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Home My WebLink AboutXR2022-2476 - Permitsr`W PO,gr City of Newport Beach p`' f O Community Development Department - Building Division r "< y 100 Civic Center Drive, Newport Beach, CA 92660 r _ - _ n Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 <+ronNNP newportbeachca.gov/inspections Combination Type - SFP Work Class - Alteration COMB Permit: XR2022-2476 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Plan Check No : PC2022-2326 Issued Date : 11/14/2022 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 : 1001 BALBOA BLVD W Legal Desc : N TR 234 BILK 10 LOT 23 TR 234 LOT 23 BLK 10 NELY 60 FT Description: SFR REPLACE ROOF FRAMING AND ROOF MATERIAL Owner: JUDY BACA Address : 1001 W BALBOA BLVD NEWPORT BEACH, CA 92661 Phone Applicant: SHEPHERD CONSTRUCTION Address : 327 S CENTER ST ORANGE, CA 92866 Phone: (949)444-1992 Owner/Builder : Address : Contractor: SHEPHERD CONSTRUCTION Address : 327 S CENTER ST ORANGE, CA 92866 Phone: (949)444-1992 Con State Lic : 479977 Lic Expire: 04/30/2023 Bus Lic: BT30078366 Bus Lic Expire : 03/31/2023 Workers' Compensation Insurance Carrier: NORGUARD INSURANCE COMPANY Policy No: DOWC352578 W. C. Expire: 8/12/2023 Architect Address Phone: State Lic Engineer: BENJAMIN AMGAD SA/vwWEL Address: 24310 MOULTON PKWY SO-105 -- LAGUNA WOODS, CA 92637 Phone : (949) 446-1417 Designer Address Phone: Phone Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $75,000.00 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 iN 0 ( O N'`A, I�t:�rlf+on sq.`ft. Bids _+:'-z i- Bldg Height : No of Stories : 1 Added/New sq. ft. Garage: 0 TOTAL sq. ft. 0 Building Setbacks : Front: 10, Side: 3, Side: 3 Flood Zone : X ON THE WEEK Ni 1 Use Zone: R-2-Two-Unit Residential PROCESSED BY: SPECIAL CONDITIONS: LIQUEFACTION, HIGH DENSITY AREA — T q�i�� 1 Il OWNER -BUILDER I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law ( Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7 not more than five hundred 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 w Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through empll improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completiol improved for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Busi apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor PUTS ❑ 1 am exempt from licensure under the Contractors' Slate License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year f sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I undersl Professions Code, Is available upon request when this application is submitted or at the following Web site:http:I1www.legmfo.ca Signature of Property ❑wogs or Authorized Agent LICENSEF) CONTRAC7 OR'S DECLARATION I hereby affirm undei penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 0 f ivi and effect. License Class License No Date 7 ' COMPENSATION DECLARATION 'ARMING: FAILURE TO -ECURC WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES DST C' C09PENSAYION, UAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under nenalty, of perjury one of the following declarations: ave'and will ma*ntzin a certificate of consent to self -insure for workers compensation, issued by the Director of Im o ce of the work for which this permit is issued. Policy No. P LI h e t,nd will maintukt workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perfol TICE carrier and policy number are: :61ner_ _ Policy Number lame of Agent certify that, in the perfomrance3LWe work for if I should become subject t e w kern co lature of Applicant Blow by the checkmark(s) I have placed next to the applicable items) or repair any structure, prior to Its issuance, also requires the applicant for hapter 9 (commencing with Section 7000) of Division 3 of the Business and 31.5 by any applicant for a permit subjects the applicant to a civil penalty of k, and the structure is not intended or offered for sale (Section 7044, ees' or personal effort, builds or improves the property, provided that the the Owner -Builder will have the burden of proving that it was not built or and Professions Code: The Contractors' Stale License Law does not to the Contractors' Stale License Law), to completion of the improvements covered by this permit, I cannot that a copy of the applicable law, Section 7044 of the Business and of the Business and Prof to9e'C nd my license Is In full force c Contractor Signature /f __- CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1a100,0001, IN AOOTTION TO THE Relations as provided for by Section 3700 of the Labor Code, for of the work for which this permit is issued. My workers' Date Led, I shall ploy any person in any manner so a4to become subject to the workers' compensation laws of California, and agre of S n 0 of the Labor Code, 1 shall forthwith co ply with those provisions. Dated>,t Keby affirm under penalty of perjury tbatfftrais�Onstruction lending agency for the performance of the work for which this Ides s 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 ha rovidedTRA I agree to comply with all applicable city and co ty ordl ances relating to building construction. I authorize representatives of this city or cou toe the roperty for inspection purposes, nature of Pronertv Owner or Authorized Ana Print Prooertv Owner's or Authorie DATE BY 166��P20MPLMNCE WITH CODE OF FEDERAL I FOR OFFICE USE ULATIONS PART 61 OF TITLE. 40 AND AQMD Rt11.F PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA _ PERMIT EXTENDED QMD Zy PERMIT FINAL BESTOS NOTIF TION I NOT C LE TO -C£RTf MI PERMIT FI NAL �(L� � a PROPOSED DEM TIOr�j �/ OCCUPANCY ISSUED SIGNATURE: ,,// Is issued (Section 3097, Civil Code). Name