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HomeMy WebLinkAboutXR2023-0959 - Permits�EWPo T City of Newport Beach `' RA Community Development Department- Building Division X R 2 0 2 3 0 9 5 9 100 Civic Center Drive, Newport Beach, CA 9266D u 2 Permit Counter Phone: (949) 644-3288 c P Inspection Requests Phone: (949) 644-3255 "0ciroaP` newportbeachca.gov/inspections Combination Type - SFP Work Class - Other COMB Permit : XR2023-0959 Plan Check No Issued Date : 04/13/2023 Inspection Area : 2 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 : 27 HARBOR ISLAND Legal Desc : N TR 802 BLK LOT 27 TR 802 LOT 27 ALL -INC BET SAME & HIGH T IDE Description: SFR REROOF T/O SLATE AND COMP AND REPLACE W/ COMP 48 SOS Owner: NANCY YOUNGMAN Contractor : Architect Address : 27 HARBOR ISLAND Address : Address NEWPORT BEACH, CA 92660 Phone: (949) 887-3197 Phone : Phone Con State Lie : State Lie Lie Expire: •' Applicant: MICHAEL COTE Bus Lie : Engineer Address : 26000 Avenida Aeropuerto #51 Bus Lie Expire : Address : r' San Juan Capistrano, CA 92675 Phone: (949) 519-5949 Workers' Compensation Insurance Phone Carrier : Owner/Builder : NANCY YOUNGMAN Policy No : Designer Address: 27 HARBOR ISLAND W. C. Expire: Address NEWPORT BEACH, CA 92660 Phone: (949) 887-3197 - Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $35,00mc - Type of Construction : V-B Fire Hazard Zone : NO Added/New/Tl sq. ft. Bldg : 0 Occupancy Groups : R-3 No of Units : 1 Alteration sq. ft. Bldg: - - Bldg Height : No of Stories : 2 Added/New sq. ft. Garage: 0 TOTAL sq. ft.: 0 Building Setbacks : Front: 15, Front: 15, Side: 4, Side: 4 Flood Zone : X Use Zone : R-1 - Single -Unit Residential PROCESSED BY: SPECIAL CONDITIONS: LIQUEFACTION O/B FORM ATTACHED 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 {teal ction 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, allor. improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for 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 fessions Code) or that he or she is exempt from licensors 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 more than five hundred dollars ($500). I, as ownerof the property, or my employees with wages as their sole compensation, will do j_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, iness and professions Code: The Contractors' State License Law does not apply to an owner of property what through employees' or personal effort, builds or improves the property, provided that the rovemenis 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 roved for the purpose of sale). 'has owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Slate License Law does not iy 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). J I am exempt from licensure under the Contractors' State License Law for the following reason: _---- y my signature below t 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 all a structure that I have built as an owner-bwldXN has notbsen constructed in' nbr ty by licensed contractors. understand that a copy of the applicable law, Section I 'rofessions Code, is available upon request whea 'v su �t the [owing Web site:httpJ/www.leginfo.ca.govlcalaw.html. lignature of Property Owner or Authorized Agent Gs Dat ACENSED CONTRACTOR'S DECLARATI hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commenc[ng with Section 7000) of Division 3"of the Business and Professions Code, ai rid effect. License Class License No Date Contractor Signature COMPENSATION DECLARATION of the Business and my license is In full force IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARS (6100,000), IN ADDITION To T DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND A"ORNEY's FEES. hereby affirm under penalty of perjury one of the following declarations_ I I have 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 erformance of the work for which this permit is Issued. Policy No. _ have 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' francs carrier and policy number are: Policy Number of Agent Date -1I certify that In the perf rmance of the work for which this armit is issued, I shall not employ person in any manner so as to become subject to the workers' compensation taws of California, and agre, hat, if I should becom s bjeet to the workers' corn o p f Section 3700 of the Labor Code, I shall forthwith comply with those provisions. '}\��f 3lgnalure of Appticant'. Da J )ECLARATION REG DI CONS tlC N LENDING AGENCY hereby affirm coder p ,natty of perjury that there is a construction lending agency for the performance of the Work for which this permit is issued (Section 30%, Ci it Code). tinder's Name Lender's Address 3y my signature ur,lvw, I certify to each of the following: I Lm the property cwner or authorized to act on the property owner's behalf. ' 'lave read th.s application and the information I have provided Is correct. I igree to ccmply'vith all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or cou o on r the above•id 3ff e for inspection purposes. N �! /� �✓ /'_ �3 Z' ;;i,imure of F. ooert" Owner or Authorized Print Property Owner's or Authorized Agent's ACi1JN DATE By V I DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY I REGULATIONS PART Gt OF TITLE 40 AND AQMD RULE 'FPMIT EXPIRE? I SUBMITTED ASBESTOS NOTIFICATION TO ?'PMIT CANCELLED EPA PERMIT EXTEAOFu PERMITFINAL ASBEST S OIIHLAFHtid'IS' APPLICAB To NLiI _ CERTIFICATE OF OCCUPANCY ISSUED �''(/'�' OSED- OUT ! 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