HomeMy WebLinkAboutXR2023-2607 - PermitsPo", City of Newport Beach 11111111i111�111111111111111111111111111111111111111 iijjjjCOMB Permit : XR2023-2607
p� d Community Development Department- Building Division X R 2 0 2 3 2 6 0 7
> j 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No
949 Ph t Permit Co
unter one: 718-1888
} S ( i Issued Date : 09/16/2923
e.. newportbeachca.gov/civic Final Date:
c94 FoaN�P Combination Type - SFP PLUM Permit Status: Issued
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Work Class - Demolition 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 : 123 CRYSTAL AVE Legal Desc : A TR BALBOA ISLAND SEC 5 BILK 2 LOT 14
Description : DEMO SFR 416 SF. 1 BEDROOM. SEWER CAP INCLUDED
Owner: 123 CRYSTAL GROUP LLC
Address : 2901 W MACARTHUR BLVD
SANTA ANA, CA 92704
Phone:
Applicant: NATALIE TANG
Address : 17272 NEWHOPE ST, Suite K
FOUNTAIN VALLEY, CA 92708
Phone :
Owner/Builder :
Address :
Phone
Contractor:
KEYSTONE D C S INC
Address :
17272 NEWHOPE ST, STE K
FOUNTAIN VALLEY, CA 92708
Phone:
(714)791-3771
Con State Lic
: 1013293
Lic Expire :
04/30/2024
Bus Lic:
BT30076080
Bus Lic Expire : 07/31/2024
Workers' Compensation Insurance
Carrier: STATE FUND
Policy No : 9157538
W. C. Expire: 4/21/2024
Architect
Address
Phone:
State Lic:
Engineer:
Address :
Phone
Designer: TIMOTHY NGUYEN
Address : 17272 NEWHOPE ST
FOUNTAIN VALLEY, CA 92708
Phone: (714)883-6001
Code Edition :
2022
Fire Sprinklers : NO
Construction Valuation : $10,000.00
Type of Construction
: V-B
Fire Hazard Zone : NO
Added/New/Ti sq. ft. Bldg: 0
Occupancy Groups
: R-3
No of Units : 1
Alteration sq. ft. Bldg :
Bldg Height :
No of Stories : 1
Added/New sq. ft. Garage : 0
TOTAL sq. ft. 0
Building Setbacks :
Front: 8, Side: 3, Side: 3, Rear: 5
Flood Zone :
X
Use Zone:
R-BI - Two -Unit Residential, Balboa
Island
PROCESSED BY:
_
E�y qr p C
. No CONSTpjUotION NOISE
SPECIAL CONDITIONS:
ON THE WEEKEND
is
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reason(s) indicated below by the eheckrnark(s) I have placed next to the applicable items)
Section 7031.5. Business and Professions Code; Any city or county that requires a permit to construct, oiler, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
in 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
rarsesions Code I 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
of more than five hundred dollars 1$500).
Z 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
USiness 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
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).
7 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
poly 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 exemptsure under the Contractors' State License Law for ilia following reason .... _..... __ ___.,— from IVicen
iy my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year
r prior to completion of the improvements covered by this permit, I.cannot legall,
ell a structure that I have built as an ownor-builder if it has not been constructed in its ontiroty 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 or at the following Web site:http:liwww.legmfo.ca.gov/calaw.html.
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 0) of Dit'sion 3 of the Business and Profe aions ode, and. my license is In full farce
rideffect. License Class License No Date 3Contractor Signatuc
VORKERS' COMPENSATION DECLARATION vkl
ARNING: FAILURE TO SECURE WORXERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP To ONE HUNDRED THOU ANO DOLLARS ($100,000), {N ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3t06 OF THE LASOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
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
'ormanca of the work 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` compensa
trance carrier and policy number are:
Policy Number
of Agent
Date
certify that, in the performance of the work for which this permit Is issued, I shall notemploy any person in any manner so as to become subject to the workers' compensation laws of California, and agre
t, if I should become subject t wor ers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Al __ ��_ _____ Dat ✓ I �/ �/ v L.7�
CLARATION REGACONB TI LENSING AGENCY
areby 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).
rdFir`s Name Lender's Address
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 stale laws relating to building construction. C7'"
1 authorize representatives of this city or county to ent ove-identified property for inspection purposes. ` /^,,(D� V ��
nature of ProDenv Owner or Authorized Anent N � Print Property Owner's or Authorized Aoent's Nan--6" V Y" 1 /s'�— Date
ACTION I DATE. 1 BY
PERMIT EXPIRED
PERMIT CANCEtlED
PERPOIT EXTENDED
Lv��
CERTIFICATE OF
OCCIPANCY15SUED
DECLARATION OF CCIRI'PL1R I)I T01 CODE OF FEDE.
RFCUI.ATION5 PART 61 OF TITLE 40 AND AQMD RULE
ASBESTOS NOTIFICATION IS NOI APPLICABLE TO
PROPOSED
FOR OFFICE USE ONLY