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HomeMy WebLinkAboutXR2023-0995 - Permits4�EWPo�T City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIII II COMB Permit : XR2U23-o995 D Community Development Department - Building Division a.'. �. 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-0886 Permit Counter Phone: (949) 718-1888 Issued Date : 05108/2023 newportbeachca.gov/civic Inspection Area : 5 °"4coa�`P Combination Type - SFP ELEC 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 : 14 SIDNEY BAY DR Description: SFR ADD COVERED ENTRY 10 SF Owner: SKEPASMENOLLC Address : 140 N CENTER ST MESA, AZ 85201 Phone: Applicant: SEAN KOSKY Address : 32946 AVENIDA DESCANSO SAN JUAN CAPISTRANO, CA 92675 Phone: (949)324-3369 Legal Desc : N TR.15445. BLK LOT 18 Contractor: MIKE HOLLAND CONSTRUCTION INC Address: 28081 MORRO CT LAGUNA NIGUEL, CA 92677 Phone : (949) 235-9477 Con State Lic : 898714 Lic Expire : 06/30/2023 Bus Lic: BT30058852 Bus Lic Expire : 04/30/2024 Architect Address Phone: State Lic Engineer: FORBES DALE L Address : 1800 E 16TH ST #B SANTA ANA, CA 92701 Workers' Compensation Insurance Phone : (714) 835-2800 Carrier: STATE COMPENSATION INSURANCE FUND STATE COMPENSATION INSURANCE FUND Owner/Builder : Policy No : 9140185 Designer Address : W. C. Expire : 7/29/2023 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 : U,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 Coast PROCESSED BY: ; SPECIAL CONDITIONS: $5,000.00 OWNER -BUILDER DECLARATION t 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 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 the 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 licensors 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 ($500j. 0 1, as owner of the property, or my employees with wages as theirsole compensation, will do L) all of or U portions of the work; and the structure is 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 boll or improved 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' 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 I am exempt from ficensure 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 boon constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is evailabie upon request when this application is submitted or at the following Web site:hitp:tfwww.teginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0) of Division of the Business and Pro e ions C e/ta d my 111%Z 111 force and aft l License Class License No Data cJ Contractor Signature WORKERS' COMPENSATION DECLARATION NARNING; FAILURE TO SECURE wORNERS' COMPENSATION COVERAGE 19 UNLAWFUL, AND SHALL SUa.rECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS RVID0,000), IN AODFTION TO THE COST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN SECTION 370E OF THE LABOR CODE, INTEREST, AND ATTORNEY'$ FEES - hereby affirm under penalty of perjury one of the following declarations: 1 have and will maintain a certificate of consent to self -insure for workers' compensation, ensued by the Director of Industrial Relations as provided for by Section 3700 of the. Labor Code, for th ?Vormanee of the work for which this permit is issued. Policy No. _ save and will maintain workers' compensation insurance as required by Section 3700 of the Labor Code, for the performance Of the work for which this permitis issued. My workers' eomponsatiol arance carrier and policy number are; Tier Policy Number Expiration Date me of Agent Phone # Certify that, in the pertarmanc I of th=LENG is issued, Fshall not employ any person in any manner so as to become subject to the workers', o pensation laws of California, and agro t, if I should beco ubjaet tv the osions of Section 3700 of the Labor Code; I shall forthwith comply with (hose provisions. nature of Applican DatAl. CLARATION REG ON �CY !reby affirm under peaalty of perjury that there is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097, ode). ider's Name Lender's Address 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 provided is correct. I agree to comply with all applicable city and cou ty ordinances and state laws g to building construction. I authorize representatives of this city or county r linenter the eve-idenfifle perty for inspection purposes. DATE. By y' DELbARATIONOF COMPLIANCE WITH CODFOF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 810E TITLE 40 AND AQMO RULE AhIMITT0 ASBESTOS NOTIFICATION PERMITEXYEruQEQ i �>!rt@Md fry PERMIT fiNA1 SKSTIt OTIFICATigN OTAPPEi iF TO CERTtflCAtE OF ROP HQ 0 OLITtON OCCUPANCYISSUED 1. si�,NAn,aF