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Home My WebLink AboutXR2022-2158 - PermitsdEW'okr City of Newport Beach II�I�IIII��III�I��I�I�II�I II COMB Permit : XR2022-21JH -- - Community Development Department- Building Division X R 2 m 2 2 2 1 5 g ,,, ty" 100 Civlc Center Drive, Newport Beach, CA 92660 Plan Check No : 1583-2019 - 0 s Permit Counter Phone: (949) 644-3288 Issued Date : 12/14/2022 Inspection Requests Phone: (949) 644-3255 Inspection Area :1 °7�/ro aH,r newportbeachce.gov/inspections 5''.. w+'�•°'�''?��. r-^� Combination Type - Work Class -Addition/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: 916 BALBOA BLVD W Legal Desc : A TR NEWPORT BEACH SEC'B BLK 109 LOT 9 Description : DELTA 1 REVISION & ADD'C SCOPE: REDUCE VALUATION TO $303,000 TOTAL FOR SCOPE OF WORK/SHOW 3RD FLR ADDITION 378 SF Owner: 916 W BALBOA BLVD ACQUISITION LLC Contractor t Architect : TALWAR SHIV DEVIDAS Address : 3379 LONG BEACH BLVD #278 Address : Address : 3340 RIVERSIDE DR #M CHINO, CA 91710 LONG BEACH, CA 90807 Phone: (949) 877-6719 Phone : - Phone : (909) 591-3939 Con State Lie: State Lie: CO23417 Lie Expire : Applicant : TALWAR SHIV DEVIDAS Bus Lie: Engineer Address : 3340 RIVERSIDE DR #M Bus Lie Expire : .Address CHINO, CA 91710 - Phone : (909) 591-3939 Workers' Compensation Insurance - Phone: Carrier : Owner/Builder: 916 W BALBOA BLVD ACQUISITION LLC Policy No : Designer Address : 3379 LONG BEACH BLVD #278 W. C. Expire: Address: LONG BEACH, CA 90807 Phone : (949) 877-6719 - Phone: Code Edition : 2019 Fire Sprinklers : YES Construction Valuation Type of Construction : V-B Fire Hazard Zone : NO Added/NewITI sq. ft. Bldg: 378 Occupancy Groups : U,R-3 No of Units: - 1 Alteration sq. ft. Bldg : Bldg Height: No of Stories : 3 - Added/New sq. ft. Garage: 0 TOTAL sq. ft. 378 Building Setbacks : Front: 5, Side: 3, Side: 3, Rear: 0 ' Flood Zone: X; AO 1 , Use Zone : R-2 - Two -Unit Residential BY: � r� I �y CONSTRUCTION f� C� NO CONSTRUCTION NOISE PROCESSED , SPECIAL CONDITIONS: REV2022-1412 ON THE WEEKEND ; I OWNER -BUILDER DECLARATION I hereby affirm under penaity 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 7031.5, Business end Professions Code: Any city or county that requires a. permitto construct, after, improve, dehldlish, or repair any structure, one( to Its issuance, also requires the applicant for the portnil to file a. signed statement that he or she is licensed pursuant to the provisions of the ContractorsStale 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 Iicensure 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 not more than five hundred. dollars ($500). 0 I, as owner of the property,or my employees with wages as their sole compensation., will do (.) ail of or U 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-Bulider will have the burden of proving that It was not built or improved for the purpose of sale). rl 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 apply 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 am exempt from Iicensure under the Contractors' State License Law for the following reason: By my signature below t acknowledge that, except for my personal residence in which I must have rmsldedfor at least one year prior to completion of the improvements covered by this permit, Icannot legall7 sell a structure that I have built as an owner-bullder If it has n onstructed In its gl raly by licensed contractors, I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, Is available upon request when this a Icajio Is subm rted.er ti6Elfollowing Web site:http*Jlwww,loginfo,ca.gov/calaw-html. Signature of Property Owner or Authorized Agertf" .�^ �—'�� Date 1,2-- )q —�LQ'72 LICENSED CONTRACTOR'S DECLARATKYW I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade, and my license Is In full force and effect, License Class. License No Date Contractor Signature COMPENSATION DECLARATION EARNING: FAILURE TO SECURE WORKERS" COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND Civil, FINES UP TO ONE HUNDRED THOUSAND DOLLARS I5100,0001, IN ADDITION TO THE �OSr OF COMPENSATION, OAMAOES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: -1 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, issued by the Director of Industrial Relatlons as provided for by Section 3700 of the Labor Code, for tit performance of the work for which this permit is issued. Policy No. -1I 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' compensation isurance carrier and policy number are: farrier Policy Number Expiration Date Jame of Agent Phone #, :9I 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 io the workers' compensation laws of California, and agrer hat, If I should become subject to the w compensatio to is If Section 3T00 of the Labor Code,. I shall forthwith comply with those provisions. >Ignalure of Applicant_ Datei Z I '20 1 Mr AD ATinu Dr r At ntiail rflki cr Cl nklb I r CAA M, r ArCMPV hereby affirm under penalty of perjury that there0le a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code) .enders Name Lenders 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 w;th all applicable city and county ordina d state laws relaLing to building construction. I authorize repreaertatives of this city or county to a Inspection purposes. 3'cnrry a of Propirty Owner or Authorized Agent — Print Pro e Fly Owner's or Authorized A anI'S Name Q M A,f1 (L•91vA L 1 ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND ARMD RU LE F.FHM,TFINAL 11>1� K./ U ASBESTOS NOTIFICATION IS NOT APPLICABLE TO Ln,1 LATE OF I PROPOSED�Ed, �7 _ OCCUP"NCYISSNEO '5IGNATUR �,� �