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Home My WebLink AboutXR2023-0036 - Permits��EWPORT City of Newport Beach IIIII IIIII II IIIIIII IIII IIII II IIIIIIIIIII II COMB Permit : XR2023-0036 Community Development Department- Building Division X R 2 0 2 3 0 0 3 6 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2023-0040 Permit Counter Phone: (949) 644-3288 Issued Date : 01/18/2023 0 x Inspection Requests Phone: (949) 644-3255 Inspection Area : 6 CqG/FOAN�p newportbeachca.gov/inspections Combination Type - SFP ELEC MECH PLUM 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: 2560 BUNGALOW PL Legal Desc : N TR 15829 BILK LOT 1 TRACT 15829, POR OF LOT 1. Description : SFR - INT ALT 1 ST FL POWDER RM, KITCHEN. LAUNDRY IN BASEMENT, 2 BATHS @ 2ND FL, DEMO POST ON 1 ST FL 3y{- Ff 1 Owner: GREGORY AND LAURA PETERSEN TRUST Address : 2560 BUNGALOW PL NEWPORT BEACH, CA Phone : Applicant: ROBERT LAWRENCE Address : 177 RIVERSIDE, PO BOX 2325 NEWPORT BEACH, CA 92663 Phone: (949)633-9560 Owner/Builder : Address : Phone Contractor: COSTA INSTALLATIONS INC Address : 1835 WHITTIER AVE, A-1 COSTA MESA, CA 92627 Phone: (949)683-4442 Con State Lie : 1031869 Lie Expire : 05131/2024 Bus Lie : BT30080169 Bus Lie Expire : 12/31/2023 Workers' Compensation Insurance Carrier: CLEAR SPRING PROPERTY & CASUALTY CO Policy No: CWC00120200 W. C. Expire : 8/23/2023 Code Edition : 2022 Fire Sprinklers : NO Type of Construction : V-B Fire Hazard Zone : NO Occupancy Groups : R-3 No of Units : 1 Bldg Height : No of Stories : 2 Building Setbacks : Flood Zone : X Use Zone : RM - Multiple Residential PROCESSED BY: SPECIAL CONDITIONS: Architect Address Phone: State Lie Engineer: YAGHISHUCRII Address: 112 E. CHAPMAN #D ORANGE, CA 92866 Phone: (714)997-9120 Designer Address : ! r^ Phone: Construction Valuation : $50,000.00 Added/New/Ti sq. ft. Bldg: 0 Alteration sq. ft. Bldg : 334 Added/New, sq. ft. Garage: 0 , ..TQTAL sq.,ft. 0 OWNER -BUILDER DECLARATION 1 hereby affirm under penally of perjury that I am exempt from the Contractors' Slate License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable Farr ) (Sectlon 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 Caw (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensum 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), ri 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) 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 itwas not built or Improvedfor the purpose Of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to constructthe project (Section 7044, Business and Professions Code: The Contractors' State License Law does not ra.�ply to an owner of property who builds or Improves: thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' state License Law). LJ I am exempt from licensure 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, learnt legal) sell 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 Professions Code:, isavailable upon requftst when this application is submitted or at the following Web site:http:l7www.leginfo.ca.govlcalaw.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 000 of Dt 'sion 3 of the Business and Prole sloes Co a is In full force and effect. License Class License No UaV I / ` r,/J 7 Contractor Signature WORKERS' COMPENSATION DECLARATION jr WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL . FINES UP TO ONE HUNDRSOT14quSAND DOLLARS 1$100,00061N ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR COO€, INTEREST, AND ATTORNEYS FEES. I hereby affirm under penalty of perjury one of the following declarations: 131 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, forth( performance of the work for which this permit is issued. Policy No. have 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' compensatio ranee carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # 1 certify that, in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as t0 become subject to the workers' compensation laws of California, and agre that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant (_`� DaSi�l f z, DECLARATION REGARDING CONSTR614 AGENCY c� I 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 (Section3097, Civil Code). Lender's Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized t0 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 app -able rite and count,, nMlnnress nrd state laws. relating to building. construction. I authorize representatives of this city or county to entror Ule,gbDv identified property for inspection purposes. / Si nature of Pro arty Owner or Autf.onzed A_gEN Print Property Owner's or Authorized Agent's Name ACTION DATE By e DECLARATION OF CONIPLIANCE WITH CODE OF FEDERAL FOR OFNCE USE ONLY REGULAnONS PART 61 OF TITLE 40 AND AQMO RULE 1�03 PERMITEXPIRED L. ; suPM'TrEO 1SBESTOS NOTIFICATION TO PERMITCANCELLED ~—QEPA PERMIT EXTENDED jEA0M D PERMIT FINAL 3 1BESr OS NOTIFi ATION IS NOTAPPUCABLE TO CERTIFICATE OF OPOSED DEMO tON OCCUPANCY ISSUED SIGNATUR