HomeMy WebLinkAboutXR2023-1920 - Permits04',�"*6
City of Newport Beach COMB Permit : XR2023-1920
Community Development Department- Building DivisionX R 2 0 2 3 1 9 2 0
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-1692
Permit Counter Phone: (949) 718-1888newportbeachca.gov/civic Final Date:
Issued DateCombination Type -ELEC PLUM Permit Status: Applied
Work Class - Other Inspection Area : 4
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 : 19 BRITTANY Legal Desc : N TR 12164 BLK LOT 1 UN 1 TR 12164 LOT 1 UNIT 1 OF
Description: MFR SUB SLAB DEPRESSURIZATION SYSTEM
Owner: BAYRIDGE PARK
ASSOCIATION
Address : 1 HARTFORD DR
NEWPORT BEACH, CA 9266
Phone: (949)706-4544
HOMEOWNERS Contractor: ENGINEERING AND ENVIRONMENTAL Architect:
CONSTRUCTION INC
Address : 7171 WARNER AVE STE B404 Address
0 HUNTINGTON BEACH, CA 92647
Applicant:
GREG SHERMAN
Address:
7171 WARNER AVE STE B-404
HUNTINGTON BEACH, CA 92647
Phone :
(760) 803-9389
Owner/Builder :
Address :
Phone
Phone: (760)803-9389
Con State Lic :
883727
Lic Expire :
09/30/2024
Bus Lic:
BT30082135
Bus Lic Expire :
07/31/2024
Workers' Compensation Insurance
Carrier: ACE AMERICAN
Policy No: C51450152
W. C. Expire : 10/1/2023
Phone:
State Lic
Engineer:
CHARLESBLANCHARD
Address:
555 12TH ST STE 215
OAKLAND, CA 94607
Phone:
(925) 580-2754
Designer
Address
Phone:
Code Edition :
2022
Fire Sprinklers :
NO
Construction Valuation : $40,000.00
Type of Construction :
V-B
Fire Hazard Zone :
NO
Added/New/Ti sq. ft. Bldg : 0
Occupancy Groups :
U
No of Units:
0
Alteration sq. ft. Bldg :
Bldg Height :
No of Stories :
0
Added/New sq. ft. Garage: 0
TOTAL sq. ft. 0
Building Setbacks
Flood Zone :
X
Use Zone :
PC - Aeronutronic Ford
0:16I9*1-9:151131
SPECIAL CONDITIONS:
- ^o
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicate
(Sec(ion 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demoll:
the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Caw
Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section
not more than five hundred dollars ($500).
13 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or i portions of the
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through am
Improvements are not intended or offered for sate. If, however, the building or improvement is sold within one year of complef.
Improved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors t0 construct the project (Section 7044, Bu
app€y to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pL
0 I am exempt from Ilcensure 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 most have resided for at least one yea
sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I Linda
Professions Code, Is available upon request when this application is submitted or at the following Web sitehUp:liwww.leginfo.i
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7 OF
and effect. License Class License No Do
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORXERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL RIL
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3TOS OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I 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. issued by the Director of IF
pe ormance of the work for which this permit is issued. Policy No,
have and will maintain workers' compens lion wired by Section 3700 of the Labor Code, for the peck
su ce carrier and policy number are:
Policy Number
of Agent
]I certify that, in thAIDE ddrmance of the work for which this permit is issued, I shall not employ any person in any manner so
iat, if I should beco NNI 5ubject to the workers' etrsatlon provisions of Section 3700 of the Labor Code, Ishall forthwith c
Ngnalure of Applicant
fECLARATIGN REG D' � �CONSTRUC71ON LENDING AGENCY
hereby affirm under p nalty, of perjury that there is a construction lending agency for the performance of the work for which V
ender's Name Lenders Address
ly my signature below, I certify to each of the following:
I am the property owner or authorized to act art the properly 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 rel g-l4 <7uilding construction.
I authorize representatives of this city cr cou en .r the a e-De property for inspection purposes.
iionature of Property Owner or Authorized Agent Print Property Owner's or Auth[
ACTION I GATE I 9Y V DEG LATIO S PARTCOMPLIANCEN OF 61 0 TTt r. 40 AND ODE OF AQMO RU EI
PERMITEXPIRED I I ° 1..11SULMITTti)
PERMIT EXTENDED �L.tAOMD
PERMIT FINAL - B65TOS NOfI FICA tION 15 NOT APPLICABLE fO
CERiffICA TE OF € P POSED D Q�TIO
OCCUPANCY 155LF b7�'�3 [ 53GNAT !
below by the checkmark(s) I have placed next to the applicable items)
,. or repair any structure, prior to its issuance, also requires the applicant for
:.hapter 9 (commencing with Section 7000) of Division 3 of the Business and
Y31,5 by any applicant for a permit subjects the applicant to a civil penalty of
k, and the structure Is not Intended or offered for sale (Section 7044,
ees' or personal effort, builds or improves the property, provided That the
the Owner -Builder will have the burden of proving that it was not built or
and Professions Code: The Contractors' State License Law does not
to the ContractorsState License Law).
to completion of the improvements covered by this permit, I cannot
I that a copy of the applicable law, Section 7044 of the Business and
dcalaw.html.
Date
f the Business and Pro
Contractor Signature
AND CIVIL FINES UP TO ONE
and my license is In full force
DOLLARS 16100,000), IN ADDITION TO THE
Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is issued. My workers'
Date
to become subject to the work f s' compensation laws of California, and agre
ply with those provisions.
Da
permit Is issued (Section 3097, 'vil Code).
FOR OFFICE U$E ONLY
Name