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HomeMy WebLinkAboutXR2024-5294 - PermitsWno?T City of Newport Beach 11II IIIII IIIIII IIII I IIIIIIIIII II IIIIIIIIII II COMB Permit: XR2024-5294 C� @ Community Development Department- Building Division X R 2 0 2 4 5 2 9 4 > I y 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: Permit Counter Phone: (949) 718-1888 Issued Date : 05123/2024 newportbeachca.gov/civic Final Date: Combination Type - SFP Permit Status: Issued Work Class - ADDITION/ALTERATION 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 : 2633 BLACKTHORN ST Legal Desc : N TR 4892 BILK LOT 71 Description: SFR REROOF - T/O TILE, R/R SHEATHING AS NEEDED, INSTL 30# UNDERLAYMENT, INSTIL COMP SHINGLE 30 SQS. Owner: Address Phone: Applicant Address Phone: WILLIAM CALHOUN/DOUGLAS ELLIMAN 2633 BLACKTHORN ST NEWPORT BEACH, CA 92660 REYES SINGLE PLY ROOFING CORP 516 W RIALTO AV RIALTO, CA 92376 Owner/Builder : Address : Contractor : Address Phone: Con State Lic Lic Expire MASTERS Bus Lic: REYES SINGLE MASTERS CORP 516 W RIALTO AV RIALTO, CA 92376 908008 12/31/2025 BT30084413 Bus Lic Expire : 05/31/2025 PLY ROOFING Architect: Workers' Compensation Insurance Carrier: EMPLOYEE SERVICE GROUP Policy No: WC581864609 W. C. Expire : 12/31/2024 Address Phone: State Lic Engineer: Address Phone: Designer: Address : Phone: Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $15,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/Ti sq. ft. Bldg : 0 Occupancy Groups : R-3 No of Units : 1 Alteration sq. ft. Bldg : 0 Bldg Height: No of Stories : 2 Add/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) r ' � t � al � �T� PROCESSED BY: / SPECIAL CONDITIONS: EL"liL���IItI7�tZ72I+Iw�.73i f f Cd: 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 checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code: Arty 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 no 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 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 penalty of not more than five hundred dollars (Sr500). rl 1, as owner of the property, or my employees with Wages as their sole compensation, will do (_,) all of or (_) 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). ❑ 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 am exempt from licansure 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 legal], sell a structure that I have built as an ownor-builder if it has not been constructed in its entiroty by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code., is available upon request when this application is submitted or at the following Web site:hUp:liwww.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent _ Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. License Class License No Date 123 13 `t Contractor Signature WORKERS' COMPENSATION DECLARATION T� NARNING: 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 (S100,000), IN ADD[rION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370E OF THE IASOR LODE, INTEREST, "a ATTORNEYB FEES. hereby affirm under penalty of perjury one of the following declarations: 1 have and WIN 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 in 3erformance 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' ,ante carrier and policy number are: Policy Number of Agent Date 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 if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. of Date_�2,3_I2 `t CLARATION REGARDING CONSTRUCTION LENDING AGENCY III 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 (does 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 application and the information I have provided is correct. I agree to comply with all applicablecity and county ordinances and state laws relating to building construction. I authorize representatives of this city or county to enter the above -identified property for inspection purposes. '1 Orn nature of pmnartv (lcvnar nr Anihnri�ed 4na:ni I f i d � /1 � Print Or...,oe„ n,.,no. � ,,, e,n6,..t.e.1 a.,a..v� n��...a ACTION I DATE BY DE•C1AR9i7RON OF COMPLIANCE WI7H CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQN1D RULE 1 1403 PERMIT EXFIRLD �' u ASBESTOS NOTIFICATION TO PEItMi'T, CAivC'kISURMITTEDLiED � I PPA PERMITFINAL fi/ 10. �l L� r J�,j A56E5T05 NUT IFICA IION I5 NOT APPLICABLE 10 OCCUPANCY OF `I"' _•I �/v gI9NA 1HTF. MQlIT6 OCCUPANCYISSUEL I ur.INen lac- �/� Civil Cade). 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