HomeMy WebLinkAboutXR2023-3215 - Permits�EWPOaT City of Newport Beach 111 IIIIIIII 111111111111111p111111111111111111p111p1111 jj COMB Permit : XR2O23-3215
Community Development Department- Building Division X R 2 0 2 3 3 2 1 5
- 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No
Permit Counter Phone: (949) 718-1888 Issued Date : 11/13/2023
u z newportbeachca.gov/civic Final Date:
C9C/F00.N�P Combination Type - SFP Permit Status: Issued
Work Class - Other Inspection Area : 5
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 : 307 CARNATION AVE
Legal Desc : P BK 222 PG 29 PAR 1 UN 1 P M 222-29 PAR 1 UNIT 1
Description: SFR PARTIAL REROOF - T/O EXISTING SHINGLES, INSTL NEW UNDERLAYMENT, R/R SHEATHING AS NEEDED, INSTL 11 SQ OF STANDING SEAM METAL
ROOF.
Owner: LICA LLC
Address : 307 CARNATION AVE
CORONA DEL MAR, CA 92625
Phone
Applicant:
TAYLORJACKS
Address :
1601 S Sinclair St Unit C, Unit C
Anaheim, CA 92806
Phone:
(714)865-1804
Owner/Builder
:
Address :
Phone :
Code Edition :
Type of Construction
Occupancy Groups:
Bldg Height:
Building Setbacks
Flood Zone
Use Zone :
PROCESSED BY:
Contractor :
SUPERIOR METAL ROOFING
Architect
Address :
360 E 1 ST ST #701
Address
TUSTIN, CA 92780
Phone:
(866)783-4400
Phone:
Con State Lic
: 865713
State Lic
Lic Expire :
02/28/2025
Bus Lic:
BT30062175
Engineer:
Bus Lic Expire : 01/31/2024
Address
Workers' Compensation Insurance
Phone:
Carrier : STATE FUND
Policy No:
9332093
Designer
W. C. Expire:
1/26/2024
Address
Phone:
2022 Fire Sprinklers :
V-B Fire Hazard Zone
U,R-3 No of Units :
No of Stories
X
RM -Multiple Resident
SPECIAL CONDITIONS:
y
NO Construction Valuation : $35,000.00
NO Added/New/TI sq. ft. Bldg : 0
1 Alteration sq. ft. Bldg :
1 Added/New sq. ft. Garage : 0
TOTAL sq. ft. : 0
OWNER -BUILDER DECLARATION
1 hereby allInn under penalty of perjury that I am exempt front the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(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 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 of the Business and
Professions Code) or that he or she is exempt from lcensure 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
not more than five hundred dollars ($500).
El I, as owner of the property, or my employees with wages as their sole compensation, will do I all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Susinass 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).
'.❑ 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
a pfy 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'
By 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 cannotlegalty
soil a structure that I have built as an owner-bmldor if it has not been constructed in its entiroty by licensed contractors. I understand that a copy of the applicable law, Section 7044 of tho Business and
Professions Code, is available upon request when this application is submitted or at the following Web site:http:liwww.leginfo.ca.govlcalaw.html.
Signature of Property Owner or Authorized AgentDate
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of pedury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) Pf Di Ision 3 of the Business and Professions Code, and my license is In full force
,and effect. License Class License No Date 111r ;12 1 Contractor Signature ��—
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),I14 ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDE') FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
ilI hereby affirm under penalty of perjury one of the following declarations:
Q 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, ter IN
performance of the work for which This permit is issued. Policy No.
PPI 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' compensatior
Insurance carrier and policy num`ber are: I y
(Carrier 5�-v. rL.� C Policy Number 33 2-dy 3 Expiration Date Zd L
Name of Agent Phone #
0i certify that in the performance of the work for which this permit is issued. I shall notemploy any person in any manner so as to become subject to the workers' compensation laws of California, and agree
that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply Win those provisions.
Signature of Applicant �_�Date_..,
DECLARATION REGARDING CONSTRUCTION. LENDING AGENCY
it hereby 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 Cade).
(Lender's Name Lender's Address
By 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 county ordinances and state laws relating to building construction. r
I authorize representatives of this city or county to enter the bove-identified property for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name. 16v- S ILS Date
ACTION DATE BY f DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
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