HomeMy WebLinkAboutXR2023-2106 - Permits�EWPORr City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit XR2023-2106
D4 ) Community Development Department- Building Division x R 2 0 2 3 2 1 0 6
F n100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2023-1834
Permit Counter Phone: (949) 718-1888 Issued Date : 0713112023
r newportbeachca.gov/civic Final Date:
°q�rcoar�" Combination Type - Permit Status: Issued
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
IdN;t 6 Z rm% 7' eN—,-.
Job Address : 100 HARTFORD DR Legal Desc : N TR 11604 BLK LOT 3 UN 59 TR 11604 LOT 3 UNIT 59 �+-'' UR
Description : MFR SUB SLAB DEPRESSURIZATION
Owner:
Address
Phone :
Applicant
Address
Phone:
BAYRIDGE PARK HOMEOWNERS
Contractor:
ASSOCIATION
1 HARTFORD DR
Address
NEWPORT BEACH, CA 92660
(949)706-4544
Phone:
Con State Lic
Lic Expire
ENGINEERING AND ENVIRONMENTAL
Bus Lic :
CONSTRUCTION INC
7171 WARNER AVE STE B404
HUNTINGTON BEACH, CA 92647
(760)803-9389
Owner/Builder :
Address :
ENGINEERING AND ENVIRONMENTAL Architect:
CONSTRUCTION INC
7171 WARNER AVE STE B404
HUNTINGTON BEACH, CA 92647
(760)803-9389
883727
09/30/2024
BT30082135
Bus Lic Expire : 07/31/2024
Workers' Compensation Insurance
Carrier: ACE AMERICAN
Policy No: C51450152
W. C. Expire : 10/1/2023
Address
Phone
State Lic
Engineer:
CHARLES BLANCHARD '
Address :
555 12TH ST STE 215
OAKLAND, CA 94607 .
Phone:
(925)580-2754
Designer:
,
Address
Phone:
Phone:
Code Edition : 2022
Fire Sprinklers :
NO
Construction Valuation
Type of Construction : V-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg
Occupancy Groups : U
No of Units :
0
Alteration sq. ft. Bldg :
Bldg Height:
No of Stories :
0
Added/New sq. ft. Garage
TOTAL sq. ft. :
Building Setbacks
Flood Zone : X
Use Zone: PC - Aeronutronic Ford
PROCESSED BY
SPECIAL CONDITIONS:
$40,000.00
0
0
0
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 checkmark(s) 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, altar, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
ie 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 liceasure 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 L) all of or U portions of the work; and the structure Is not Intended or offered for sale (Section 7044,
alsiness and Professions Code: The Contractors' Slate 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
nproved for the purpose of sale).
1 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
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)..
I I am exempt from licensure under the Contractors' State License Law for the following reason _ _.__..____
-y 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],
all a structure that I have built as an owner -builder if it has not been 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 oral: the following'Neb site: Tlp:lAroww.leginfo.ca.gcv)caIaw.htmI.
ignature of Property Owner or Authorized Agent - Date _
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions o�yf,����n� '�',/p ry�P ing with Se to O vi i f the E ine s and Profe ns Cod�,,wd-srrNcense is In full force
rid effect. License Class License No [�= ( Z 1 to Contract Si r1\ature
WORKERS' COMPENSATION DECLARATION
fARN ING! FAILURE TO SECUPE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS (6100,000). IN ADDITION TO THE
:DST OF COMPENSAT:3 a, LAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR C00E1 INTEREST, AND ATTORNEY'$ FEES,
ha:LLy a.`fllel urJer FE .illy of perjury one of the following declarations:
have and Will maintain a certificate of consent to self -insure for workers' compensalion, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
fa, maoce of the vrork for which this permit is issued. Policy No.
and wit! maim€'.n 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'
carrier and policy number are:
Ta o' Agent _
G3 t N that, In
If I s:,ould
let ure of ppl'
Policy Number
Date
performs ce 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 Califomia, and agre
to ibje Wide orkers' v satlon previsions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. e
AROING CONSTRUC71ON LENDING AGENCY --�� ��____
hereby affirm under penalty of perjury that there is a construction fending agency for the performance of the work for which thus permit is issued (Section 3 97, C it Code).
.ender's Name Lender's Address
3y 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 at] applicable and county ordinances and state laws relating to building. construction.
I authorize representatives of this city o.. my property for inspection purposes. r r.
3i nature of Property tD ter t above -I Owner or Authorize ent Print Property Owner's or Authorized A 's N"
ACTION DATE 11 DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE,
1403
PERMIT EXPIRED 1 SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CAIyCFL LED
PERMITEATENDED _ LIAOMO
_.__._..._.._ ._ _ _..... _. ..-........ _.._._....__ ..__.....
PERMIT FINAL Q l� ' �t.J ASBESTOS NOTIRCA'I ION IS N07 APPLICABLE TO
CERTIFICATE OF /i/ r PROPOSED DEMOLITION
OCCUPANCY ISSUED 1 SIGNATURE;