HomeMy WebLinkAboutXR2023-0049 - Permits��WPORT
City of Newport Beach
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Community Development Department - Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone: (949) 644-3288
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Inspection Requests Phone: (949) 644-3255
newportbeachca.gov/inspections
Combination Type -
Work Class - Alteration
COMB Permit : XR2023-0049
Plan Check No : PC2023-0053
Issued Date : 0210112023
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 : 133 OPAL AVE Legal Desc : A TR BALBOA ISLAND RESUB SEC 1 BLK 9 LOT 19
Description: MFR REMOVE FRONT WINDOWS & PORTION OF WALL TO CREATE NEW BI FOLD DOORS
Owner:
MIKE GROSS
Address :
133 Opal Ave
Newport Beach, CA 92662
Phone:
(626)232-4400
Applicant:
DANNY REYNOSO
Address :
17832 E Edna PI
Covina, CA 91722
Phone:
(626)536-7786
Owner/Builder : MIKE GROSS
Address : 133 Opal Ave
Newport Beach, CA 92662
Phone: (626)232-4400
Contractor
Address :
Phone:
Con State Lie
Lie Expire
Bus Lie:
Bus Lie Expire
Workers' Compensation Insurance
Carrier :
Policy No:
W. C. Expire:
Architect
Address
Phone:
State Lie
Engineer:
Address
Phone:
Designer
Address
Phone :
6 ry
HERRERA EDGAR E
1971 S SUNRISE DRIVE
MONTEREY PARK, CA 91754
Code Edition : 2022
Fire Sprinklers :
NO
Construction Valuation :
Type of Construction : V-B
Fire Hazard Zone :
NO
Added/NewlTl sq. ft. Bldg
Occupancy Groups : R-3
No of Units :
2
Alteration sq. ft. Bldg :
Bldg Height:
No of Stories :
2
Added/New sq. ft. Garage
TOTAL sq. ft. :
Building Setbacks : Front: 10, Side: 3, Side: 3, Rear: 5
Flood Zone : X; AO 1
Use Zone : R-BI - Two -Unit Residential, Balboa Island
PROCESSED BY:
SPECIAL CONDITIONS: 0/13 FORM ATTACHED
$10,000.00
0
0
0
NO CONSTRUCi IC)i ,-,,,
'ON THE WEEKEND `
OWNER -BUILDER DECLARATION
€ 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 -Items)
Section 70315, 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
ID 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 licensors and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civ;) penally of
6�ttt 'm'ore than five hundred dollars ($500).
11, as owner of the property, or my employees with wages as their sole compensation, will de (_) all of or onions of the work, and the structure Is not intended or offered for sale (Section 7044,
rusiness and Professions Code: The Contractors State License Law does not apply to an owner of propert)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
nprovedfor the purpose of sale).
Z 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 improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
1 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 lag,all}
ell a structure that I have built as an owner -builds if i has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Secti 7 44 of th Businasls
rofessons Code,, is available upon request when ih appllcafio s u mitt or at th rl Website:httpalwww.eginfo.ca.gov(caiaw.html.
.ignature of Property Owner or Authorized Agent _ Do
.ICENSED CONTRACTOR'S DECLARATI----
hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9- (commencing with Section 7000) of Division 3 of the Business and Professions Code, Let my license is In full force
nd effect. License Class License. No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
iARNING: FAILURE TO SECURE WORY.FRS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
ORT OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37QS OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEee
hereby affirm under penalty of perjury one of the following declarations:
1 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.
have and will maintain workers' compensation insurance, as required by Section 37CO of the Labor Code, for the performance of the work for which this permitis issued. My workers'
rance carrier and policy number are:
Policy Number
of Agent
Date
It certify that. in the pert mano1 of the work for which this permit is issued.. 1 shall not employ any parson in any manner so as to become subject to the works ompensatinn lawsmia, and ogre
Tat, if I should beco s bject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
signature of Applies - D
LECLARATION REGA DIN NSTRUC7fON LENDING AGENCY
hereby affirm under penal f perjury that there is a construction lending agency for the performance of the work for which this permit Is issued' (Section 309 Ci 'I Code).
enders Name Lender's Address
ly my signature below, I certify to each of the following:
I am the property owner or authorized to out on the. property owner's behalf.
I have read this application and the information I ha provided is correct.
I agree to representatives
all applicable city and co t ordinances and state laws relating to building. construction. q� ,wr� (� f
i authorize representatives of this coy or county i rite abo dentlfied property for inspection purposes. ,A/\ (/ /b S Y t
tignatum of Property Owner or Authorized Agent � PF�LPLopertv Owner's or Authorized Acent's Name i Dat
ACTION
DATE
BY I DECCARLYrIONOF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY / \
E REGULATIONS PART 51'OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
I ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
�SUBMITTED
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L�EPA
PERMIT EXTENDED
€.k08
PERMIT FINAL
OF
_
ES O5ONF OON 15 MCI APP'J';AblE TCCERTIFICATE
PSF C T
OCCUPANCYISSUED
SIGNATUR