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HomeMy WebLinkAboutXR2024-0539 - Permits�E.wn aT City of Newport Beach 0� e� Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Counter Phone 718-1888 ul z Permit (949) o- newportbeachca.gov/civic FonN`" Combination Type - SFP Work Class - Repair COMB Permit : XR2024-0539 Plan Check No : Issued Date • 03/0612024 Final Date: Permit Status: Issued Inspection Area : 1 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 : 5112 RIVER AVE Legal Case : N TR 3162 BLK LOT 23 Description: SFR REROOF OVER (E) 1-LAYER OF COMP SHINGLES WITH GAF COMPOSITION SHINGLES ([CC ESR-3267) 29 SQUARES Owner: BLACKMAN ROBERT W TR Contractor: SCHILLER ROOFING INC Architect Address : 4917 EL CARRO LN Address : 1527 W ORANGEWOOD AVE Address CARPINTERIA, CA 93013 ORANGE, CA 92868 Phone: Phone: (714)538-3780 Phone: Con State Lie : 692490 - State Lie ..tic Expire: 11/30/2025 Applicant : SCHILLER ROOFING INC Bus Lie : BT30082372 Engineer Address : 1527 W ORANGEWOOD AVE Bus Lie Expire : 08/31/2024 Address ORANGE, CA 92868 Phone: (714) 538-3780 Workers' Compensation Insurance Phone: Carrier: AMERICAN ZURICH INSURANCE COMPANY owner/Builder: Policy No : WC112583004 Designer Address : W. C. Expire : 12/31/2024 Address Phone: - Phone: Code Edition : 2022 Fire Sprinklers : NO _ Construction Valuation : $23,120.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 Occupancy Groups : U,R-3 No of Units : 1 Alteration sq. ft. Bldg : Bldg Height : No of Stories : 1 Added/New sq. ft. Garage: 0 ' TOTAL sq. ft. 0 . Building Setbacks : Front: 5, Side: 3, Side: 3, Rear: 10 Flood Zone : X Use Zone : R-1- Residential 'Siinngle-Unit DOT 9 a PROCESSED BY: SPECIAL CONDITIONS: I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for there as Ortiz) indIca led below by the checkmark(s) I have placed next to the aDOIcab Ia item Is) ($action 7031.5. Business end Professions Code: Any cllty or sourly that requires a perm Iff to constmCIL alter, improve, demolish, orrelI any structure, priortoils Issuance;: alsorequires the applicant for the permit to file a signed statement that ho or she is lConsad pursuant to the provisions of iho-Contractors" State License Law (Chapter-9 (commencingwlth Section 7000)of Dlvtsion 3 of the Business and Professions Code) or that he or she is exempt from licensors End 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), El 1, as owner of the property, ormy employees with wages as the IT com pansatfon, Will dO U all of or (_) portions of the work, and the structure is not Intended oroffered for sale (Section 7044, Business and Professions code: "fhe 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, 11, however, the building or improvement Is sold within one year of completion, the Owner-Sutlderwill have the burden of proving that It was not Gulf or Improved for the purpose of sale)" r1 1, as. OIr of the property, ant exclusively Contracting with Ilcensed ContrWOrs to construct the project (Section 7044, Business and Professions Coda:. The Contractors' Stale License Law. does not apply to an owner of property who builds or Improve s, thereon and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). © I am exempt from licensors under the Contractors' State License Law for Uie following reason By my signature belovr i acknowledge Ihat, except for my personal residence in which I In ust have TaSided for at least one year prior IG Door pletlon of the Improvements covered by thus dormtt, I.ca nnal legal soil a structure that I have built as an ov.�nor-butdor if it has not boon constructed in its primly by licensed contractors. I understand that a copy of (heapplicable law. Section 7P44 of :the Business and, Professions Code, is available upon request whenthis application is submitted or at the following Web site: hlolivv,v,.legiTic. ca.goalcalavahtml. Signature of Property Owner or Authorized Agent ....._._....__..�.__._..._......_____._._.._ Dale _ LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty Of perjur, lhah am licensed under provisions of Chapter (p0ommending with Section 7000) of wisicn'3-of the Business and. ProtesSl s n. a, and If II rs, te1nJ 11 fo c one effect. License Class `� C/ License No ipR'2 Y ! Date �� Contractor Signature G(/' WORKERS'COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL; AND SHALL SUBJECT AN EMPLOYERTO CRIMINAL PENALTIES AND CIVIL FINES UP TO. ONE HUNDRED THOUSAND DOLLARS (4000.,000){IN AOOrTJON TO THI COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penally of perjury one of the following declarations: ❑ 1 have and wilt maintain.. a eorlilioate of consent to sell -insure for workers' compensator, Issued by: the Director of Industrial Relations as provided for by Section 3700 of the. Labor Code, for tl performance of the work for which [hispermitIs issued. PolicyNo. avo 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' Ince carrier and policy number are; is of Agent certify that, In the parf nice of if I should becam �ubi 't to the isture of Applicaln Policy Number Expiration Date this p mit is Issued, shall not employ any person in any manner so as to become subject to Ins workers' compensation laws of California, and agre silo rov£s••.ions of Secliofl 00 of the Labor Code,' I shall forthwith comply vrilh those provisions. 3 &_A/-/ Date areby affirm Under penalty of peis a conslruc4difr ending agency for the performance of the. work for which' this permit Is Issued -.QSectlon'3097,: Civil Code). mar's Name Lenders Address. lily signature Eaiow, I oartlfy to each of fire fpiloMng: I am t;ie property owner or authorized to act on the property owner's behalf. I have read ti.is pplcation and the Informalion 1 have evided is correct, I ag,-aa to comply with all applicable city and cow or nancosaandtat laws relating to building. construction. 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