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HomeMy WebLinkAboutXR2023-2093 - Permitso��elPoRr City of Newport Beach Community Development Department- Building Division F - 100 Civic Center Drive, Newport Beach, CA 92660 u r+ ¢ Permit Counter Phone: (949) 718-1888 .�.. newportbeachca.gov/civic Combination Type - SFP ' Work Class - Repair iiiiiiiiiii II COMB Permit : XR2023-2093 Plan Check No: Issued Date: 07/28/2023 Final Date: Permit Status: Issued Inspection Area : 8 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 : 1012 NOTTINGHAM RD Legal Desc : N TR 3031 BILK LOT 63 Description: SFR RE -ROOF DETACHED GARAGE WITH IN) SHEATHING, 30# FELT UNDERLAYMENT AND GAF COMPOSITION CLASS W SHINGLES. 8 SQUARES Owner: VICTOR WOODWORTH Address : 1012 NOTTINGHAM RD NEWPORT BEACH, CA 92660 Phone Applicant: Jeff Ratliff Address : 10 Arada Street Rancho Mission Viejo, CA 92694 Phone: (714)450-5563 Owner/Builder Address : Contractor: KENNETH DEAN ALCANTRA Architect Address : 10 ARADA ST Address RANCHO MISSION VIEJO, CA 92694 Phone : (949) 246-8784 Phone Con State Lic : 544282 State Lic: Lic Expire : 1013112024 Bus Lic : BT30080448 Engineer Bus Lic Expire : 01/31/2024 Address Workers' Compensation Insurance Phone Carrier: STATE COMPENSATION INSURANCE FUND Policy No: 9338236 Designer: W. C. Expire : 5/4/2024 Address Phone: Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $6,500.00 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-1-600.00 -- Single -Unit Residential (6000 indicates minimum lot area) V PROCESSED BY: SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmatk(s) I have placed next to the applicable iterl 3ecllon 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 1e 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 'rofeswons 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 Density of of more than five hundred dollars ($500), 1 1, 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 (Seclion 7044, Business and Professions Code: The Contractors' Stale License Law does not ppiy 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). 3 1 am exempt from licensure under the Contractors' State License Law for the 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 oil a structure that I have built as an ownor-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 srofessions Code, is available upon request when this application is submitted or at the following Also site:http:fAvww.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 70 ) f Divi tan 3 of the Business and Professi s o e, and m� fcense i�5 In full force nd effect. License Class License No Date ,7 Contractor Signature /�1fh9) 4,w PORKERS' COMPENSATION DECLARATION 10 'ARNING: FAILURE TO SECURE WORNSRS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLDYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (S100,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3T06 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, e0brmance of the work for which this permit is issued. Policy No. 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' Too earner ana oilcy nu Der are: f� Policy Number 33 G 2 5 Expiration Date of Agent Phone # certify 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 if I should become subject.,to the workers' compensat(eq provisions of Section 3700 of the Labor Code, I shall forthwith comply with (hose provisions. of Date � ✓� % Ireby 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). Ides 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 ..Fp'ication andthe information I have provided is correct. I agree to corri '.r'h all applicable oily and county ordinances and state laws relating to building construction. ' authrize rerress.^.`.rtives of this city or county tP enA (te atyove-id qmtified property, for Inspection purposes. , n r rn_ a/i l nature of Pl Owner or Authorized Agent y Print Property Owner's or Authorized A AC21oN DATE BY I DECLARATION MPUANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY , j j REGULATIONS PART 61 OF TITLE AO AND AOMQ RULE I SUBMITTED AS RFSTOS NOTIFICATION TO PERMIT Cl,NCEIlED Pt-RAdT F14AL — L !J'Zi ASBESTOS NOT IFICA I"IONI5 NOT APPLICABLE TO 'A CERF'CATE OF s ROFOSEC DEM I I N O_CUPAN1 Yt.55UE9 SIGNA7URE� /i7; Q"g�jj Date/2,! a3