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Home My WebLink AboutXR2023-1632 - PermitsaEwvoRT City of Newport Beach II IIIIIII� IIII IIII �IIIII IIIII IIIIIIIIIII I II COMB Permit : XR2023-1632 o� @ Community Development Department -Building Division X R 2 0 2 3 1 6 3 2 r 1y" 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : 1538-2022 Permit Counter Phone: (949) 718-1888 Issued Date : 06/16/2023 ue. newportbeachca.gov/civic Inspection Area : 6 °9<iFona`r 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 : 819 GARDENIA WAY Legal Desc : N TR 12245 BILK LOT 37 Description: DELTA 2-'ADDITIONAL SCOPE' REMODEL GUEST BATHROOM AND MASTER BATHROOM 177 SF. REV2023-1132 Owner: REYNOLDS CRAIG L TR Address : 819 GARDENIA WAY CORONA DEL MAR, CA 92625 Phone Applicant: DAWN VAUGHT Address: 1041 W 18TH ST,Al06 COSTA MESA, CA 92627 Phone: (714)488-8003 Owner/Builder : Address: Contractor: BURKHART BROTHER'S CONSTR INC Address : 12 BALBOA COVES NEWPORT BEACH, CA 92663 Phone: (949)508-8478 Con State Lic : 905510 Lic Expire : 10/31/2023 Bus Lic: BT30026859 Bus Lic Expire : 03/31/2024 Workers' Compensation Insurance Carrier: SECURITY NATIONAL INS CO Policy No: SNP1426534 W. C. Expire : 2/1/2024 Architect: JASON RICHART Address: 1041 18TH W, A106 COSTA MESA, CA 92627 Phone: (949)422-9191 State Lic: Engineer: JAMIL BASHAR S Address : 751 SHASTA DR CORONA, CA 92881 Phone: (714)883-4124 Designer: Address: Phone: Phone Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $15,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/Ti sq. ft. Bldg : 0 Occupancy Groups : R-3 No of Units : 1 Alteration sq. ft. Bldg : 177 Bldg Height: No of Stories ; 2 Added/New sq. ft. Garage: 0 TOTAL sq. ft. 0 Building Setbacks: Front: 5, Side: 4, Rear: 10 Flood Zone : X Use Zone : PC - Jasmine Park R PROCESSED BY: SPECIAL CONDITIONS: RUIZ, 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 eheckmangs) I have placed next to the applicable item(s) 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 is permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Stste License Lew (Chapter 9 (commencing with Section 7000) of Division of the Business and 'rofesaloris Code)or that he or she is exempt from licansure 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), 3 I, as owner of the property, or my employees with wages as their sole compensation, will do L)all of or U portions of the work, and the structure Is not intended or offered for sale (Section 7044, iusiness and Professions Code: The Contractors' Stale 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 Impmvomant 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). _! I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project j6ection 7044, Business and Professions Code: The Contractors' State License Law does not ly to an owner of property who builds or Improvesthereon, and who contracts for the projects with alicensed Contractor pursuant to the Contractors' State License Law). I am exempt from ecensure under the Contractors' State License Law for the following 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. lagall, oil a structure that I have built as an owner -bustler if R has not been constructed in its entirely by licensed Contractors. I understand that a copy of the applicable law, Section 70" of the Business and Irotessiohs Corse, is available upon request when this application is submitted prat the following Web site:http:/lwww.Wginfo.ca.gaWcalaw.htmi. Ilgnature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjurythat ) am l€Densed under provisions of Chapter 9 (commencing with section 7000}pf Dw ion 3 M the Business and Professipr10 Code, and my license is in full force nd effect. License Class License No Data 1F I l 7�2 fontractor Signature i PORKERS' COMPENSATION DECLARATION FANNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 19 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS tii00,000), IN AUWTION TO THE GET OF COMPENSATION; DAMAGES AS PROVIDED FOR IN SECTION 070t OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES, hereby affirm under penalty of perjury 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, forth erfgnorance 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 ranee carrier and policy number are, is of Agent certify that, In the performance of , If I should become subjec( t .the ialure of ADolicant / Policy Number Expiration Date work for which this permit is issued, I shall not employ any person in any manner sous to become subject to the workers compensation laws of California, and 'kers' compensation provisions of Section 3700 of the Labor Cade, I shall forthwith comply with those provisions. Date ®OZ Ir°nrw r curnun AYacur•v hereby affirm ur.der Deraltyof perjury that there is a construction lending agency for the performance of the work for which this permit. is. issued (Section 3097, Civil Code). .cnoer's Name Lender's Address 3_my siVirsture 4eihw, I certify to each of the following; I am the property owner or authorized to act on the property owner's behalf. I hove read this application and the Information I have provided incorrect I acres tO comply W€.h all applicablecity and county ordinances and state laws relating to building construction. i authorize repmsematfves of this city or county to r the aboll"entified property for inspection purposes. % aipnature of Prooi,r y C wner or Authorized nt �'" � Pon{ Pro a Owners or Authorized Agent's Name /��`/ tc"FIVIN m DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61. OF TITLE 40 AND AQMD RULE NERMITLANCELUD I IJEPA PERMIT EXFENDED qM0 PERMITFINAL {{� ASBESTOS NOTIFICANON IS NOT APPLICABLE TO CERTIFICATEOF ��"'1$ ! +��'X'� PROPOSED DEMOLITION . ,