HomeMy WebLinkAboutXR2022-3092 - PermitsaEWPoRr City of Newport Beach II II II I I IIIII IIII I IIIIII IIII I III II
p`< @ Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
Cq[�pppN�P newportbeachca.gov/inspections
Combination Type - SFP
Work Class - Repair
COMB Permit : XR2022-3092
Plan Check No : PC2022-2575
Issued Date : 11/28l2022
Inspection Area : 3
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 HOLIDAYS IN ALL AREAS
AAND
Job Address : 20242 ORCHID ST
Legal Desc : N TR 1500 BILK LOT 32
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Description: SFR REROOF W/DIMENSIONAL SHINGLES 40
SQ, MIN CLASS B T/O SAME
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Owner: PARTNERS OF PAYMENT RELIEF DEII
Contractor : Jason Hoffman
Architect :
Address : 920 CASSATT RD #210
BERWYN, PA 19312
Address : 16205 CHIPPEWA RD
APPLE VALLEY, CA 92307
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Address : ✓4=
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Phone:
Phone: (760)628-9378
Phone: ••°�
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Con State Lic : 1040696
•
State Lic
Lic Expire : 06/30/2024
Applicant: Jason Hoffman
Bus Lic: BT30080124
Engineer: ° •
Address : 16205 CHIPPEWA RD
Bus Lic Expire : 11/30/2023
Address :
, ^ • °
APPLE VALLEY, CA 92307
Phone : (760) 628-9378
Workers' Compensation Insurance
Phone : • ° °
° ° °. ,.
Carrier:
Owner/Builder :
Policy No:
Designer : -
• ..
Address :
W. C. Expire:
Address
Phone:
Phone: •°'•
•°„
Code Edition : 2019
Fire Sprinklers : NO
Construction Valuation : $0.00
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/Ti sq. ft. Bldg : 0
Occupancy Groups : 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: 20, Side: 5, Side: 5, Rear: 25
Flood Zone : X
Use Zone : SP-7 - Santa Ana Heights peci is Plan
PROCESSED BY:
SPECIAL CONDITIONS: CONTRAC OING 2 OR MORE UNRELATED TRADES
OWNER -BUILDER DECLARATION
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)
ieclion 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior toits issuance, also requires the applicant for
ID permit to file a signed statement that lie or she is licensed pursuant to the provisions of the Contractors' State License Low (Chapter 9 (commencing with Section 7000) of Division 3 of the Bush and
Tofessions Code) or that he or she is exempt from licensum and the basis for the alleged exemption. Any violation of Section 7031.S by any applicant for a permit subjects the applicant to a civil penalty of
of more than five hundred dollars ($500).
1 1, 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,
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 tha
nprovements are not intended or offered for sale. It, 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 thepurpose of sale).
1 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does not
pply to an owner of property who builds or improves: thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I I am exempt from licensure under the Contractors' State License Law for the following reason:
y my signature below 1 acknowledge that, except for my personal residence in which I must have resided for at least one year prior t0 completion of the improvements covered by this permit I cannot legal[)
ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Tofessions Code., is available upon request when this application is submitted or at the following Web site:http:tiwvay.leginfo.ca.govlcalaw.html.
.ignature of Property Owner or Authorized Agent _ - .._._... Date
TCENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter S (commencing with Section 7000) o ivis'on 3 of the Business and Professions C y license is In full force
nd effect. Licem.c Cla,b License No Date I L Contractor Signature
YCIRKERS' COMPENSATION DECLARATION
'AKNING: FAILURE TU aLCJd6 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
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370E OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby afivm under penalty of perjury one of the following declarations:
] I have and wil; mo;nicin 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
er'ormTece of the work for which this permit is issued. Polley No.
]I have and will maintaili 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
Isura.,L. carrier and policy number are:
i — —-
ke Of Agent _ _
Policy Number
Date
entry `hat, in th z pe:lcrmance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of C2liforrlia, and agre
If i mould become subject tD,the/wor s//c/c #eassaa/6n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
store of ADolicant / � /�i160L : �i _____. DataT y7 / ��
rreby affirm under penalty of perjury that there 6 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 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 ail applicable city and county ordinances and stale laws relating to building construction.
I authorize representatives of this city or county t enter the dentifled property for inspection purposes. /
nature of PFODertv Owner or Authorized Agent !:, � Print Property owner's or Authorized Agent's Namy ,.\ , vO
ACTION
PERMIT EXPIRED
PERNNTCANCELLED
PERMIT EMENDED
CERriFICATf Or `• %i
OCCUPANCY ISSUED l
BY - LARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART fit OF TITLE 40 AND ACtNID RULE
TO
NOTIFICATION IS NOTAPPLIGAHLE TO