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Home My WebLink AboutXR2023-0997 - PermitsCity of Newport Beach 0 p Community Development Department- Building Division y 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 tea. m Inspection Requests Phone: (949) 644-3255 °gcrFoaN`P newportbeachca.gov/inspections Combination Type - SFP ELEC MECH Work Class - Addition/Alteration 11111111111111111111111111111111111111111111111111111111I 11COMB Permit : XR2023-0997 Plan Check No : 1016-2022 Issued Date : 04/28/2023 Inspection Area : 5 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 : 18 ARCHIPELAGO DR Legal Desc : N TR 15817 BLK LOT 4 Description: SFR -ADD 1ST FLR LIVING AREA (105 SF); ADD DECK ON 2ND FLR W/ STRUCTURAL CHANGES (105 SF)(REV2023-0723) Owner: DEMIA INVESTMENT GROUP LLC Address : 43 BRIDGEPORT RD NEWPORT COAST, CA 92657 Phone Applicant: AMERICAL CONSTRUCTION MGMT Address : 26081 MERIT CI #114 LAGUNA HILLS, CA 92653 Phone : (949) 276-1604 Owner/Builder : Address : Contractor: AMERICAL CONSTRUCTION MGMT Address : 26081 MERIT CIR #114 LAGUNA HILLS, CA 92653 Phone: (949)276-1604 Con State Lie : 949438 Lie Expire : 06/30/2024 Bus Lie: BT30071151 Bus Lie Expire : 02/28/2024 Workers' Compensation Insurance Carrier: STATE COMPENSATION INSURANCE FUND Policy No: 9241513 W. C. Expire : 11/15/2023 Architect: SALAT JOHN A Address: 22386 WOO DGROVE RD LAKE FOREST, CA 92630 Phone: (949)235-4847 State Lie Engineer : BURKE THOMAS Address : 151 KALMUS DR#140 "" COSTA MESA, CA 92626 Phone : (949) 494-0776 Designer Address Phone: Phone: a Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $20,006.00 ' Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 Occupancy Groups : U,R-3 No of Units : 1 Alteration sq. ft. Bldg : 105 Bldg Height: No of Stories : 2 Added/New sq. ft. Garage : 0 TOTAL sq. ft. : 0 Building Setbacks Flood Zone : X Use Zone : PC - Newport Coast IIQ_ PROCESSED BY: SPECIAL CONDITIONS: 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 item(s) 3ecUon 7031.5, 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 is 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 afire Business and 'rofessions 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 of more than five hundred dollars ($500). 1 I, as owner of the property, or my employees with %Vegas as their sole compensation, will do Uall of or U portions of the work, and the structure is not Intended or offered for sale (Section 7044, Li and Professions Corte: The Contractors' State License Law does not apply to an owner of property who, through employees' cr personal effort, builds or improves the property, provided that the aprovements 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). 1 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 pp y, 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). 3 1 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 legal; all a structure that I have built as an owner -builder if it has not been constructed in its entirety 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:/I"t v.leginfo.ca.gov/calaw.html. 'Ignature of Property Owner or Authorized Agent __ I I Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjgtat I am licensed under provisions o t f co ep '; ith Section 700 o D*nhe Business ofessio s e m nseis In full force rid effect, License Class License No Date �'antra ignature JORKERS' COMPENSATIO ECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML. PIN UP TO ONE HUNDRED THOUSAND DOLLARS 11690,0001. IN ADDITION TO THI OST OF COMPENSA', IA-, DAMAGES AS PROVIDED FOR IN SECTION JTOS OF THE LABOR LODE, INTEREST, Me ATTORNEY'S FEES. hereby affirm unce: parralty of perjury one of the following declarations: I' I havq and will rreimam 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 tr erf�nce of the wo,K for which this permit is issued. Policy No. - 1 hC.%'3 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' compensatiol nsaranne carrier and Oc, cy number are: _ f— =3rne• d 4tt-+ ('[ A t!: lIJWcy-Plumber Expiration Date T J7Ts cf Agent T^ 4 Phone it uen,fy that, in the performance of the wofik for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compesalion laws f Califomia, and agre a:, !I' I Should become subjac the workerB' compensation visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 3Ignalure of Applir F nt _ Date )ECU-MATION REG DING CON5TR. ON LENDING AGENCY herauy affirm w,d oef.,alty 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). _Ender's Name L Lenders Address 3y my signature below, I certify to each of the following: I am the property owner or authorized to act on the p aperty owner's behalf. I have read this application and the Infor I hav provid is Corr t. I agree to comply with all applicable tit %d co o c d tat la% relating to building construction. I authorize representatives of this city or county to r a Identi roperty for inspection purposes. z_ ii nature of Property Owner or Authorized Agent Print Pro ert Owner's or Authorized. e Date ACTION DATE BY ''i DFCLARATCON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART SS OF TITLE 40 AND AQNIO RULE 1403 PER&FtTEXPiRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO P€RMIFCANCECEED f EP PERIYpT£XTENOED J QN1D PCRILNT PINAL lL-Zl- J(t i ASBE5TO5NOTFICA'rIONI5N01'A7PLICABLE TO CERTIFICATE OF PRO SED O 1T60N OCCUPANCY ISSUED I SIGN R€.