyeb site:http://wvnv.leginfo.ca.govlcalaw.htmi, Signature of Property Owner or Authorized Agent ___ „__, Date -ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Qivfi n 3 of the Business and Professions Code nd c rrf ca and effect. License Class License. No Date !"/% 2 Contractor Signature VORKERS' COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDEE HOUSAND DOLLARS (E100,000), IN ADDITION TO THE iOST OF COMPENSATION: DAMAGES AS PROVIDED FOR IN SECTION 370E OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penally of perjury one of the following declarations: id 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 of the work for which this permit is issued. Policy No. and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permitis issued. My workers' carrier and policy number are: Policy Number 1e of Agent certify that, in the performance of the work f which this , if I should become subject to a rk cam ' lature of Applicant ! Jv, Date issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and is of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Dale— !S areby affirm under peAfty 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), rder's Name Lenders Address my signature below, I certify to each of the fallowing: 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 ordinances and state aws relating to building construction. I authcrize representatives of this city or county to antes ttW abgJe-I title erty for inspection purposes. ACTKON PERMCCXPtRED GATE BY rG �A PON5 PART OF TITLE 40 AND AQMD RULE FEDERAL FOR OFFICE USE ONLY R Pthb 1 XTENDEDITI I�P.QMD CLRM71 AVA1 _ 7�/W / �� PROPOSED DI NQT% I ptgTAppUCggl£ TO fcRRE/CA-'E OF PROPOSED DE / O-CIFAv_yiSSUEO SIGNATURE: