HomeMy WebLinkAboutXR2023-0761 - PermitsCity of Newport Beach
Community Development Department- Building Division X R 2 0 2 3 0 7 6 1100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
newportbeachca.gov/inspections
04'.
Combination Type - SFP
Work Class - Other
COMB Permit:XR2023-0761
Plan Check No
Issued Date : 03/22/2023
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: 416 LUGONIA ST
Legal Desc : N TR 772. BILK 15 LOT 20 TR 772 LOT 20 BLK 15 ALL (EX NELY 18 FT) THEREOF
Description: SFR REROOF (GARAGE ONLY) T/O FLAT ROOF AND REPLACE W/ CAP SHE6TB.U.R 8 SQS
Owner: MATTHEW WILEY
Contractor: VEROME ROOFING
Architect
Address : 409 COLTON ST
Address : 20 E 55TH ST
Address
NEWPORT BEACH, CA 92663
LONG BEACH, CA 90805
`, e
Phone:
Phone: (562)619-4934
Phone: A"6
Con State Lie : 1086801
State Lie
Lie Expire: 01/31/2024
Applicant: VEROME ROOFING
Bus Lie: BT30080901
Engineer
Address: 20 E 55TH ST
Bus Lie Expire : 03/31/2024
Address
LONG BEACH, CA 90805
Phone: (562) 619-4934
Workers' Compensation Insurance
Phone:
Carrier: STATE COMPENSATION INSURANCE FUND
Owner/Builder:
Policy No: 9310132
Designer
Address :
W. C. Expire: 12/17/2023
Address
Phone:
Phone:
Code Edition : 2022
Fire Sprinklers : NO
Construction Valuation : $7,000.00
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: 5, Side: 3, Side: 3, Rear: 5
Flood Zone : X
Use Zone : R-1 - Single -Unit Residential
PROCESSED BY:
SPECIAL CONDITIONS
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable Remits)
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 toits issuance, also requires the applicant for
ie permit to file a signed statement that he or she is licensod pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
'rofessions Code) or that he or she is exempt from licensee 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
of more than five hundred dollars ($50D),
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,
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
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)-
1 I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does not
9ply 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' State License Law for the following reason:
1y 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
all a structure that I have built as an ownor-builder if it has not been constructed in its entirely by licensed contractors. ) understand that a copy of the applicable law, Section 7044 of the Business and
'rofessiobs 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_N Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section O) of Division 3 of the Business and Profe�i6ns ode, and y license is In full force
nd effect. License Class License No Date Contractor Signature ��( /
VORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARS ailD0,00a, IN ADDITION TO THE
DST 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 w1f 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
ormance of the work for which this permit is issued. Policy No.
xe ,.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' eompensa
franca carrier and policy number are:
Policy Number fration Date
of Agent Phone #_
I certify that, in the performa ce 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' Componsatton laws Of California, and agref
t, if I should become s bje to the wor ors venation provisions of. Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
�1 sN
nature of Applicant / Date O{7-d7-7-
CLARATIGN REGARDING TRUCTION LENDING AGENCY
areby affirm under penalty of perjury that thereis a construction lending agency for the performance of the work forwhich this permit is issued (Section 3097 Civil Code).
Wer's Name Lender's Address _
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 u ty ordinances and state laws relating to building construction.
I authorize representatives of this city or cou o entert a above, -identified property for inspection purposes. ///y\ q , /iJ
nature of Procarb, Owner or Aulhorzed AaenU /y Print Prooertv Owner's or Authorized Agent's Name/ \ I iri Ril(-r✓1 Ve-Ile, }Y. Ate 6y-ZZ-7-3
ACTION DATE. BY1 DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE AO AND AQNIO RULE
PERAIITrANCELLLED +__I-'i LJ I SEPA ITTED ASBESTOS NOTIFICATION TO
PERMITFINAL I(,/')T/111 J(Z- �i�/Jgll E5Tg5 yOTIFICA I ION 15 NOTAPPUCABLE TO
CERTIFICATE OF I 44 �_UU(, ,jI-PROOpbSED DI �MOLITIOhd n�
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