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Home My WebLink AboutXR2022-1956 - PermitseaPORr City of Newport Beach II III I I I II COMB Permit XR2O22-1956 I II I III IIIII II II Community Development Department -Building Division : y, 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: Permit Counter Phone: 949 644-3288 ( ) Issued Date :07/1912022 Inspection Requests Phone: 644-3255 Inspection Area : 2 c P 9e,Foae` newportbeachca.gov/inspections ons --_-"' Combination Type - SFP Work Class - Re -roof 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 : 126 CRYSTAL AVE Legal Desc : A TR BALBOA ISLAND SEC 5 BLK 3 LOT 17 BALBOA ISLAND SEC 5 LO T 17 BILK 3 W 55 FT Description: SFR REROOF W/LIGHTWEIGHT TILE12 SQ R 2 SO TORCH (ON FLAT) CL "A" T/O TILE AND TORCH Owner: SUSANGLOCKNER Contractor: Adams Roofing Address : 126 CRYSTAL NEWPORT BEACH, CA Address : 3435 S. Silver Spur Santa Ana, CA 92704 Phone: (760)846-6259 Phone: (714)965-0245 Con State Lic : 524341 Applicant : Adams Roofing Lic Expire : 06/30/2024 Address : 3435 S. Silver Spur Santa Ana, CA 92704 Bus Lic: BT30078082 Phone: (714) 965-0245 Bus Lic Expire : 02/28/2023 Workers' Compensation Insurance Carrier : Policy No W. C. Expire: Code Edition : 2019 Fire Sprinklers : NO Type of Construction : V-B Fire Hazard Zone : Y Occupancy Groups : R-3,U No of Units : 1 Bldg Height: No of Stories : 2 Building Setbacks : Front: 8, Side: 3, Side: 3, Rear: 5 Flood Zone: X Use Zone : R-BI - Two -Unit Residential, Balboa Island PROCESSED BY Architect Address Phone: State Lic Engineer Address Phone: Designer Address Phone: Construction Valuation : Added/New/Ti sq. ft. Bldg Added/New sq. ft. Garage SPECIAL CONDITIONS: �� NSPE T i I $8C,001.00 OWNER -BUILDER 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 requires the applicant for the 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 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). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure 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 who, through employees' or 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 -Builder will 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 t0 an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' Slate License Law). ❑ i am exempt from licensors 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 legall, sell a structure that I have built as an owner -builder if it has not een constr d 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 who tJfis ap lica' n is submitttild or at the following Web site:http:/Avww.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent X, Dal/ !/ LICENSED CONTRACTOR'S DECLARATION/ I hereby elan under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 N on 3 of the Business and Profep;lons Code, a my lipel}ite is in full force and effect. License Class License No Date Contractor Signature % Y4 NORKERS' COMPENSATION DECLARATION NA^NING: F',ILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE CO.'. U.f 6L.4PFNSA', ION, J. AGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm unL:cr penalty of perjury one of the following declarations: ❑ 1 hev< 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 4ar�nmiance of the work for which this permit is issued. Policy No. rya%z 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' compensatioi can^e carrier and poliry number are: 'e• Policy Number Expiration Date -s cf 4gent Phone # certify chat. in ,he., performance of the work for ich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensatlon,laws of California, and agre if I _hjuld become subject to a workers' c ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. I P P Iature of Applic: rl1k Dale Ireby 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). Ider's Name Lenders Address my signature below. I certify to each of the following: I am the properly 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 slate laws relating to building construction. / I authorize representatives of this city or county to enter ttX above entified property for inspection purposes. ./ nature of Prooertv Owner or Authorized, Print Properly Owner's or Authorized Agent's Name %�� /�t�r•'�" ACTION I DATE BY 1 I REGULATIONS PART061 OF TITLE 40 AND AOMD RULE WITH CODE OF FEDEI PERMITEXPIREO ( I LI&BMITTED PERMIT CANCELLED EPA CERFICATEOf LI I I q .NM GNPc ATURE• DEMOLITION ION IS NOT APPLICABLE TO OCCUPANCYISSUEO ddd»>VVV„I FOR OFFICE USE ONLY All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shall be in place prior to approval to fill pool/spa & shall remain in place & be maintained for the life of the pool.