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Home My WebLink AboutXR2023-0843 - PermitscEvuaoRr City of Newport Beach o� @ Community Development Department- Building Division X R 2 0 2 3 0 8 4 3 COMB Permit : XR2023-0843 > 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: >+� S Permit Counter Phone: (949) 644-3288 Issued Date : 03/30/2023 Inspection Requests Phone: (949) 644-3255 Inspection Area : 3 q<�ce0.N� newportbeachca.gov/inspections 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: 1821 HIGHLAND DR Legal Desc : N TR 3057 BILK LOT 3 Description: SFR REROOF T/O ASPHALT SHINGLES REPLACE WITH NEW GAF SHINGLES 35 SQ'S; ESR -1475 Owner: PAUTSCH DWAIN E TR Address: 341 NASSAU RD COSTA MESA, CA 92626 Phone Applicant: SHELLEY STEPHEN ROOFING CO Address : P 0 BOX 1286 SAN CLEMENTE, CA 92674 Phone : (949) 292-2942 Owner/Builder : Address : Phone Contractor: SHELLEY STEPHEN ROOFING CO Address : P O BOX 1286 SAN CLEMENTE, CA 92674 Phone: (949)292-2942 Con State Lie : 525478 Lie Expire: 09/30/2024 Bus Lie: BT30079642 Bus Lie Expire: 09/30/2023 Architect Address Phone: o00 State Lie Engineer Address Workers' Compensation Insurance Phone Carrier: STATE+COMPENSATION+INSURANCE+FUN D Policy No: 1137303 W. C. Expire : 6/1/2023 Designer: Address Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $21,750.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/Ti sq. ft. Bldg: 0 Occupancy Groups : U,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 Residential (6000 indicates minimum lot area) PROCESSED BY SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjurythat 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 applicableitem(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 eipplicent for io 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 or the Business and -rofessions Code) or that he or she is exempt from lieensure 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 at more than rive hundred dollars ($500). 3 t, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) 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 rate year of completion, the Owner-Soitderwill 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' State License Law does not poly to an owner of property who builds or Improvesthereon; and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I I am exempt from lieensure under the Contractors' Slate 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 legalb 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:hltp:ltwww.leginfo.ca.go0colaw.html. signature of Property Owner or Authorized Agent --__- Bate .ICENSiD CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 of Division 3 of the Business and PQLOSSion C n tic Is In full force ad effect. License Class License No Date Contractor Signatur es VORKERS' COMPENSATION DECLARATION IARNING: FAILURE TO S GLRE WORHERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLDYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000), IN AOOnION TO THE OST OF COMPENSA, ION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND ATTORNEYS FEES. harebv ai;lrm under penalty of perjury one of the following declarations: I ve and wiz meirlairr a certificate of consent to selfinsurefor workers" compensation, Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th ee of the work for which this permit is issued. Policy No. A and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code. for the performance of the work for which Ibis permit is issued. My workers' canner erd ro'icy number are: Policy Number Expiration Date is of Agent Phone # redifv 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 i(( I should become ,ubject to thjl w 1Isers-'spmpensgflon prop sions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. of Applicant _ CIBgATION FlSe alill C6,WTRUCITON LENIDING A3il6ICY Dates `-� — 30 .'k iireby affirm unuer 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). iders Name Lenders 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 incorrect. I agree to comply with all applicable city and county ordinances and state Is I authorize representatives of this city or county to ante�ft�brwe>idog lf* ACTION PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE Of OCCUPANCY ISSUED DATE I BY 15- or g to building construction. for inspection purposesu vner's or Authorized AD OF FEDERAL i FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND ACLMD RULE 1403 ASBESTOS NOTIFICATION JS NOTIFICATION IS NOT APPLICABLE TO DEMOLITION --?Cj�2