HomeMy WebLinkAboutXR2023-2824 - Permits4i,
City of Newport Beach
Community Development Department- BuildingDivision
�_, 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 718-1888
newportbeachce.gov/civic
a411-7 NCombination Type - MFP ELEC PLUM
Work Class - Other
11111111111111111111111111111111111111111111111111111111I 11COMB Permit : XR2O23-2s24
Plan Check No : PC2023-2457
Issued Date : 1011112023
Final Date:
Permit Status: Issued
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 : 50 SEABOROUGH, 26
Description : MFR SUB SLAB DEPRESSURIZATION
Owner: MADELINE LEFEBVRE
Address : 50 SEABOROUGH, 26
NEWPORT BEACH, CA 92660
Phone :
Applicant: GREG SHERMAN
Address : 7171 WARNER AVE STE B-404
HUNTINGTON BEACH, CA 92647
Phone: (760)803-9389
Owner/Builder :
Address :
Phone
Legal Desc : N TR 12164 BLK LOT 3 UN 25 TR 12164 LOT 3 UNIT 25
Contractor • ENGINEERING AND ENVIRONMENTAL Architect:
CONSTRUCTION INC
Address :
7171 WARNER AVE STE B404
HUNTINGTON BEACH, CA 92647
Phone:
(760)803-9389
Con State Lie
: 883727
Lie Expire :
09/30/2024
Bus Lie:
BT30082135
Bus Lie Expire : 07/31/2024
Workers' Compensation Insurance
Carrier: ACE AMERICAN INSURANCE COMPANY
Policy No : C51450152
W. C. Expire: 10/1/2024
Code Edition :
2022
Fire Sprinklers :
NO
Type of Construction :
V-B
Fire Hazard Zone :
NO
Occupancy Groups :
U,R-2
No of Units :
1
Bldg Height:
No of Stories :
1
Building Setbacks :
Flood Zone : X
Use Zone : PC - Aeronutronic Ford
PROCESSED BY: 37
SPECIAL CONDITIONS:
Address :
Phone :
State Lie
Engineer: CHARLES BLANCHARD
Address : 555 12TH ST STE 215
OAKLAND, CA 94607
Phone: (925)580-2754
Designer
Address
Phone:
Construction Valuation : $40,000'00.
Added/New/Ti sq. ft. Bldg : D '
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage: 0
TOTAL sq. ft. : 0 '
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that f. am exempt frorn 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 and Professions Code: Any city or county that requires a permit to construct, alter, improve, dernolish, 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 licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing Willi 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 for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500).
Ell, as owner of the property., or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure is not intendedor offered for sale (Section 7044.
Business and Professions Code: The Contractors' Stale 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, ilia Owner -Builder will have the burden of proving that it was not built or
Improved for the purpose of sale).
❑ 1, as owner of the properly, am exclusively contracting w€lh licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
appIv t0 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 licensors under the Contractors' Slate License Law for the following reason:
By 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)
sell a structure that I have bull[ as an owner -builder If it has not been constructed in its entirely 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 application is submitted Or at the following Web she:http:ffwww.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized AgemDate
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penally of perjury that I ono licensed under provisions of Chapter 9 (commencing with Section 70 0 i j; ipn�Byof the Business and Profe s de, an enser is in full force
and effect. License Class License No Date (i S Contractor Signature
WORKERS' COMPENSATION DECLARATION ki
WARNING: 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 (i104000), IN ADDRION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby a krm under penally of perjury one of the following declarations:
Vand 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
,ofthe work for which this permit is issued. Policy No.
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' compense fo
insurance carrier and policy number are:
Carrier Policy Number Expiration Date
Name of Agent Phone #
❑I certify that, in the performance of the work for which this per 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
that. if I should become subject to thew I
kern' corn = , ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant _ '" .. ..._._.._.._. Date
DECLARATION REGARDING C NSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performanceof the work for which this permit Is issued (Section 3097, Civil Code).
Lenders Name _ _ _ Lender's Address _
By my signature below. I certify to each of the following:
i' ' Tm the propei,y owner or authorized to acton the property owner's behalf.
I have read (hs application and the information I have provided is correct
I acree to con'' with all applicable city and county ordinances and state laws relating to building construction,
'ki authorize ropresenlahves of this city or county to nler th above -Identified arty for in purposes. ro/I ,I/rg \)
,onaure of Pro art CWner or Authorized Agent Print Property Owner's or Authorized Agent s Name EE�6 `'' ' r" r^" Date v (( Z
ACTION DATE By '.. DECLARATION OF COMPLIANCE N9TA CODE OF FEDERAL FOR OFFICE USE ONLY
RFGUt ATIONS PART 61. OF TITLF 40 AND AQMD RULF
1403
',AA,di':XPMFO L1 I Sf1BMITTFD ASBESTOS NOTIFICATION TO '» -
PFRN11TCANCEIIFD E A
PERMIT XTENDED QMD
PERMt7 FINAL �� 23 r ',ASBESTOS NOTIFICATION IS NOT APPLECABLE TO
CERTIFICATE OF lilik PROP05ED DEMO ITION
PtAMITFINAI 11WOCCUPANCY ISSUED SIGNATURE: