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Home My WebLink AboutXR2023-1107 - Permits��EapoRT City of Newport Beach IIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XR2023-1107 p „ e Community Development Department -Building Division fi 100 Civic Center Drive, Newport Beach, CA 92660 X R 2 0 2 3 1 1 0 7 Plan Check No: T 35-2021 Permit Counter Phone: (949) fi44-3268 }� Issued Date : e4/28/202023 � Inspection Requests Phone: (949) 644-3255 �'<ico aN�r newportbeachca.gov/inspections Inspection Area : 3 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: 389 23RD ST Legal Desc : P BK 273 PG 45 PAR 1 Description: SFR INFILL VAULTED CEILING TO ADD 2 BEDROOMS, 2 BATH & GYM (511 SF, REMODEL 675 SF) *renew expired permit X2021-1518* Owner: JAMESDOBSON Address : 433 HARBOR ISLAND DR NEWPORT BEACH, CA 92660 Phone : Applicant: BURKHART BROTHER'S CONSTR INC Address: 12 BALBOA COVES NEWPORT BEACH, CA 92663 Phone: (949)508-8478 Owner/Builder : Address : Phone Code Edition : 2019 Type of Construction : V-B Occupancy Groups : U,R-3 Bldg Height : Contractor: BURKHART BROTHER'S CONSTR INC Architect Address : 12 BALBOA COVES Address: NEWPORT BEACH, CA 92663 Phone : (949) 508-8478 Phone Con State Lic : 905510 State Lie Lie Expire: 10/31/2023 Bus Lic: BT30026859 Engineer: Bus Lie Expire : 03/31/2024 Address Workers' Compensation Insurance Phone: Carrier: SECURITY NATIONAL INS CO Policy No: SNP1426534 Designer W. C. Expire: 2/1/2024 Address Phone: Fire Sprinklers : NO Construction Valuation Fire Hazard Zone : NO Added/New/Ti sq. ft. Bldg : 1 No of Units: 1 Alteration sq. ft. Bldg: No of Stories : 2 Added/New sq. ft. Garage : 0 TOTAL sq. ft. : 1 Building Setbacks : Front: 20, Side: 5, Side: 5, Rear: 20 Flood Zone : X Use Zone : R-1-7200 - Single -Unit Residential (7200 indicates minimum lot area) PROCESSED BY: 60*� SPECIAL CONDITIONS: OVVNL'H-b UILUCM UCLLHRMI IWIl I hereby affirm under penalty of perjury that I all, exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the appltcable_item(s) ;Section 7034-:5, Business end 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 ar 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 orofessions 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 Tot more than five hundred dollars ($500). 0 I,.as owner of the property, or my employees with wages as their sole compensation, will do U 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 built 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 improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I am exempt from licensure under the Contractors' State License Law for the following reason: -- By my signature below € 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 Iegalll 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., is available upon request when this application is submitted or at the following Web sfte;http:hwww.leginfo.ca,govlcalaw.ntml. 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 7000) of Di listen 3 of the Business and Professiy(' s Cod and my license is in full force and effect. License Class License No Data, 2a Contractor Signatl±rlg� /� WORKERS' COMPENSATION DECLARATION VV WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 15100,0001, IN ADDITION TO THE .COST 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 following declarations: �lA 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 th I ormance of the work for which this permit is issued. Policy No. I h ve and will maintain workers' compensation Insurance, as required by Section 37CO of the Labor Code, for the performance of the work for which this permit. is issued. Myworkers compensatio msur ce carrier and policy number are: ar Policy Number Expiration Date is of Agent certify that, in the performance of . if 1 should become suhjecj/)o the of for which this permit is issued., I shall not employ any person in any manner so as to become subject to the workers' compens lion I cos of Calif omla, and ogre compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Da;� L 2E CLARATIDN NttiAKtJtrvt+;,Lil tmv. I ION LENDING AGENCY ((�T Ireby affirm under penalty of per}ury that there is a construction lending agency for the performance of the work for which this permit is Issued (Section 3097, Civil Code). 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 county ordin Dees and plete taws relating to building construction. I authorize representatives of this city or county to enter a above- entifled property for inspection purposes. Lam- naifira of PrODertV Owner or Authorized Ag Print Property Owner's or Authorized Agent's Name '� ACTION I DATE BY i DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY E REGULATIONS PART 61 OFTITLE 40 AND AQNID RULE 1403 PERMIT EXPMED �Sl BMIT'i ED A56FSTOS Ni'TI FICATION , O PEAMITCANCFCLED ' IPA _-.. PEAiN/TF/NAL BESTOS NOftFICATION IS NOTAPPLIC.AaLE TO CERTIFICAYE OF )2'27 PROPOSSn 7EM/'7LITJR}7 OCCUPANCY ISSUED 'I D "/ I SIGNATUPF{� C,IZb/2