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Home My WebLink AboutXR2023-0101 - PermitsCiof ty Newport BeachCommunitymunnitty eoeDpmnt- Building Division II III IIIIIIIIIIIIIIIIIII 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 newportbeachca.gov/inspections Combination Type - SFP ELEC MECH PLUM Work Class - Addition/Alteration IIII IIIIIIIIIIIIIIIIII II COMB Permit : XR2023-0101 Plan Check No: PC2022-2455 Issued Date : 0112412023 Inspection Area : 2 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 : 2871 BAY SHORE DR Legal Desc : N TR 1014 BILK LOT 58 Description: DELTA 1 REVISION & ADD'L SCOPE: EXPAND 25 SF @ ENTRY, WIDEN KITCHEN WINDOW, REMOVE WALL @ KITCHEN/WIC/OFFICE, ADD BATH 3 Owner: DEYOUNG-DEVAERE TRUST Contractor : Architect Address : 4427 W COAST HWY Address : Address NEWPORT BEACH, CA 92663 Phone: (760)703-2983 Phone: Phone: Con State Lie : State Lie Lie Expire : Applicant: Phil Edmondson Bus Lie : Engineer : NAGARAJAN 3IV-ARA',I ' Address : 305 Orange Ave., suite B Orange Ave. Bus Lie Expire : Address : 167 MATISSE CIRCLE Huntington Beach, CA 92648 ALSO VIEJO, CA 92653 Phone : (949) 675-9468 Workers' Compensation Insurance Phone : (714) 444-2422 - Carrier : Owner/Builder : DEYOUNG-DEVAERE TRUST Policy No: Designer : Phil Edmonuso,i Address: 4427 W COAST HWY W. C. Expire : Address : 305 Orange A, P., suite B'Orange Ave. NEWPORT BEACH, CA 92663 Huntingtow Beach, CA,P,2 a�8 ' Phone : (760) 703-2983 Phone : (949) 675 P45$ Code Edition : 2019 Fire Sprinklers : NO Construction Valuation':'$8,000.00 Type of Construction ; V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 25 Occupancy Groups : U,R-3 No of Units : 1 Alteration sq. ft. Bldg : Bldg Height: No of Stories ; 2 Added/New sq. ft. Garage : 0 TOTAL sq. ft. : 25 Building Setbacks : Front: 10, Side: 3, Side: 3, Rear: 10 Flood Zone : X; X Use Zone: R-1 - Single -Unit Residential NO CONSTRUCTION N0i0.L PROCESSED BY: SPECIAL CONDITIONS: a�� Oil THk wEEKEND IL OWNER -BUILDER DECLARATION I hereby affli under penalty of perjury that I am exempt from the Contractors' Slate License Law for the rP.ason(s) indicated below by the checkmark(s) I have placed next io the applicable items) ,Section 7031.5, Business and Professions Cade: Any city or county that requires a permit to consti alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for he permit to file a signed statement that ho 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 Professions 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 fora permit subjects the applicant to a civil penalty of ,gt more than five hundred dollars (5500). I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or t_) 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 thepurpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7D44, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 3 I am exempt from licensure under the Contractors' State License Law for the following reason: B m'si nature below[ acknowledge that, except form personal residence In which I must have resided For at least one year prior to completion of the improvements covered by this permit, 1 cannot iegaily y k g 9 p Y loll a structure that I have built as an owner -builder it it has not' oen co str ct i s entirety by licensed contractors. I understand that a copy of the applicable law, Suction 70M� of the Business and Professions Code, is available upon request when"dund s to r the following Web site:http:Ifwww.leginfo.ce.gov/ca[aw.html. Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARAT1 i hereby affirm under penalty of perjury that I am Ilevisions of Chapter 9 (commencing with Section 7000) of Division 3of the Business and Professions Code, and my license is In fall force and effect. License Class License No Date Contractor Signature NORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WOR.(ERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (6100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES As PRO'gDED FOR 1N SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEye FEES. hereby affirm under penelly, of perjury one of the following declarations: -11 have and will mail a uerrfi.^ate 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 lh cerformance of the wc,k for which this permit is issued. Policy No. have and will mainl workers compensation insurance, as required by Section 37CO of the Labor Code, for the performance of the work for which this permit is Issued. My workers' ranee carder and policy number are: Policy Number Date To of Agent. _ Phone # certify that. in Ilia rerfrr.nana 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 Cal'domia, and if I should becoin- 4ub act to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. lgnature Of Appliean° --_ _ _. Date_ rECLARATION REGARDING CONSTRUCTION LENDING 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). Branca Name Lender's Address ly my signature below, I certify to each of ilia following: I am the property owner or authorized to act an 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 coup ordinances an st to I elating to building construction. �f�7 I authorize representatives of this city or county tie IterjK9,lfdovvlyn d7 fi operty for inspection purposes. ACTION DATE BY '(i AF.6j AR�TfON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY `-rREGULA1`ION5 PART 51 OF `UTLE 4C AND AQMD ROLE PERMIT EXPIRED I U SUBMITTEDASBESTOS NOTIFICATION TO PERMITC4'NCELLED 1 EPA PERMITFINAL IdJ'ASBE5T'OS OTiFICA'1 N15 OT PPL//(//LLE 10 OCCUPANC OF I ( 4n^ , PR0905F.D D 2/y OCCUPANCVf55UED r rV i slcNnTURF�` /,F /