HomeMy WebLinkAboutXR2022-2738 - PermitsWpo City P of Newport Beach I III I I I I II I I I I III I
C @ Community Development Department -Building Division
100 Civic Center Drive, Newport Beach, CA 92660
U S Permit Counter Phone: (949) 644-3288
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e:Inspection Requests Phone: (949) 644-3255
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�,FcaN` newportbeachca.gov/inspections
Combination Type - SFP PLUM ..
Work Class - Demolition
COMB Permit : XRZO22-2738
Plan Check No : PC2022-1949
Issued Date : 10/14/2022
Inspection Area : 3
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: 1424 GALAXY DR
Legal Desc : N TR 4224 BLK LOT 78
Description: SFR DEMO (E) 1-STORY 3060 SF RESIDENCE
W/ 702 SF GARAGE. (3-BEDROOM /2-BATHROOM). CAP SEWER.
Owner: OCEAN MANOR GROUP LLC
Contractor: BURKHART BROTHERS CONSTR
Architect
Address : 3235 E OCEAN BLVD
Address : 12 BALBOA COVES
Address
LONG BEACH, CA 90803
NEWPORT BEACH, CA 92663
Phone :
Phone : (949) 375-6725
Phone
Con State Lic : 905510
State Lic
Lic Expire : 10/31/2023
Applicant : BURKHART BROTHERS CONSTR
Bus Lic : BT30026859
Engineer
Address : 12 BALBOA COVES
Bus Lic Expire : 03/31/2023
Address
NEWPORT BEACH, CA 92663
Phone: (949) 375-6725
Workers' Compensation Insurance
Phone:
Carrier: SECURITY NATIONAL INSURANCE
COMPANY
Owner/Builder :
Policy No: SWC1373426
Designer: CRAFT PAUL DOMINICK
Address :
W. C. Expire: 2/1/2023
Address : 8512 OXLEY CIR
HUNTINGTON BEACH, CA 92646
Phone:
Phone: (714)270-3311
Code Edition : 2019
Fire Sprinklers : NO
Construction Valuation : $0.00
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 : 1
Added/New sq. ft. Garage : 0
TOTAL sq. ft. Bldg : 0 '
Building Setbacks : Front: 20, Side: 6, Side: 6, Rear: 6
Flood Zone: X
' ' ' '
Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area)
PROCESSED BY:
SPECIAL CONDITIONS: HAULER: JD DEMO
LIQUEFACTION ZONE
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 items)
'action 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
to permit to file a signed statement that he or she is licensed pursuantto 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 licensure 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
of more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do U 811 of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
asinees 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 it was not built or
nproved for the purpose of sale).
3 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
pply to an owner of property who builds or improves thereon. and who contracts for the projects with a. licensed Contractor pursuant to the Contractors' Stale License Law).
1 am exempt from licensure under the Contractors' Stale License Law for the following reason
ly 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 legall}
ell a structure that I have built. as an owner -builder if i1 has not been constructed In its entirely by licensed contractors I understand that a copy Of the applicable law, Section 7044 of the Business and
Irofessions Code, is available upon request when this application is submitted or at the following Web site:hlip:/i' w .legfnfo.ca.govlcalaw.htmi.
lignalure of Property Owner or Authorized Agent____ Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 D rsion 3 of the Business and Profes s,r Coddd/aaa' al-�,,- `^'IDen is in full force
nd effect. License Class License No Date W 1 Z Contractor Signature 'i(.'^'''�1--�--
VORKERS' COMPENSATION DECLARATION U
TARRING: FAILURE TO SECURE WORKERS' COMPENSATION COVE PAGE IS UNLAWFUL, AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOU$AN•••0 DOLLARS ($100,000), IN AUDITION TO THE
'.DST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES.
hereby affirm under penalty of perjury one of the fallowing declarations:
] I have and will maintain a certificate of consent to self -Insure for workerscompensation. issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
erformance of the work for which this permit is issued. Policy No.
Ahave 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' compensatiol
nsurance, carrier and policy number are:
]amier Policy Number Expiration Date
dame of Agent Phone N
:3I certify that. in the perform a 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 I ws of California, and agre
but, if I should become sub' t the workers' c0 ensati C pro�{Ision of Section 3700 of the Labor Code, I shall forthwith comply With those provisions.
3ipnalure of Applicant._. __ _ _ J,y��
)ECLARATION REGAR !CONSTRUCTIO�NGAGENSO
hereby affirm under penalty of perjury that there is a construction lending agencyfor the performance of the work for which this permit is issued (Section 3097, Civil Code).
-ender s Nrme Lenders Address
3y my signaWla palow, I certify to each of the following:
I am the Dronerly owner or authorized to act on the property owner's behalf,
I have read th.s application and the information I have provided is correct.
I agree to comply with all applicable city and coup ordinances and sta laws relating to bullding construction.
I authorize representatives of this city or county ter the above led property or inspection purposes. p
>I nature nr e,cp^r Owner or Authorized A enl rL� Print Property Owner's or Authorized Agent s Name V \ X Date �O Z
ACTION OATS By ECLARATION OF COMPLIANCE WITH COO EDP FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 51 OF TITLE 40 AND AQMD RULE
PERMIT EXPWIED
PERM7T CAiPCfL.ED
AERA4IT £Xl £ND£tJ
PERMIT FINA!
CERTIFICATE OF
OCCUPANCY ISSUED
3 Rw� ircil I__1 ASBES'105
C Ik^S PROPOSED DE
. SIGNATURE:
NOTIFICATION TO
TO
■ Complete item's1, 2, and 3. t re
■ print your name and address on the reverse X / ❑Agent
so that we can return the card to you. dressee
■ Attach this card to the back of the mailpieee, i y (Printed Warne) C. Date of Delivery
or on the front if sp sr�-
1. ArticleAddress D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
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11111111111103
I I IIIIII I9402 � 519"803839111
95909402751
7020 0o90 0000 4045 7839
PS Form 3811, July 2020 PSN 7530-02-000-9053
■ Complete items 1, 2, and 3.
■ knt your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
t. Article Addressedto:
N-�rn�. 0�ner
IIIIIIIII I'll IIIIII IIIIIIIIIIIIIIIIII IIIIII III
9590 9402 7519 2098 8009 75
7020 0090 0000 4045 7754
3. Service Type
❑ Priority Mail Express®
O Adult Signature
❑ Registered MallTM
❑ Adult Signature Restricted Delivery
❑ Registered Mail Restricted
❑ Certified Mail®
Delivery
❑ Certified Mail Restricted Delivery
❑ Signature ConfirmationTM
❑ Collect on Delivery
❑ Signature Confirmation
Onllect on Delivery Restricted Delivery
Restricted Delivery
nsured Mail
neared Mail Restricted Delivery
—lover$500)
Domestic Return Receipt
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0' Itecel�Pn O A r� I C. Date of Deli
D.I �,'ve address different m i7 ❑Yes
S nter delivery address a ❑No
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Adult � S
❑ Adult Signattu -d
❑ Registered
❑ Adult Signature pest a slivery
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❑ Certified Mall®
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❑ Registered Mail Restricted
Delivery
❑ Certified Mail Restricted Delivery
❑ Signature confirmation-
El Collect on Delivery
❑ Signature Confirmation
>Ilect on Delivery Restricted Delivery
Restricted Delivery
eurad Mail
—eared Mail Restricted Delivery
PS Form 3811, July 2020 PSN 7530-02-000-9053
Domestic Return Receipt
USPS TRACKING #
1111111111111111111111111
9590 9402 7519 2098 8038 39
United States
Postal Service
Sender: Please print your name, address, and
P+46 in this box•
USPS TRACKI
First-Class Mail
Postag11111 11111 NO #
11 111111 1 USPS aPermd No. G-10 o. G-10Fees aid
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9590 `1402 7519 2098 8009 75
United States
Postal Service
• Sender: Please print your name, address, and ZIP+4® in this t
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