HomeMy WebLinkAboutXR2024-0961 - PermitseWPORT. City of Newport Beach IIIIIIIIII I I IIII I IIIIIIIIIII IIII II I II COMB Permit : XR2024-0961
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/� Community Development Department- Building Division X R 2 0 2 4 0 9 6 1
> a y 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No:
Permit Counter Phone: (949) 718-1888 Issued Date : 0411212024
U p S
_ newportbeachca.gov/civic Final Date:
01clrog�Combination Type - Permit Status: Issued
Work Class - Alteration Inspection Area : 1
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 : 111 42ND ST Legal Desc : N TR 3813 BILK LOT 45
Description: DUPLEX RE -ROOF, T/O (E) ROOF & INSTALL #30 FELT & 50YR COMP SHINGLE, 21 SO
Owner: JAY GOODING
Contractor: RON ANDERSON ROOFING
Architect
Address : 111 42ND ST
Address : 2570 GOLDEN AVENUE
Address
NEWPORT BEACH, CA 92663
LONG BEACH, CA 90806
Phone: (610) 745-4541
Phone: (562) 612-8591
Phone:
Con State Lic : 977979
State Lic
Lic Expire : 11/30/2025
Applicant : RON ANDERSON ROOFING
Bus Lic : BT30080007
Engineer
Address : 2570 GOLDEN AVENUE
Bus Lic Expire : 11/30/2024
Address
LONG BEACH, CA 90806
Phone: (562) 612-8591
Workers' Compensation Insurance
Phone:
Carrier: STATE COMPENSATION INSURANCE FUND
Owner/Builder :
Policy No: 9030195
Designer:
Address :
W. C. Expire : 10/16/2024
Address
Phone:
Phone:
Code Edition : 2022
Fire Sprinklers : NO
Construction Valuation : $14,000-00
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 : 2
Added/New sq. ft. Garage: 0
TOTAL sq. ft. 0
Building Setbacks : Front: 10, Side: 3, Side: 3, Rear: 0
Flood Zone: X
Use Zone: R-2 - Two -Unit Residential
PROCESSED BY: /cc _ NO CONSTRUCTION NOISE
SPECIAL CONDITIONS:
L
OWNER -BUILDER DECLARATION
I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the reasons) 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
to 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
of more than five hundred dollars ($500).
I, 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,
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 the
nprovements 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
nproved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7D44, Business and Professions Code: The Contractors' State 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 am exempt from licensure under the Contractors' Slate License Law for me following reason:
,y 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
'rofesslons Code, is available upon request when this application Is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
ignature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7. 0) o ivisi 3 of the Business and Prof s io o:dz, and I ense is i I force
nd effect. License Class License No Date Contractor Signature
PORKERS' COMPENSATION DECLARATION
'ARNING: 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 (5100,0001, IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
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 thr
yrformance of the work for which this permit is issued. Policy No.
9Phave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this ermit i issued. My workers' compensatior
Isurance ca G, LarWd policy tuber ar Jrt Cy
varier /i///Z— /' Policy Number9U��% / G J Fcpiration Date
lame of Agent Phone #
]I certify that, in the performance of the work for which th mil is issod, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree
tat, if 1 should become
`sup"act to does' comps U provisio f Section 3700 of the Labor Code, I shall forthwith complywith those provisions.
ignature of Applicant ys ��� Date is _
IECLARATION RLG.S IN C STRUCTION NDING AGENCY
h.a. ct/ affirm ur,d i 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 Co e).
enders Name Lender's Address
y Inv 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 thin dppli. alion and the information I have provided is correct.
I ag, ee to comply with all applicable city and county ordinan and slate I elating uilding construction.
I aj:honze repres,mtatives of this city or county to a above-iden' propert r inspection purposes,
a of Property Owner or Authorized Agent - Print Property Owner's or Authorized Agent's Name .24
4]IUIJ DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PETT A71T EXPIRED
LJ I SUBMITTED ASBESTOS NOTIFICATION
PERMIT CANCELLED
UEPA
PERMIT EXTENDED
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PERMITFINAL
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