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Home My WebLink AboutXR2023-1209 - PermitsEWPoRT City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XR2023-1209 oF. Community Development Department -Building Division x R 2 0 2 3 1 2 0 9 .F. 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: 0, S Permit Counter Phone: (949) 718-1888 Issued Date: 05/09/2023 ., ... newportbeachca.gov/civic S P Inspection Area °jCiFoa"`r Combination Type - SFP Work Class - Re -roof t m w 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 : 209 AMETHYST AVE Legal Desc : Description: DUPLEX REROOF. INSTALL 1/2" SHEATHING WITH 8D AT 6" ON CENTER NAILING. INSTALL GAF ASPHALT SHINGLES WITH 2-LAYERS OF UNDERLAYMENT. 22 SQUARES. REMOVE (E) SKYLIGHT. Owner: HAN CAO Address : 3667 ARLINGTON AVE RIVERSIDE, CA 92506 Phone: Applicant: Dustin Dunning Grimme Address: 20771 Cashew St Wildomar, CA 92595 Phone: (949)867-9733 Owner/Builder : Address: Contractor: DUSTIN DUNNING GRIMME Address : Phone: (619)733-7267 Con State Lie : 1099604 Lie Expire : 12131/2024 Bus Lie: BT30081501 Bus Lie Expire : 05/31/2024 Workers' Compensation Insurance Carrier: STATE COMPENSATION INSURANCE FUND Policy No: 9326411 W. C. Expire: 10/1/2023 Architect Address Phone: State Lie Engineer: Address Phone: Designer: Address : Phone: Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $27,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg: 0 Occupancy Groups : R-3,U No of Units : 2 Alteration sq. ft. Bldg : _ Bldg Height: No of Stories : 2 Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 0 Building Setbacks Flood Zone: ' .. Use Zone PROCESSED BY: NC] ONSTAUCTION NOISr SPECIAL CONDITIONS: ON THE WEEKEND OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that t 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 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 Irofessions Code) or that he or she is exempt from iicensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of lot more than five hundred dollars ($500), 3 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work; and the structure is not Intended or offered for sale {Section 7044, 3usiness 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 Tiprovements 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 builtor mproved 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 ply 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). I am exempt from licensors under the Contractors' State License Law for the following reason: _ 3y 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 .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 rrofessions Code,, is available upon request when this application is submitted or at the following Web site:http:li v w,leginfo.ca.govicalaw.html, Signature of Property Owner or Authorized Agent Date -ICENSED CONTRACTOR'S DECLARATION hereby affirm under papally of perjury that I am licensed under provisions of Chapter 9 {commencing with Section 7000 Q pi i iof�3 of the Business and Profess Code, and my license is in full force and effect. License Class License No Date V 1 _{ Contractor Signature 777�� PORKERS' COMPENSATION DECLARATION EARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 14100,000i, IN ADDITION TO THE :DST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN SECTION a706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: ] 1 hava 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 th, erf9Knance of the work for which this permit is issued. Polley 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' ranee carder and policy number are: ie of Agent Certify that, in the pi if I should become lature of Applicant_ Policy Number Expiration Date If Ice 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 Califomia, and agre to the workers' compensation provisions of Section 3700 of the Labor Code; I shall forthwith comply With those provisions. _.-.--- ---- ._..._ ------ Date��'Z� ereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work forwhich this permit Is issued (Section 3097, Civil Code). Idefs Name Lenders Address my signature WOW, I certify to each of ilia following: I am the property owner or authorized to act on the property owner's behalf. I have read this appt:cation and the information I have provided is correct. I agree to comply with all applicable city and couordinances and state taws relating to building. construction. I aurhorize re,iresentntives of this city or county nteT the above -identified property for inspection purposes. ignature of Property Owner or Authorized Agent Print Property Owner's or Authorized Ag A-TIO.'l DATE BY i DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY I REGULATIONS PART fit OF TITLE 40 AND AOMD RULE NOTIFICATION TO PFP 1'iT TENDED P RN7T FINAL i UAD 5BE5TOS N If ATION IS NOT APPLICABLE TO CFAT'r'CA'E OF PROPOSEO DEM EON OLrVP4MCY155UEo (•b / :. SIGNATURE: W