HomeMy WebLinkAboutXR2024-0258 - Permitsa�wPoRr City of Newport Beach IIII�I�III��III�II�III��I�I�I��IIII II
p d CommunityDevelopment Department Division COMB Permit : XR2024-0258
p P X R 2 0 2 4 0 2 5 8
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No
Permit Counter Phone: (949) 71B-1888 Issued Date : 0210112024
.a.. newportbeachca.gov/civic 3Final Date:
C9lIFOQN`P Combination Type - SFP Permit Status: Issued
Work Class - Re -roof ONLINE 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: 515 FULLERTON AVE
Legal Desc : A TR FIRST ADD TO NEWPORT HEIGHTS BILK 38 LOT 21
Description: SFR REROOF(PARTIAL) WITH COMPOSITION
SHINGLES. 20 SQUARES.
remove existing shingles, replace damaged wood, instal synthetic underlayment, install new Landmark shingles
Owner: r
Contractor: SUPERIOR METAL ROOFING
Architect
Address
Address: 360 E 1 ST ST #701
Address
TUSTIN, CA 92780
Phone:
Phone: (866) 783-4400
Phone
Con State Lic : 865713
State Lic
Lic Expire : 02/28/2025
Applicant: TAYLOR JACKS
Bus Lic : BT30062662
Engineer:
Address : 1601 S Sinclair St Unit C, Unit C
Bus Lic Expire : 03/31/2024
Address
Anaheim, CA 92806
Phone: (714) 865-1804
Workers' Compensation Insurance
Phone:
Carrier: CAROLINA CASUALTY INSURANCE
COMPANY
Owner/Builder :
Policy No: BNUWC0162115
Designer
Address :
W. C. Expire : 1/26/2025
Address
Phone:
Phone:
Code Edition : 2022
Fire Sprinklers : NO
Construction Valuation : $12,000.00
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/Ti sq. ft. Bldg : 0
Occupancy Groups : R-3,U
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: 4, Side: 4, Rear: 5
Flood Zone : X
Use Zone : R-1 - Single -Unit Residential
PROCESSED BY:
SPECIAL CONDITIONS:
I hereby affirm under penally of perjury that t am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed Textile the applicable items)
(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 iiconsed 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 licensors 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).
0 I, as owner of the property., or my employees with wages as their sole compensation, will do C_) all of or f_) 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 withinone year of completion, the Owner -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
0 h 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 properly 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 cannot legail
sell 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 this applicable law, Section 7044 of the Business and
Professions Code, Is available upon requestwhen this application is submitted or at the following Web site:httpJ,••www.legonfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent, _ Date
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) f ivision 3 of the Business and Professions Code., and my license is In full force
and effect. License Class License No Date 7_f Z- 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 t5100,000), 3N ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I hereby affirm under penalty of perjury one of the following declarations:
111 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 the
performance of the work for which this permit is issued. Policy No.
[l have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the workfor which this permit is issued. My workers' compensation
insurance carrier and policy number are;
Policy Number
Date
Tie of Agent Phone a-
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 agree
:, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply With those provisions.
nature of Applicant _ �^-�- Dal I'
' Zy
CLARATION REGARDING CONSTRUCTION LENDLNI5 AGENCY _r /
,reby 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).
,der s Name Lender's Address
my s€gnature 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 1 have provided is correct.
I agree to comply with all applicable city and county ordinances and slate laws relating to building construction
I auff 3rize representatives of this city or county to enter the above -identified property for Inspection purposes. I11/' 1,�
natnro of Procerty. Owner or Authorized Agent �'� Print Property Owner's or Authorized Agent's Name —/ ,- , uL YS Date 2 I `-
ACPON DATE BY I DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
403
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