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Home My WebLink AboutX2021-1951 - Permitse��" City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2021-1951 a ., 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 1 9 5 1 Project No : 1705-20211 ,. _ - Permit Counter Phone (949)644-3288 w .. sr Inspection Requests Phone (949)644-3255 Issued Date :07127/2021 `:'tzvq,u'�'`' Combination Type - MFP - Inspection Area : 1 F , PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 07/27/2024 OR PERMIT WILLBE IN LIC Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays qt pl Job Address: 108 26TH ST NB J e,`` �+G n A Description: MFR REMOVE/REPLACE DRY -ROT @ RAIL & DECK, W/LIFE DECK ESR#2701 *STOP WORK 121-2296 t5xjl 1`N� Legal Desc.: NEWPORT BEACH CITY BLK 25 LOT 8 Owner: OPITTEK EUGENE Contractor: TIM OUTZEN ROOFING Architect: eNF%OSECr Address: 235 VIA SOCORRO Address: 1059 S CLIFFORED AVE Address: SAN CLEMENTE CA 92672 RIALTO CA 92376 { f_cp►`,""" ` GO�• Phone: Phone: 626-792-5171 Phone: [.-' Ad �ge e- tI 'L _y Applicant: OUTZEN TIM Con State Lic: 1017146 Engineer: MXc r� � Address: 1059 S CLIFFORD AVE Lic Expire: 08/31/2022 Address: RIALTO CA 92376 Bus Lic: BT30076059 Phone: 714-815-5165 Lic Exp Date: 07/31/2022 Phone: State Lic: Code Edit : 2019 Worker's Compensation Insurance Designer: OUTZEN TIM Type of Construction: VB Carrier: STATE COMP. Address: 1059 S CLIFFORD AVE Occupancy Group: R3/U Policy No: 9144811 RIALTO CA 92376 Added /New sq.ft. Bldg: 0 Expire: 11/0112021 Phone: 626.792-5171 Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: / Special Conditions: LIQUEFACTION AREA No of Units : 2 Front: / PLAN ATTACHED TO Bldg Height: 0 Left: / PERMIT - Bldg Sprinklers: Right: / Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $15.000.00 Building Permit Fee: $331.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $287.97 Additional Fee: $0.00 Plan check Fee : $52.00 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Investigation Fee: $331.00 Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 PAN Plan Check : $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 - $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE: $1,002.97 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $1,002.97 PROCESSED BY: PVBr-rC WORKS APPROVAL: a ... ... c ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: `m° .",, 415RROVAL11d ISGLE: ° e d. OWNER -BUILDER DECLARATION I hereby affgm 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) 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 ie 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 'rofessions Cduc; nr 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 thae five hutic red 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, tusiness 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 forMtte purpose of sale) ' I, a"s'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 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). am exempt from licensure under the Contractors'=State.,License Law for the following reason: iy my signature below. I'acknowledge that, except for mypersonal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot Iegall) ell a structure that l have built as an owner-buitde['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 'rofessions Code, is available upon:lrequest when this appl'icztion is submitted or at the following Web site:http://www. leginfo.ca.gov/calaw.htmi. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION; hereby affirm under penalty o erju that I� aam licensed under provisions of Chapter 9 ( ommencing with Section of D' ision of the Business and Pro s lons_sCC a and rises In full force nd effect. License Class �- �� l License No /O i 7 9 io Date Contractor Signature / _i- VORKERS' COMPENSATION DECLARATION IARNING: 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 IE100,0001, IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S 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 th ,?erf mance of the work for which this permit is issued. Policy No. have and wilLmajQtain workers' cpawinsaflon insurance, required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatiol Isurance came d po' y number are: 1. Ler, :arrier �— n 1 �Poliav N tll eri Expiration Date of Agent :1I certify that, in the performance of the wol 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 khat, if I should become subject to t_he okers co/r17/�¢nsatio r ision f Section 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of Applicant � - -f •�� Date1 )ECLARATION REGAR STRUCTION ENDIN AGE C 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). -ender's Name Lender's Address 3y 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 all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or count bove-iden Tied y f inspection purposes. 3ignature of Property Owner or Authorized Agen - rint Property Owner's or Authorized Agent's Na 1 OJ2( 1.t. D '7 ACTION DATE BY LARpTION OF COMPLIANCE IT CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 63 OF TITLE 40 AND AQMD RULE f 1403 •<• •a• • ••s uiwoimiiiwn�ovniw-,vv neni,u,.v • s PERMIT CANCELLED � EPA' �• • • w •• -+-r • PERMIT EXTENDED QMD PERMII FINAL 16/2)/C,( �JL- PASBESTOS TIFICATION IS NOTAPPLIC TO CERTIFICATE OF 11,, ll PROPOS D� E OLITL1 y2 -v--- OCCUPANCYISSUED 61GNARE: