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Home My WebLink AboutXR2023-1421 - Permits�gwaoRr City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XR2U23-1421 D4 Community Development Department - Building Division X R 2 0 2 3 1 4 2 1 �i 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2023-0284 r D Permit Counter Phone: (949) 718-1888 Issued Date : 05/30/2023 u newportbeachca.gov/civic Inspection Area : 3 Combination Type - SFP Work Class - Other 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: 1621 INDUS ST Legal Desc : N TR 4307 BILK LOT 18 Description: SFR T/O (E) COMP/TORCH-DOWN. INSTALL 1 LAYER FELT, COMP SHINGLES & TORCH -DOWN (FLAT AREA) 30 SQ TOTAL. R/R PLYWOOD IF Owner: MERRELL JOSHUA TR Address : 2182 MESA DR newport beach, CA 92660 Phone : (714)742-5552 Applicant: SHORELINEROOF.COM Address : 17603 ERIC AVENUE CERRITOS, CA 90703 Phone: (562)402-6744 Owner/Builder : Address : Phone : Contractor: SHORELINEROOF.COM Architect: Address : 17603 ERIC AVENUE Address CERRITOS, CA 90703 Phone: (562)402-6744 Phone: Con State Lie : 780947 State Lie Lie Expire : 06/30/2024 Bus Lie: BT30081688 Engineer: Bus Lie Expire : 05/31/2024 Address Workers' Compensation Insurance Phone: Carrier: STATE FUND Policy No: 9035461 Designer: W. C. Expire: 12/1/2023 Address Phone: MASSARO ANTHONY P 2533 GREENBRIAR LN STE A MESA, CA 92626 (714) 556-8299 Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $12,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/Ti sq. ft. Bldg : 0 Occupancy Groups : U,R-4 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: 20, Side: 5, Side: 5, Rear: 25 Flood Zone : X Use Zone : SP-7 - Santa Ana Heights Specific Plan PROCESSED BY: _ SPECIAL CONDITIONS: 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 the permit to file a signed statement that he or she is licensed pursuant to the previsions 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 ficensure 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). 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) 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). ri 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 a ply 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). 1 am exempt from Ilcensureunder the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided far at least one year prior to completion of the improvements covered by this permit, I cannot legal) sell 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 Professions Code, is available upon request when this application is submitted or at the following Web slte:http:llwww.laginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent _ Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that. I am licensed under provisions of Chapter 9 (commencing with Section 7000_''e f Division 3 of the Business and Prg Codeand my license is In full force and effect. License Class License No Date 70 Z- Contractor Signature WORKERS' COMPENSATION DECLARATION „7�l WARNING: 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 (S100,000), IN MD91ON TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES. I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to selfAnsure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th p formance of the work for which this permit is issued. Policy No. aye 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` compensatio rance arr r a�J,d polic umber re'. Carrier,({[(yAl. Policy Number %W 3 S Z6 Expiration Date Name of Agent Phone 8 1 certify that, in the performance 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 California, and agre that, if I should become s bjec t worker compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature Of: Applicant D�,% U Z� DECLARATION RIEGAA6110 CONSTRUCTION LENDING AGENCY ✓✓✓✓✓✓��`` I hereby 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). Lenders Name Lender's Address By 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 1 have provided is correct. I agree to comply with all applicable city and cowity ordinances and state laws relating to building construction. I authorize representatives of this city or count.y to enter the a ove-identifted property for inspection purposes. Signature of Property Owner or Authorized A an Print Property Owner's or Authorized A ent's Nam L svr Date (� ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS. PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO _ PERMIT CANCELLED UEPA PERMIT EXTENDED VlA_LIINp PERMIT FINAL �ji7 n� ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATE OF 1 /' ` PROPOSED DEMO T€ON OCCUPANCYISSUED l SIGNAFUR