HomeMy WebLinkAboutXR2023-0488 - Permits�EWeORT City of Newport Beach II II II I I I II IIIIIIIII III IIII III III I II COMB Permit: XR2023-0488
D� @ Community Development Department - Building Division X R 2 0 2 3 0 4 8 8
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2023-0406
U Permit Counter Phone: (949) 718-1888 Issued Date : 05/12/2023
w'.newportbeachca.gov/civic Inspection Area : 2
°"aFOF P Combination Type - MFP ELEC
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 : 22 ENCORE CT Legal Desc : N TR 7817 BILK LOT 4 UN 217 TR 7817 LOT 4 UNIT 217 OF PROJECT LOCATED ON AP
Description: MFR ALT CONVERT CRAWLSPACE TO STORAGE 350 SF
Owner: JEFFREY KLINGELHOFER
Address : 989 PASEO DEL SUR
SANTA FE, NM 87501
Phone : (760) 807-5530
Applicant: BOURKE CONSTRUCTION INC
Address: 1039 SOUTH ARMSTRONG CIRCLE
ANAHEIM, CA 92807
Phone : (714) 281-1974
Owner/Builder:
Address :
Contractor:
BOURKE CONSTRUCTION INC
Address :
1039 SOUTH ARMSTRONG CIRCLE
ANAHEIM, CA 92807
Phone :
(714) 281-1974
Con State Lic
: 717199
Lic Expire :
04/30/2025
Bus Lic:
BT30081632
Bus Lic Expire : 05/31/2024
Workers' Compensation Insurance
Carrier: STATE FUND
Policy No: 9099377
W. C. Expire: 5/14/2024
Architect
Address
Phone:
State Lip:
Engineer: XIAO QIANG
Address: 1520 BROOKHOLLOW DR #45
SANTA ANA, CA 92705
Phone: (714)662-0510
Designer:
Address :
Phone:
Phone:
Code Edition :
2022
Fire Sprinklers :
NO
Construction Valuation :
$10,000.00
Type of Construction :
V-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg :
0
Occupancy Groups :
U.R-2
No of Units :
8
Alteration sq. ft. Bldg :
350
Bldg Height :
No of Stories :
2
Added/New sq. ft. Garage:
0
TOTAL sq. ft.
0
Building Setbacks
rl
Flood Zone :
X
Use Zone :
PC - Newport Crest - UP1585
PROCESSED BY:
- -
- -
SPECIAL CONDITIONS:
DECLARATION
t hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate 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 0r-oieant for
is permit to file a signed statement that he or 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
'rofessions Code) or that he or she is exempt from iiceasureand 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, 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,
rosiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employeesor personal effort, builds or improves the property, provided that the
npravements 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
nproved for the purpose of sale).
3 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
pply 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),
3 1 am exempt from licensure under the Contractors' State License Law for the following reason: ___
ly 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 legal],
ell a structure that I have built as an owner -builder if it has not boon constructed in its entirety 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 VVeb site:http:/Ica ,f.leginfo.ca..gov/calaw,himl.
lignature of Property Owner or Authorized Agent Date
ACENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjupj that I am licensed under provisions of Chapter 9 (commencing with Section 7000 of Division 3 of the Business and Profeg a and. ense is in full force
no effect. License Class \� License No i I-? / 01`1' Data 3 Contractor Signature
✓•
UORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS [5100,000), IN ADDITION TD THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3T00 OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES_
hereby affirm under penalty of perjury one of the following declarations:
I have and 411 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 in
�,�Unance of the work for which this permit Is issued. Policy No.
and will maintain workers' compensation insurance as required by Section 3700 of the Labor Code, for the performance of the work for which this permitis issued. My workers'
carrier and policy number are:
Policy Number Expiration Date
of Agent
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
. If I should become sublect to3he-workens' compensatfon Drovtsin of Section 3700 of the Labor Code. I shall forthwith comply with those Drovisions.
of
nedy affirm underlftenalty 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).
ider's Name Lenders 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 ordinances and state laws relating to building. construction.
I authorize representatives of this city or counrt�y, toe Ified property for inspection purposes, n
nature of Property Owner or Authorized Agent. % Print Property Owner's or Authorized Aaerins Name/\/ \ -Acllc
BY
PERMIT EXPIRED
P€RMI7 CANCELLE'7
PERMIT EXTENDED
PERrbil'T FINAL
CERTiFlCAT E OF
OCCUPANCY ISSUED
REGULATIONS PART 51 0E TITLE 40 AND AQNID RULE
1403
1 SUBMITTEDASBFSTOS NOTIFICATION TO
NO7IRCA't1ON 15 NOT APPLICABLE TO
FOR OFFICE USE ONLY
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