HomeMy WebLinkAboutXR2023-1520 - Permits04)
City of Newport Beach 111IIIpIII111111111111111p1111111111111p11111111111111 jj COMB Permit:XR2023-1520
Community Development Department- Building Division X R 2 0 2 3 1 5 2 0
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No
Permit Counter Phone: (949) 718-1888 Issued Date : 06/0612023
newportbeachca.gov/civic Inspection Area : 1
CCombination 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 : 332 COLTON ST
Legal Desc : N TR.772 BILK 14 LOT 12 TR 772 LOT 12 BLK 14 ALL (EX NELY 4 F T) AND NELY
Description: SFR WINDOW/DOOR CHANGE OUT (6/3)
Owner: BRAEDON DUNG
Contractor: PACIFIC SHORES DISTRIBUTING
Architect
Address: 332 COLTON ST
Address : 10573 ELLIS AVE.
Address
NEWPORT BEACH, CA 92663
FOUNTAIN VALLEY, CA 92708
Phone: (714)496-4214
Phone: (714)841-2228
Phone:
Con State Lie : 1078177
State Lie
Lie Expire : 07/31/2025
Applicant: PACIFIC SHORES DISTRIBUTING
Bus Lie: BT30076070
Engineer
Address : 10573 ELLIS AVE.
Bus Lie Expire : 06/30/2024
Address
FOUNTAIN VALLEY, CA 92708
Phone: (714) 841-2228
Workers' Compensation Insurance
Phone:
Carrier: COMPWEST INSURANCE CO
Owner/Builder :
Policy No: CWWCP100067178
Designer:
Address :
W. C. Expire : 10/25/2023
Address
Phone:
Phone:
Code Edition: 2022
Fire Sprinklers : NO
Construction Valuation :
$16,455.14
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/TI sq. ft. Bldg:
0
Occupancy Groups : U,R-3
No of Units : 1
Alteration sq. ft. Bldg :
Bldg Height :
No of Stories : 1
AddedlNew sq. ft. Garage :
0
TOTAL sq. ft. :
0
Building Setbacks : Front: 5, Side: 3, Side: 3, Rear: 5
Flood Zone : X
Use Zone : R-1 - Single -Unit Residential
PROCESSED BY: �� o #," r— T
SPECIAL CONDITIONS: f Lzc OR
1
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 items)
9acifon 7031.8, 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 statement that he or she is licensed pursuant to the provisions of the Contrectors' 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 llcensure and the basis for the alleged exemption Any violation of Section 7031.6 by any applicant for a permit subjacts the Applicant to a civil penalty of
of more than five hundred dollars ($500).
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 structure is not intended or offered for sale {Section 7044,
usiness 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 building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that 4 was not built or
IT roved 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
ly 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 licensum under the Contractors' State License Law for the following reason: _
•y my signature below I acknowledge that, except tot my personal residence in which I must have resided for at least one year prior to completion of the improvements CCvmRd by this permit, I cannot legall)
oil astructure 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
Tofassions Code, is available upon request when this application is Submitted brat the following Web site:httpliwww.teginfo.ca.gov/ceiaw.html.
8gnature of Property Owner or Authorized Agent Date
.ICENSEA CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (Commencing with Section'. 0 n 3 of the Business and ass - ry Ilrie isirThfli force
nd effect. License Cliss License. No Dete Contractor Signature l7
VORKIERS' COMPENSATION DECLARATION
'ARNING' FAILURr TC SEC.IRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (11400.088): M ADDITION TO THE
OST OF COMPENLATIO(r DAMAGES AS PROVIDED FOR IN SECTION 370 OF THE LABOR CODE, INTEREST, AND ATTORNEt"'S FEES,
he eby affirm under penalty of perjury one of the following declarations:
I 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 Cade, for
me of the work for which this permit Is issuad. Policy No..
:and w'I rlsint.An 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' compensa
carrier and policy number are:
re of Agent
ea.t;P, that, in the p
If t should bLco,ne
Tatars of Aoolicant
Policy Number Expiration Date
Phone IS
for which It is it isissued, I shall not employ any person In any manner so as to become subject to the workers' oompansatioD laws of Califomia, and Agra
eons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Dat �ll0��3
tN L R40 ENCY
hereby affirm under penalty of l'rerjury that there n construction lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil Code),
ender's Name
Y my signature below, I certify to each of the. rollow ing:
I am the property owner Or auttionaed 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 county ordinanc no state..
I allthortze mpmsentatives of this city or Gounwo.4mer tWa-I tday ifteS
041111110
PERAUTFINAL
CERTIPCATEOF l
OCCUPANCY ISSUED
to building construction.
sr inspection purposes.
PUANCE WITH CODE Or FEDERAL
OF TITLE 40AND AQMD RULE
FOR OFFICE USE ONLY
A,LCL ,,( A(is- lc(! _ . 1