HomeMy WebLinkAboutXR2023-2113 - Permits�EWPORT City of Newport Beach jj� IIIIIIII 11111p11111111111111111111111111p111p1111jj COMBermit : XR2023-2113
C4 d Community Development Department - Building Division X R 2 0 2 3 2 1 1 3
q 100 Civic Center Drive, Newport Beach, CA 92660 Plan Ch ck No:
U = Permit Counter Phone: (949) 718-1888 Issued Date : 07/31/2023
newportbeachca.gov/civic Final Date:
Cq�/cORN�P Combination Type - Permit Status: Issued
Work Class - Repair 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 WOR ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address : 410 GOLDENROD AVE Legal Desc : P BK 259 PG 15 PAR 1 UN 1 PM 259-15, PAR. 1 OF PRO
Description: SFR RE -ROOF T/O 1 LAYER OF TILE, REPLACE UNDERLAYMENT, R/R SHEATHING AS NEEDED. INSTL 18 SF FULL WEIGHT TILE ER-1900 10 PSF
Owner: GRONSKI TODD ARNOLD TR Contractor: CROWN RECONSTRUCTION SVCS Architect
Address : 410 GOLDENROD AVE APTA Address : 45 VANTIS DR Address
CORONA DEL MAR, CA 92625 ALISO VIEJO, CA 92656
Phone : Phone : (949) 273-6782 Phone
Con State Lie : 1051230 State Lie:
Lie Expire : 03/31/2025
Applicant: Michael v Constantine Bus Lie: BT30066708 Engineer
Address : Bus Lie Expire : 04/30/2024 Address
92625
Phone: (194) 935-7627 x4 Workers' Compensation Insurance Phone:
Carrier: STATE+COMPENSATION+INSURANCE+FUN
D rJ
Owner/Builder : Policy No : 9224420 esigner
Address : W. C. Expire: 8/11/2023 ddress
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 : R-3 No of Units : 2 Alteration sq. ft. Bldg :
Bldg Height : No of Stories PIdded/New sq. ft. Garage:
TOTAL sq. ft.
Building Setbacks : Front: 15, Side: 3, Side: 3, Rear: 5
Flood Zone : x NO CONSTRUCTION WORK
Zone : R-2 - Two -Unit Residential
PROCESSED BY: '
ON SATURDAYS
SPECIAL CONDITIONS: OK TO ISSUE PER ZZ NEW TILE IS LIGHTER THAN OLD TILE
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)
Eection 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
io permit to f le 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
+rofossions Code) or that he or she is exempt from lieensureand 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 1, 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 cr 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 properly, provided that the
nprovements afe 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 Wit or
nproved for the purpose of sale).
3 I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7344, Business and Professions Code: The Contractors' State License Law does not
pply 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).
3 1 am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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 legall,
all a structure that I have built as an owner-buildor 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 Cade, is available upon request when this application is submitted orat the following Web site;http:fiwww.leginfo.ca.govlcalaw.btmL
lignaluro 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 7000) of Division 3 of the Business antiU-Pro n, de, and y li nse is In full force
nd effect. License Class License No Date % _ 2Contractor Signature
VORKERS' COMPENSATION DECLARATION
FARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOU AND DOLLARS (6100.000), IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under 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, forth
94mrance 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'
rance carrier and policy number are:
Policy Number Expiration Date
to of Agent Phone #
certify that. in the performance of she 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
6i . if I should EFc4N biect to the Loiters* comoensatlon provisions of Section 3700 of the Labor Code. I shall forthwith comply with those provisions.
nature of Applicant _ Uv —C
CLARATION REGARDING CONS TION LE DING AGENCY
Date-7— a ` qoZ_
meby affirm underpenalty of perjury hat there is a construction lending agency for the performance ofihe work for which this permit is issued (Section 3097, Civil Cade).
ider'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 coup ordinances and state laws relating to building construction.
I authorize representatives of this city or coorrty-teXmA toe above-ifenti* property for inspection purposes. u e
ACTION DATE BY DECLAIEATION OF WMPUANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 6.1 OFT€TLF. 40 AND AQMD RULE
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