HomeMy WebLinkAboutXR2023-0860 - PermitsaE.r✓aoRT.
City of Newport Beach
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Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone: (949) 644-3288
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Inspection Requests Phone: (949) 644-3255
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newportbeachca.gov/inspections
Combination Type - MFP
Work Class - Alteration
11111111111111111111111111111111111111111111111111111111JillCOMB Permit : XR2023-0ss0
Plan Check No : PC2023-0756
Issued Date : 04/04/2023
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 : 1815 SHERINGTON PL, V 301
Description: MFR WATER DAMAGE REPAIR
Owner: UDR NEWPORT BEACH NORTH LP
Address : 1745 SHEA CENTER DR STE200
HIGHLANDS RANCH, CO 80112-9
Phone : (720) 283-6120
Applicant: SIGNAL RESTORATION SERVICES
Address: 7221 ORANGEWOOD AVE
GARDEN GROVE, CA 92841
Phone : (714) 763-4153
Owner/Builder :
Address:
Phone
Legal Desc : P BK 15 PG 36 PAR 2
Contractor: SIGNAL RESTORATION SERVICES
Address : 7221 ORANGEWOOD AVE
GARDEN GROVE, CA 92841
Phone:
(714)763-4153
Con State Lic:
986693
Lic Expire :
09/30/2023
Bus Lic:
BT30071857
Bus Lic Expire : 05/31/2023
Workers' Compensation Insurance
Carrier: STARR INDEMNITY & LIABILITY CO
Policy No: 1000002994
W. C. Expire: 10/16/2023
Code Edition :
2022
Fire Sprinklers :
NO
Type of Construction :
V-B
Fire Hazard Zone :
NO
Occupancy Groups :
U,R-3
No of Units :
1
Bldg Height :
No of Stories :
2
Building Setbacks
Flood Zone :
X
Use Zone:
PC - Oakwood Apartments - UP1370, UP 1405
PROCESSED BY:
SPECIAL CONDITIONS:
Architect
Address
Phone:
State Lic
Engineer:
Address
Phone:
Designer: JON HURLEY
Address :
Phone : (619) 248-2673
Construction Valuation :
Added/New/TI sq. ft. Bldg
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage:
TOTAL sq. ft. :
$2,000.00
0
0
0
OWNER -BUILDER DECLARATION
€ hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate 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: Any city or county that requires apermit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
he permit to file a signed statement that he or she is liconsod pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Suction 7000) of Division 3 of the Business and
Imfessions 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 fare permit subjects the applicant to a civil penalty of
rot more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is notintended or offered for sale (Section 7044,
iusiness 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
mprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of cumpletion, the Owner -Builder will have the burden of proving that it was not built or
mprovod for the purpose of sale).
1 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
Ippty 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).
1 am exempt from licensure under the Contractors' State License Law for the following reason:
3y rimy 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 legally
;all 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 a copy of the applicable law, Suction 7044 of the Business and
'rofessions Code, is available upon request when this application is submitted oral the following Web site:http:l(www.leginfo.ca.gov/calaw.html.
signature of Property Owner or Authorized Agent -w, to
_ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700N)ffivation 3 f the business and P f us' n o e, and my Boer is In full force
old effect License Class License. No Date Contractor Signat r
VORKERS' COMPENSATION DECLARATION
IARNING: 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 ($100,000), IN ADDITION TO THE
:DST OF COMPENSATION, DAMAGFSAS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
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
formance of the work for which this permit is issued. Policy No.
eve 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' eompensatior
asur nce carrier and policy number are:
C^arfier Policy Number Expiration Date
Name of Agent Phone #
-1I certify that, in the performance of the rk for which this permit is Issued. I shall not employ any person in any manner so as to become subject to the workers' compens ion laws of California. and agree
.hat, if I should become su lect to the r ere' compensation provisions of Section 3700 of the Labor Code, I -shall forthwith comply with those provisions. J
Signature of Applicant
DECLARATION REeARbift coNstROcTioN LENDING AGENCY
hereby, 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, Ivil Code).
_endar's Name Lender's Address
3y 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 pr vided is correct.
I agree to comply with all applicable city and county or rites and state laws relating to building construction.
I authorize representatives of this city or county to a er the above-idenfified property for inspection purposes.
Signature of Property Owner or Authorized t Pent Property Owner's or Authorized Agent's Na - Date
ACTION DATE. Y DECLARATION OF COMPLIANCE WITH CODE. OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 51. OF TITLE 40 AND AQNIO RULE
1403
PERMITEXPIRED _ _ _ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED EIEPQ
PERMIT EXTENpEl7 _ qMb
PERMIT FINAL '�'Z �J 1 BESTOSNOTtFic 1m NOTAPPUECi E'TO
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