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Home My WebLink AboutXR2023-2458 - PermitsaEWPo�r City of Newport Beach 1111111111111111111111111111111111111111111111p111111111 jj COMB Permit : XR2O23-2458 0 .0 @ Community Development Department- Building Division �+ 4. 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: n: Permit Counter Phone: (949) 718-1888 Issued Date : 09/05/2023 U gym. newportbeachca.gov/civic Final Date: °"y�� n,N`" Combination Type - SFP Permit Status: Issued Work Class - Other Inspection Area : 6 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 : 21 VIA PALLADIO Legal Desc : N TR 14070 BLK LOT 91 Description: PLUMB PEX REPIPE WHOLE HOUSE (24) FIXTURES. RENEW EXPIRED PERMIT Owner: TRIDER ALAN TR A D Address : 3230 E IMPERIAL HWY STE2D8 BREA, CA 92821 Phone : (949) 306-2526 Applicant: BEN MEDINA Address : 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Phone: (818)735-7876 Owner/Builder : Address : Phone Code Edition : 2022 Type of Construction : V-B Occupancy Groups : U,R-3.1 Bldg Height: Building Setbacks Flood Zone : X Use Zone : PC - Newport Coast PROCESSED BY: ,`• SPECIAL CONDITIONS: i �33 CC Contractor: PIPELINE RESTORATION PLUMBING Address : 29291 KENSINGSTON DR LAGUNA NIGUEL, CA 92677 Phone: (714)860-4250 Con State Lie : 965054 Lie Expire : 08/31/2025 Bus Lie : BT30074100 Bus Lie Expire : 01/31/2024 Workers' Compensation Insurance Carrier: SENECA INS CO INC Policy No : SWC1439227 W. C. Expire : 5/13/2024 Fire Sprinklers : NO Fire Hazard Zone : YES No of Units : 1 No of Stories : 1 Architect Address Phone: State Lie Engineer: Address: Phone: Designer: Address Phone: Construction Valuation : $0.00 Added/New/TI sq. ft. Bldg : 0 Alteration sq. ft. Bldg : Added/New sq. ft. Garage : 0 TOTAL sq. ft. 0 OWNER -BUILDER DECLARATION I hereby affirm under penally 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) Section 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 re permit to Me a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Low (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 'rofessions Code) or that he or she is exempt from I+censure 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). 1 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended cr 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 it was not built or n roved for the purpose of sale). 3 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does not poky to an owner of properly who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I I am exempt from licensure under the Contractors' Slate License Law for the fallowing reason ry 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 iegally oll a structuro that I have built as an owner -builder if it 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 'rofessions Code, is available upon request When this application is submitted or at the following N'eb site:http:liwww.leginfo.ca.gov/celaw.html. signature of Property Owner or Authorized Agent w_ Date ACENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of C a r 9 Do eri with Section 700 Divisf�3 of the Business and Profes ' s Cc , and my license is in full (area no effect. License Class � -- zpLicense No �� —C Daie Contractor Signature VORKERS' COMPENSATION DECLARATION 'A RN ING: 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 IS 100,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of periury one of the following declarations* I 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 erformance of the work for which this permit Is issued. Policy No. A 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` compensatior i'§erance carrier and policy number are: Policy Number of Agent Date It 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 to become subject to the workers' compensation laws of California, and agre tat, if I should become suble' Workers' comp provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Ignalure of Applicant i:� _--.- _. _._..� _______ _�.. ._ Data•._.�,,1" ____.Y_ I ECLARATION REGARDING CONOING AGENCY 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 (Section 3097, Civil Code). endnr's Name __ _ Lenders Address :y illy signature below, certify to each of_ the following: I am the properly 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 ordinances and state laws relating to building construction. I authorize representatives of this ray or curly "a enter i ai o dentified property for inspection purposes. ,onature of PrODertV Owner o, Authorzed Anent C',--e—�__--.=_______EEki Property Owner's or Authorized Aaent's NameDate ACTION ! DATE I( t By DECLARATION OF COMPLIANCE WIT14 CODE OF FEDERAL RFGliLA"TONS PART 61 OF TITLE 40 AND ACIMD RULE � 11,•D3 FOR OFFICE USE ONLY ' r FEHiN'iT EXPIRED IEl I ,UF1r11TFDASBFSTOS NOTIFICATION TO __.. ....... ................ PFRMIT CAh CFI 1 FD , ............ _,.---w-..-...._-- .-.._-._________.._�_.__ �[' PERic11T EA TENDED OAOMD P@RNI T FINAi MA1BESiOS NGI IFICAItON IS NOI: APPLICABLE 10 CERTIFICATE OF q_3'f OCCUPANCY ISSUED 1 DrW. PROPOSED DEMOl17 SIGNATURE: // /