HomeMy WebLinkAboutXR2023-0862 - Permits�EwpoRr City of Newport Beach IIIIIIIIIIIIIII IIIIIIIIIII IIIIIIIIIII IIIIII I II COMB Permit : XR2023-0862
Community Development Department- Building Division X R 2 0 2 3 0 8 6 2
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-0756
Permit Counter Phone: (949) 644-3288 Issued Date : 04/04/2023
Inspection Requests Phone: (949) 644-3255 Inspection Area : 8
gt�FepH� newportbeachca.gov/inspections
Combination Type - MFP
Work Class - Alteration
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 : 1895 SHERINGTON PL, T 103
Legal Desc
: P BK 15 PG 36 PAR 2
Description:
MFR WATER DAMAGE REPAIR UNIT TS103 AND TS303
Owner:
UDR NEWPORT BEACH NORTH LP
Contractor:
SIGNAL RESTORATION SERVICES
Address :
1745 SHEA CENTER DR STE200
Address :
7221 ORANGEWOOD AVE
HIGHLANDS RANCH, CO 80112-9
GARDEN GROVE, CA 92841
Phone :
(720) 283-6120
Phone :
(714) 763-4153
Applicant:
SIGNAL RESTORATION SERVICES
Address:
7221 ORANGEWOOD AVE
GARDEN GROVE, CA 92841
Phone :
(714) 763-4153
Owner/Builder
:
Address :
Phone
Con State Lic : 986693
Lic Expire : 09/3012023
Bus Lie: BT30071857
Bus Lic Expire : 05/31/2023
Workers' Compensation Insurance
Carrier: STARR INDEMNITY & LIABILITY CO
Policy No: 1000002994
W. C. Expire : 10/16/2023
Architect
Address
Phone:
State Lie
Engineer
Address
Phone :
Designer
Address
Phone:
JON HURLEY
(619)248-2673
Code Edition :
2022 Fire Sprinklers :
NO
Construction Valuation :
$2,000.00
Type of Construction :
V-B Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg :
0
Occupancy Groups:
U,R-2 No of Units :
2
Alteration sq. ft. Bldg :
Bldg Height:
No of Stories :
2
Added/New sq. ft. Garage :
0
TOTAL sq. ft. :
0
Building Setbacks
Flood Zone :
X
Use Zone :
PC - Oakwood Apartments - UP1370, UP 1405
0
PROCESSED BY:
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the mason(s) indicated below by the check marks) I have placed next to 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
To permit to file a signed stafcmant 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
'rofossons Code) or that he or she is exempt from licensure and the bass for the alleged exemption. Any violation of Section, 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of
at 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements are not intended or offered for sale. If, however, the holding 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).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does not
ppty 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).
I I am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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 legalh
ell a structure that I have built as an ownar-buildor if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
'rofessions Code, is available upon request when this application is submitted or at the following Web site:hitp/lwvnv.leginfo.ca.gov/calav+.html.
llgnature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7Q,Q0 'vi ion 3 of the Businass and Professio e cm liCen is in full force
nd effect. License Class License. No Dale S Contractor Signatu;gr
VORKERS' COMPENSATION DECLARATION ,/k\ i
'ARMING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGES UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3108 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following dectarations:
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
lance of the work for which this permit is issued. Polley No.
1. I ave 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' compensatio
ns r nea carrier and policy number are:
er Policy Number Expiration Date
Name of Agent. Phone 0
I certify that, in the performance of the wor r 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 agre
that, 1f I should become subject to the work o ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant - J _
DECLARATION REGARISING,CONSTR. ON LADING AGENCY
I hereby affirm underpenalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Cade).
Lender's Name Lenders Address
By 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.
1 have read this application and the information I have praydipef is correct.
I agree to comply with all applicable city and county ordi a and slate laws relating to building construction. /1 µryGL-
1 authorize representatives of this city or count. to am ove-identified property for inspection purposes. li' / - 3
Signature of Property Owner or Authorized Aga Print Property Owner's or Authorized Agent's Nam 7i Date
ACTION ➢ATE Fy ➢ RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
{ REGULATIONS PART SS OF TITLE 40 AND AQMO RULE
ACTION _777i 1403
PERMITCANCELLED
_... _... _ _..................... _........ ----------
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY155UEO
APPLICAI I<` TO
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