HomeMy WebLinkAboutXR2023-2644 - Permits�EWPo T City of Newport Beach ����p���Il������p���►�p���►�������111111111111111111 ill COMB Permit : XR2O23-2644
pF A Community Development Department - Building Division X R 2 0 2 3 2 6 4 4
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No
S Permit Counter Phone: (949) 718-1888 Issued Date : 09/20/2023
newportbeachca.gov/civic
Final Date:
Combination Type - SFP Permit Status: Issued
Work Class - Repair Inspection Area : 4
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: 2601 ALTA VISTA DR Legal Desc : N TR 4893 BLK LOT 108
Description: SFR REROOF, T/O EXISTING SHINGLES, INSTL SYNTHETIC UNDERLAYMVNTREPLACE SHEATHING AS NEEDED, INSTL NEW COMP SHINGLES (57 SQS)
Owner: ROUSSELOT THOMAS TERRY TR
Contractor: ALL SERVICE ROOFING
Architect
ROUSSELOT QPRT
Address : 2601 ALTA VISTA DR
NEWPORT BEACH, CA 92660
Address : 16371 HEMLOCK ST
FOUNTAIN VALLEY, CA 92708
Address
Phone:
Phone: (714) 457-0906
Phone:
Con State Lie : 1070058
State Lie
Lie Expire : 10/31/2024
,
Applicant : ALL SERVICE ROOFING
Bus Lie : BT30075513
Engineer
Address : 16371 HEMLOCK ST
Bus Lie Expire : 06/30/2024
Address
FOUNTAIN VALLEY, CA 92708
.. ,
Phone: (714) 457-0906
Workers' Compensation Insurance
Phone:
,
Carrier: STATE COMPENSATION INSURANCE FUND
,
Owner/Builder:
Policy No: 9284028
Designer:
Address :
W. C. Expire : 9/14/2023
Address
Phone:
Phone:
,
Code Edition : 2022
Fire Sprinklers : NO
Construction Valuation :
$40,000.00 .. ,
Type of Construction : V-B
Fire Hazard Zone : NO
Added/NewITI 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: L
SPECIAL CONDITIONS
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury, that I am exempt from the Contraclors State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable fterl
(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 applicant for
the 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
Professions Code) or that he or she is exempt from ticensureand 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
not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with. Wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business 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
improvements 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
improved for the purpose of sale).
ri 1, 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
apply 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 I am exempt from licensure under the Contractors' State License Law for the following reason
By my signature below 1 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-legall,
sell a structure that I have built as an owrtor-builder if it has not boon constructor] in its entirety by licensed contractors. 1 understand that a copy of the applicable low, Section 7044 of the Business and
Professions Code, is available upon request when this application is submitted or at the following Web site;tlttpr/hvW'svaeginfo.ca.gav/aalaw.html.
Signature of Property Owner or Authorized Agent _ (late _
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of p urn {at i am licensed under provisions of ChApter ( endng with a`tc on
77 % f Qh Sion 3 of the Busoess d Professoory^+ - oda, and q tcDOES is In full force
and effect.License Class (.,`-5�\ License No (�/li S� \ / O n�J Contractor Diur¢ %/L/�l��z-ir�
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE is UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR 1N SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES_.
I hereby affirm ends, Lnafty of perjury one of the following declarations:
13 1 Itsvp and will matntain a certificate of consent to self -insure lot workers compensation, Issued by the Director of industrial Relations as provided for by Section 3700 of the Labor Code, for ih
u.0 iai ee of the work orwhich this permll Is Issued, Policy No.
av^ and will maintain workers' compensation insuran a as required by Section 3700 of the Labor Code.. for the performance of the work for which this permit is Issued. My workers' compensatioi
Ins rrncocarrier ens olio numberare., r rZ /
policy 1 �/'
Carrier G.{)tM C �v'15, `Policy Number � (/� � Expiration Date
Npma rf Agent IPhone k
❑ vui I"y that, in the performance of the work for which this permit's issued, I shell not employ any person in any manner so as to become subject to this workers' ompensalion laws of California, and agra
ih t, ti' ;haul co sub' t to the war rs' compensation provisions of Section 9700 of the Labor Code, I shall forthwith comply with those provisions.
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&tnavls if Ap �t t.-.'� � Dal �
nit -A ARAIN f2F • IFPdNC rnNS�ENntNG AGENCY
It 3J, u;'flrm under I}eInally of perjury that there is a construct ion lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
ir'e-`; Name Lender's Address
my signature below, I car* to each of the following:
I am the property owner or authorized to act on the properly owner's behalf.
I have read this application and the mfomtetion 1 have provided is correct.
pp
I agree Io comply with all applicable city and County ordinances and state laws relating to building construction.
I authorize representatives of this city county tD r a above-� �e tified property for inspection purposes.
nature of Property Owner or Author ed Agent //�>%'--��Y_ Print Property Owner's or Authorized Ate
ACTION i DATE. - BY DECLARAT€ t4OFCOMPLIANCEUUTHCOOK.OFFF.DERAL FOR OFFICE USE ONLY r
REGULATIONS PART 51 OF TITL£ 40 AND AOMD RULE /
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