HomeMy WebLinkAboutXR2023-0144 - PermitsaEWPOQT City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit XR2U23-o144
C� Community Development Department- Building Division X R 2 0 2 3 0 1 4 4
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No:
,= Permit Counter Phone: (949) 644-3288 Issued Date : 01/2412023
.s+ Inspection Requests Phone: (949) 644-3255 Inspection Area : 5
cqC/FppN�P newportbeachca.gov/inspections
Combination Type - SFP
Work Class - Other
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: 24 BAFFIN BAY
Legal Base : N TR 15851 BLK LOT 20
Description: SFR PEX REPIPE
Owner: VUCHINICH K MARK TR
Contractor: KALKA KEVIN J HEATING & A/C
Architect
Address : 24 BAFFIN BAY
Address : 15550 ROCKFIELD BLVD #A-100
Address
NEWPORT COAST, CA 92657
IRVINE, CA 92618
Phone :
Phone : (949) 458-6600
Phone
Con State Lie : 677889
State Lic
Lie Expire : 10/31/2024
Applicant: KALKA KEVIN J HEATING & A/C
Bus Lie : BT30074347
Engineer
Address : 15550 ROCKFIELD BLVD #A-100
Bus Lie Expire : 05/31/2023
Address
IRVINE, CA 92618
Phone: (949) 458-6600
Workers' Compensation Insurance
Phone:
Carrier: NORGUARD INSURANCE COMPANY
Owner/Builder:
Policy No: KKWC252994
Designer:
Address :
W. C. Expire : 1212312023
Address
Phone:
Phone:
Code Edition : 2022
Fire Sprinklers : NO
Construction Valuation
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/Ti sq. ft. Bldg
Occupancy Groups : R-3
No of Units : 1
Alteration sq, ft. Bldg :
Bldg Height:
No of Stories : 2
Added/New sq. ft. Garage
TOTAL sq. ft. :
Building Setbacks
Flood Zone : X
Use Zone : PC -Newport Coas�\`\��
PROCESSED BY,
SPECIAL CONDITIONS:
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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
Professions Code) or that he or she is exempt from kcensure 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
not more than five hundred dollars ($500).
71 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structures not. intended or offered for sale (Section 7044,
Business 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
Improvements 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
Improved for the purpose of sale).
0 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
apply 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),
0 1 am exempt from Ncensure under the Contractors' State License Law for the following reason:
By 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 legal],
sell 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 theapplicable law, Section 7044 of the Business and
Professions Code, is available upon request when this application is submitted or at the following Web site:http:/lwww.leginto.ca.gov/calaw.fitml.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sect! 00 ) of D)"vision of the Business and Prafes I s C e, n y tic n is In full force
and effect. License Class License No Date ^2��2 Contractor Signature
COMPENSATION DECLARATION
NARNING: FAILURE TO SECVRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUS)LND DOLLARS f$100,e001, IN AUCTION
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION ]TOs 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
ormance of the work for which this permit is issued. Policy No.
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'
carrier and policy number are:
Policy Number
Date
lame of Agent Phone t#
-1I certify that, intheXnalty
ance 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 worke ' e mpensation laws of California, and agre
tat, if I should becomct tot or ers' oompens Ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
lignalure of Applicant Date ZC/ Z?
IECLARATtGN REGSTRUCTION LE G AGENCY
hereby affirm under pof perjury that there is a construction lending agency for the performance of the work for when this permit is issued (Section 309 , civi Code).
ender's Name Lender's Address
ly 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 andthe information I have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building. construction. ] (�
I authorize representatives of this city or c It to e tithe ajaove-identified property for inspection purposes. lionatura of Pmoartv Owner cr Authorized ADen I /,i film Print Pmnerty Owner's or Aanhnriza.8 Anant's Nan to L
AC71ON
bATE. I 3v t/ 1 r FC_ARATe1N OF CON,PLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
- lLA'IOZ PAR � Fl OF TITLE 40 AND AQNID RULE
110S
PERN7T EXPIRED
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I0 1 SUBMITTED ASBFSTOS NOTIFICATION TO
PERMrf CAA'CELLED
ME.
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P€RMIFEXTENDED
PE.RNtiT FINAL
CERTIFICATE i5
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