HomeMy WebLinkAboutXR2023-1060 - Permits�EWPORT City of Newport Beach
Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
i Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
C9</pp0.N�P newportbeachca.gov/inspections
Combination Type - SFP
Work Class - Other
1IIIIIIIIIIIII 111111111111111111111111111111111111111111I 11COMB Permit : XR2023-1060
Plan Check No:
Issued Date : 04/25/2023
Inspection Area :3
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 : 1400 VIVIAN LN Legal Desc : N TR 1805 BILK LOT 31
Description: SFR REROOF REMOVE AND REPLACE COMP SHINGLES 28 SOS
Owner: ANTHONY BELL
Address : 1400 VIVIAN LN
NEWPORT BEACH, CA 92660
Phone
Applicant:
ANDRES GURROLA
Address:
2102 W 9TH ST
SANTA ANA, CA 92703
Phone:
(714)720-8373
Owner/Builder :
Address :
Phone
Contractor:
ANDRES GURROLA
Address :
2102 W 9TH ST
SANTA ANA, CA 92703
Phone:
(714)720-8373
Con State Lic
: 1058217
Lic Expire :
03/31/2024
Bus Lic:
BT30081381
Bus Lic Expire : 04/30/2024
Workers' Compensation Insurance
Carrier: STATE COMP
Policy No: 9268145
W. C. Expire : 1/17/2024
Architect
Address
Phone
State Lic
Engineer
Address
Phone
Designer
Address
Phone:
Code Edition :
2022
Fire Sprinklers :
NO
Construction Valuation : $18,000.00
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:
1
Added/New sq. ft. Garage: 0
TOTAL sq. ft. : 0
Building Setbacks :
Front: 20, Side: 6, Side: 6, Rear: 6
Flood Zone :
X
Use Zone:
R-1-6000 - Single -Unit Residentii¢000
indicates minimum
lot area)
PROCESSED BY:
SPECIAL CONDITIONS
h`l211a 7/111/14 3
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkrnark(s) I have placed next to the applicableitem(s)
Section 7031,5, Business and Professions Code: Any Cfly or county that requires a peril 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' Slate License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
'mfessions 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
lot more than five hundred dollars ($500).
1, 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,
lusiness 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
mprovements 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
mproved for the purpose of sale).
1, as 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
I p€y 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 ficensure under the Contractors' State License Law for the following reason:
ly 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
�o11 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
?rofessions Code, Is available upon request when this application is submitted or at the following Web siteihttp:/iwww.leginfo.ca.govlcalaw,html.
>ignature of Property Owner or Authorized Agent _ Date
_ICENSED CON7 kMrTOR'S DECLARATION
hereby affirm unue, penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 0)-of ivisi6 3 of the Business and Prof o s L� e, and n Iicens s T u I force
r;,C .a:Cc:. Lice:r c Class License No Date °- -29 e Contractor Signature
NORKERS' CON ENSATION DECLARATION
r RNAG: ,-AILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRE THOUSAND DOLLARS (S1D0,000), IN ADDITION TO THE
,UST OF COMPENSATION, nAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES,
hemby Pffirm under panaky of perjury one of the following declarations:
J I have and Y fi: 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, forth
�evorma�ce of the work for which this permit is issued. Policy No.
0bI 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` compensatiol
li rzanc€ carrier Rid po!Icy number are:
:arrler_ _ Policy Number Expiration Date
Ndme of ,Agent _ _ Phone #
:1I certify that, in the pe0,0
work 10 hiOh this permit' sue shall n employ any person in any manner so as to become subject to the workers' - mpansatio aws o alifomia, and agra
hat, if I should become srkers' pensalion pr sue Sectin 00 of the Labor Code, I shall forthwith comply w th those provisions.
>Ignature of Applicant � DateTECLARATION REGARUCTION LENDING A ENCYhereby affirm under penat there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Ci II Code).
-ender's Name Lenders Address
iy 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 come
I agree to comply with all applicable city and coon y ordma es and - a laws retail g to b ' ding nslruction.
I authorize representatives of this city or coup to ant r abov titled pro Bob n purposes.
iignature of Property Owner or Authorized Agent artOwner's or Authorized A ant's Name Da
ACTION DATE BY LARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 610E TITLE AO AND AQF RULE
PERMIT EXPIRED
PERMITCANCELLED
___..._........._.—._........_...._.....
PERMIT EXTENDED
PERMITFINAL
CERTIFICATE OF
S.1-23
OCCUPANCYISSUED
M
ASBESTOS
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