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Home My WebLink AboutXC2024-0131 - Permits�gWPORr City of Newport Beach 1111 Jill COMB Permit: XC2024-0131 0 @ Community Development Department -Building Division x C 2 0 2 4 0 1 3 1 r � 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No u >m 2 Permit Counter Phone: (949) 718-1888 Issued Date : 04/02/2024 <s. newpurtbeachca.gov/civic Final Date: Combination Type - Permit Status: Issued Work Class - Repair 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 : 600 ST ANDREWS RD, BUILDING C Legal Desc : A TR IRVINE SUB BLK 54 LOT 171 IRVINE SUB BLK 54 L Description: COMM REROOF OVERLAY POLYESTER FABRIC EMBEDDED IN ASPHALT EMULSION, RECOAT W/ COOL ROOF ACRYLIC ESR#2871 134 SOS Owner; CHURCH ST ANDREWS PRESBYTERIAN OF Contractor: HIGHLAND COMMERCIAL ROOFING Architect NEWPORT Address : 600 SAINT ANDREWS RD Address : 5105 HEINTZ ST Address NEWPORT BEACH, CA 92663 BALDWIN PARK, CA 91706 Phone: (949)574-2205 Phone: (626)856-2076 Phone: Con State Lie : 632551 State Lic Lie Expire : 07/31/2024 Applicant: ADVANCED PERMIT SERVICES INC Bus Lie; BT30083922 Engineer: Address : 24310 MOULTON PKWY, 0137 Bus Lie Expire : 03/31/2025 Address : LAGUNA HILLS, CA 92637 Phone: (949) 207-3468 Workers' Compensation Insurance Phone: Carrier: AMERICAN CASUALTY COMPANY Owner/Builder : Policy No: 7011688782 Designer: Address • W. C. Expire : 11/1/2024 Address Phone: Phone: Code Edition : 2022 Fire Sprinklers : YES Construction Valuation : $25,000.00 Type of Construction : I -A Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg: 0 Occupancy Groups : U No of Units : 0 Alteration sq. ft. Bldg : Bldg Height: No of Stories: 1 Added/New sq. ft. Garage: 0 - TOTAL sq. ft.: 0 Building Setbacks Flood Zone: X Use Zone: PI - Private Institutions ' � of'` - PROCESSED BY: SPECIAL CONDITIONS: I hereby affirm under penally of perjury that I am exempt from the Contractors' Slate License Law for the mason(s) indicated below by the checkmark(s) I have placed next to the applicableitem(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 io 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 3 of the Business and Yofessions 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 of more than five hundred dollars ($500). 3 I, 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 cr offered for sale (Section 7044, iusiness and professions Code: The Contractors' Slate License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the nprovemenls 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 nproved for the purpose of sale). 7 I, as owner of the property, am exclusively contracting with licensed Contractors 10 construct the project (Section 7044. Business and Professions Code: The Contractors' State License Law does not pply to an owner of property who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ] 1 am exempt from licensure under the Contractors' Stale License Law for the following reason: 1y 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, 1 cannot legalll all a structure that I have built as an owner -builder if It has not been constructed in its entirely by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and 'rofessions Code, isavailable upon request when this application is submitted or at the following Web site:htip:llwww.leginfo.ca.gov/calaw.html, signature of Property Owner or Authorized Agent Dale .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perury that I am licensed under provisions of Chapter 9 (commencing with Section 70 'on 3 of the. Business. and Pro ssii an rise is in full farce rid effect. License Class License No Date COThector.Signatum VORKERS' COMPENSATION DECLARATION !ARMING; FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRMURAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,W0), IN ADDITION TO THE DST OF COMPENSATION; DAMAGES AS PROVIDED FORIN SECTION 0700 OF THE LABOR CODE, INTEREST, AND ATTORNEV'S FEES. hereby affirm under penalty of perjury one of the following declarations: ] I have and will maintain a cer ifrWfe 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 me arf ance of the work for which this permit Is issued. Policy ND. I 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' compensation isurance carrier and policy number are: :arrier Policy Number Expiration Date lame of Agent Phone 8 �I certify that, in the perfor ammm of the won Ich this permit is issued; I shall not employ any person in any manner so as to become subject to the warkeis' compens lion laws of California, and agrac sal, if i shoWd become su so ttf the work ' co anon provisions of Section 3700 of the Labor Code, Ishall forthwith comply with those provisions. eby 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). lees Name Lender's Address iy signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners behalf. I have read this application and the information 1 rovided is correct. I agree to comply mth all applicable city and calAtylordinances n ate aws relating to building Construction. I auihorize rep, esdntatives of this city or coon vet ad property for inspection purposes. af ire of Property �,nner or Authorized Agent to r t abo` Print Property Owner's or Authorized Agent's Name` J '� "CiC�� Dafe • / Z� ION, DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY i REGULATIONS. PART 5I OFT[TLE 40 AND AQMO RDLE PEPMfTCANCELLE6 PEg5417` EYTENDED To CEIiTIFIr{ITE OF k'7— 16,