HomeMy WebLinkAboutXR2023-2946 - Permits�EWPo," City of Newport Beach 111111p111111111111111111p11111111111111111111111111111 jj COMB Permit : XR2O23-2946
I Community Development Department - Building Division
H y# n 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2022-3218
l 2 Permit Counter Phone: (949) 718-1888 Issued Date : 1011812023
newportbeachca.gcv/civic Final Date:
c"��roaN�r Combination Type - SFP Permit Status: Issued
Work Class - Demolition 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
Job Address : 7 HERMITAGE LN Legal Desc : N TR 7223 BILK LOT 88
Description: DEMO DETACHED GARAGE, INCLDS SEWER CAP
Owner: KHOURY ABDO H TR KHOURY LIVING TR
Address : 18 CHERRY HILLS LN
NEWPORT BEACH, CA 92660
Phone:
Applicant: TERRY CHANG
Address : 22 CORPORATE PARK, SUITE 200
IRVINE, CA 92606
Phone: (949)955-3282
Owner/Builder
Address :
Contractor :
RDMS INC
Address :
250 BAKER ST E, 300
COSTA MESA, CA 92626
Phone:
(714)546-1130
Con State Lic
: 815872
Lic Expire :
12/31/2024
Bus Lic :
BT30008726
Bus Lic Expire : 01/31/2024
Workers' Compensation Insurance
Carrier: EVEREST PREMIER INS CO
Policy No: 7600015443221
W. C. Expire : 9/1/2024
Architect : TAJUDIN AMAT K
Address : 22 CORPORATE PARK, 2,')QJRJjNE, CA
92606
Phone : (949) 955-3282 - - .....
State Lic
Engineer: XIAOQ[AN G '
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 :
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 : 1
Added/New sq. ft. Garage
TOTAL sq. ft.
Building Setbacks ;
Front: 10, Side: 5, Side: 5, Rear: 15
Flood Zone :
X
Use Zone :
PC - Big Canyon
PROCESSED BY: k
SPECIAL CONDITIONS
$2,000.00
0
0
0
OWNER -BUILDER DECLARATION
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 ftem(s)
(Section 7031-5, Business and Professions Coda: 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
the permit to file a signed statement that he or she is Iiconsed 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 for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars 1$500).
0 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) 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. II, 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 the purpose of sale).
111, as owner of the properly, 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 ovmer of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
,J I am exempt from licensure under the Contractors' State License Law for the following reason
q my signature below I acknowledge that, except for my personal residence in which I must Have resided foran least one year prior to completion of the improvements covared by this permit 1 cannot legally
all a structure that I have built as an ownor-builder if It has not been constructed in its entirety by licensed contractors. I understandthat 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 Web site:httpaiwww'.leginfo.ca.gov/calaw.html.
.ignahlre of Property Owner or Authorized Agent __,_____ Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penally of perjury that I am licensed under provisions of Chapter g (commencing with Section 71 Divisi n 3 of the Businads and Professions Cope and�ny license is In full force
nd effect. L'tc�nse Class License No Dat D Conlr or Signature �� 5�d�
VORKERS' COMPENSATION DECLARATION
',tkN,Na: FAILURE 10 eECVRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS t6100,000), IN ADDITION TO THE
DST OF COMPENr A7"0 1,. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND ATTORNEYa FEES.
herebv affirm un'ter penalty of perjury one of the following declarations:
I I 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 thl
e,formance of the wc.k for which this permit is issued. Policy No,
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'
rar-e carrier and policy number are•.
Policy Number
cf Agent _ _
Date
1' rer fy 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 agre
,1l if I should oe�cme subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
�ignafure of APpli � //-- ^� ZO?
IEC LARATIO GARDtNG CONSTRUCTION LENDING AGENCY Date /
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, Ivil C de).
enders Name Lender's Addra."
Iy 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 autherize representatives of this N or ounty to enter the above-jydentified property for Inspection purposes.
iionafure of PrOoerty Owner or Authet ent S' �(Print Property Owner's or Authorized AqV(s Nam,. .--� i
ACTION
EXPIRED
P€RMITEXTENDED
-'-'-'--... ............._. ....__ _....�___.._.
PCRiU1T PINAt
CERTIFICATE OP
OCCUPANCY ISSUED
DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOROFFICEUSE
REGULATIONS PART 61 OF TITLE 40 AND AQM D RULE
5UBMITTED ASBESTOS NOTIFICATION TO
PROPOSED
NOTIFdCATION IS NOT APPLICABLE TO