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HomeMy WebLinkAboutXR2022-2128 - Permits�aEWPORT City of Newport Beach o Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 t S Permit Counter Phone: (949) 644-3288 .� Inspection Requests Phone: (949) 644-3255 Cq[/F00.N`P newponbeachca.gov/inspections Combination Type - SFP ELEC MECH PLUM Work Class - Alteration II III I I I II I II I II II II II I II COMB Permit : XR2022-2128 Plan Issued e0 Check No: C2022-1967 Inspection Area:4 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 : 1936 PORT ALBANS PL Legal Desc : N TR 6565 BLK LOT 21 Description: SFR INTERIOR ALTERATION OF KITCHEN 350 SF � , C , Owner: DENIS MATSUOKA Contractor: TRIANGLE INSTALLERS Architect Address : 1936 PORT ALBANS PL Address : 6122 DUNDLE Address NEWPORT BEACH, CA HUNTINGTON BEACH, CA 92647 ^ ^ ^ o Phone: Phone: (714)842-0920 Phone: ^.^o Con State Lic : 821885 State Lic Lic Expire : 07/31/2023 Applicant : Bill Brundige Bus Lic : BT30079699 Engineer Address : 21740 Potomac Ave Bus Lic Expire : 09/30/2023 Address Yorba Linda, CA 92887 Phone: (714) 732-7325 Workers' Compensation Insurance Phone: Carrier: STATE+COMPENSATION+INSURANCE+FUN D Owner/Builder: Policy No : 9106503 Designer : Bill Brundige Address : W. C. Expire: 7/15/2023 Address : 21740 Potomac Ave Yorba Linda, CA 92887 Phone: Phone: (714)732-7325 Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $25,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 Occupancy Groups: R-3 No of Units : 1 Alteration sq. ft. Bldg : 350 Bldg Height : No of Stories : 2 Added/New sq. ft. Garage : 0 Building Setbacks : Front: 18, Side: 5, Side: 5, Rear: 10 Flood Zone : X Use Zone : PC - Harbor View Hills 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 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 a permit 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 licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 'rofessions Code) or that he or she is exempt from Iicensure 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 penaty of lot more than five hundred dollars ($500). 1 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, 3usiness and Professions Code: The ContractorsState License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the mprovemenls 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 mproved for the purpose of Sale)- 3 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 reply 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 am exempt from licensure under the Contractors' State License Law for the following fy my signature below I acknowledge that, except for my personal residence in which I must have rosided for at least one year prior to completion of the improvements covered by this permit, I cannot lagall) 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. Section 7044 of the Business and 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:liwww.leginfo.0 .gov/calaw.html, ignature of Property Owner or Authorized Agent m� _-_ _ Date _ -ICENSED CONTRACTOR'S DECLARATION hereby affirm under papally of perjury that. I am licensed under provisions of Chapter 9 (commencing with Section ),pf l2ivi i 3 of the Business and Prof ens Code, e y I e is null force and effect. Licensc -:azs License No Date 'ZZ �'1 7L Contractor Signature VORXERS' COh FEN3ATION DECLARATION IARNING: FAILURE TO 9-.CORE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOU AND DOLLARS (3100,000), IN ADDITION TO THE :Can OF COMPENSATION. DAMAGESAS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES_ hureby :affirm under penalty of perjury one of the following declarations: t .1 1 lave and will molnL in 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 Ih tipormance of the +;irk for which this permit is issued. Policy No. and will ma,r,t.i., workers' compensation insurance, as squired by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' carrier and policy number are: Policy Number Expiratic of Aqent Phone # Date JI cart;fy 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 laws of California, and agre iat, III should become ualact to the worke s ens' rovisi ction 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of Applicant 1" Pat rECLARA7€GN REGA PING TR4CTIQN IEN.. ING AGENG 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, Civi Code). ender's Name Lenders Address ly 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 co hty ordinances and state laws relating to building construction. I authorize representatives of this city or count. t entert i enti for inspection purposes. L.. ,ionature of Prooanv Owner or Authorized Auant Print Property Owner's or Authorized Acent's Name F v'D1 t�.TrV ��Da DATE BY / : DECLARATON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE AD AND AQMD RULE I SUBMITTED ASBESTOS NOTIFICATION TO PERNi1 CAI ENOED ._ ;RQA, SQED MO ITICA'11QN I5 Nq`I'AVPlICABLE CERTIRCATE OF OCCUPANCYISSUEA m Fy m x Ob 0 v o Z UO o U M W m� Z Z F, AzIt- Oo �I m tz Q z— Q V A ea rn OC7�� Z� a�p� a'ul U m W d0 OU. W E- > Fy LU i�l U W Y U o o o U) N` C N N N N al ` p .F+ ... co O m '0 N ELL o 'C 0 a m O c° O y y o E m m a) 5 ° 0 M E � o ° s°� N mYU) o m o> N (D O o 3 as 00 ° mas o �E m a) a) X 0 y O. 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