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Home My WebLink AboutXR2022-1930 - Permits¢��WPORr City of D_ "I Community 100 Civic C Permit Cou U } Inspection I c9GIF00.N�P newportbee Work PERMITS NO CONSTRI Job Address : 221 ABALOh Description : SFR PARTIA Owner: GARY FOX Address: 221ABALONE, 92662 Phone: Applicant : GARY FOX Address : 221 ABALONE 92662 Phone: Owner/Builder : Address Phone: Code Edition : 201 Type of Construction : V-B Occupancy Groups: U,R Bldg Height : Building Setbacks : F Flood Zone : X Use Zone : R PROCESSED BY: op oft Beach vmentDepartment - Building Division II I IIIIIIIII II IIII II II er Drive, Newport Beach, CA 92660 Phone: (949) 644-3288 C7 1nests Phone: (949) 644-3255 :a.gov/inspections SP Type - SFP Alteration COMB Permit : XR2022-1930 Plan Check No: Issued Date : 07/15/2022 Inspection Area : 2 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS AVE Legal Desc : A TR BALBOA ISLAND SEC 5 BLK 7 LOT 18 REROOF 13 SQ: T/O (E) WOOD SHAKE & INSTALL CLASS W WOOD SHAKE (CC ESR-2573) CHANGE OUT (6) WINDOWS Contractor : Gary Fox Roofing, Inc Architect 1E NEWPORT BEACH, CA Address : P.O. Box 2713 Newport Beach, CA 92659 Address Phone : (949) 2904856 Phone : Con State Lic: 685119 State Lic Lic Expire: 05/31/2024 NEWPORT BEACH, CA Bus Lic: Engineer: Bus Lic Expire : Address Workers' Compensation Insurance Phone: Carrier: STATE+COMPENSATION+INSURANCE+FUN D Policy No: 9077462 Designer: W. C. Expire: 10/31/2022 Address Phone: Fire Sprinklers : NO Fire Hazard Zone : No No of Units : 1 No of Stories : 2 5, Side: 3, Side: 3, Rear: 0 -Two-UnitResidential, Balboa Island SPECIAL CONDITIONS: (kCInge S"Pe 1proxn Construction Valuation : Added/New/TI sq. ft. Bldg Alteration sq. ft. Bldg : Added/New sq. ft. Garage %I�� v rn s�ta(cE e�ass (8-lZ-Zo2Z) $7,800.00 0 0 OWNER -BUILDER DECLARATION 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 checkrnark(s) I have placed next to the applicable Remits) ;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' Stalc 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 ($500). El I, as owner of the property, or my employees with wages as their sole compensation, will do t_) all of or U portions of the work, and the structure Is not intendedor 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 arenot 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 bulit or improved for the purpose of sale). ❑ i, as owner of the properly, 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). 0 I 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 prior to completion of the improvements covered by this permit, Icannot legallt 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 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:http:tiWVAV,leginfo.ca.govicalavi.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 oej9. and my license Is in full force and effect. Licen=e Class License No Date' 20 a Contractor Signature ,ir --t i" WORKERS' COMPENSATION DECLARATION --� WARNAG: FAILURE TC SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREO OUSAND DOLLARS t$100,0004, IN ADDITION TO THE n OSr OF COMFENC ATIC A, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY-S FEES. II-hhereby affirm under penalty of perjury one. of the following declarations: t,.,: 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, for th ro.,eiff rmance X Via work for which this permit Is issued. Policy No. Nam, .save and r',ll 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 workerscompel 'ns-r once cal ner and. policy number are: a,rlar Policy Number Date ri cf Agent Phone # 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 taws of Califomia, and agre n should beco na subject to the orkars c/om/!%/�(nsal nvisons of $Do ion 3700 of She Labor Code, I shall forthwith comply with those provisions. tl retire of Appl¢,.an[..........Y :,........ areby affirm under pan of perjury that there is a construction tending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Nets Name Lenders Address my signature below, I certify 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 information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county to an�l�en//th5 above/-i enf properly for inspection purposes. /}\� .nature of Property Owner or Authorized Agent _.1�'NV 71 Print Property Owner's. or Authorized Agent's Name iC !/safil !'� " Date ACTION DATE BY CLARATION OF COMPLIANCE WITH CODE OF FEDE '.I REGULATIONS PART Fl OF TITLE Ail AND AQMD RULE 11403 PERMUT EXPIRED I SURMITTED ASBFSTOS NOTIFICATION TO PERMIT CANCELL€D I EPA. _ f�5` PEANUTEXTFNDED -LAAQM", PERMITFINAL 'gl�y AS BESTUS NOTIFICATION IS NOT APPLICABLE TO per. , T60t�lj/'� OCCUPANCyClERTORCATE �SUfD I S GNATURE: "xPROPOSED FOR OFFICE USE ONLY All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shall be in place prior to approval to fill pool/spa & shall remain in place & be maintained for the life of the pool.