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Home My WebLink AboutXR2023-1153 - Permits04'. City of Newport Beach 111 IIIIIIII 11111111111111111111111111111111111111111p 11111 COMB Permit:XR2O23-1153 Community Development Department- Building Division X R 2 0 2 3 1 1 5 3 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : 1698-2022 Permit Counter Phone: (949) 718-1888 Issued Date : newportbeachca.gov/civic Inspection Area : 3 Combination Type -SFP Work Class - Other 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 : 376 VISTA BAYA Legal Desc : N TR 2609 BLK LOT 5 Description: SFR ADDED SCOPE: REPLACE ALL DRYWALL; REPLACE ALL STUCCO WITH HARD] -SIDING; REPLACE SIDING WITH STONE VENEER Owner: SAM & BRENTON LOVE Address : 376 VISTA BAYA NEWPORT BEACH, CA Phone Applicant: CZAJKOWSKI MACIEJ W. Address: 300 EAST 23RD STREET COSTA MESA, CA 92627 Phone: (714)928-6220 Owner/Builder : Address : Contractor: WELL DONE BUILDING & DESIGN Address : 8576 HAMILTON AVE HUNTINGTON BEACH, CA 92647 Phone: (714)421-8853 Con State Lie : 1040701 Lie Expire : 06/30/2024 Bus Lie: BT30074930 Bus Lie Expire : 04/30/2024 Workers' Compensation Insurance Carrier: STATE COMPENSATION INSURANCE FUND Policy No: 9329091 W. C. Expire : 9/24/2023 Architect Address Phone: State Lie Engineer: CZAJKOWSKI MACIEJ W. Address: 300 EAST 23RD STREET COSTA MESA, CA 92627 Phone: (714)928-6220 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 : R-3 No of Units : 1 Alteration sq. ft. Bldg : Bldg Height : No of Stories : 1 Added/New sq. ft. Garage TOTAL sq. ft. : Building Setbacks : Front: 20, Side: 5, Side: 5, Rear: 20 Flood Zone : X Use Zone : R-1-7200 - Single -Unit Residential (7200 indicates minimum lot area) PROCESSED BY: o ' SPECIAL CONDITIONS: REV2023-0780 - - $25,000.00 0 0 0 OWNER -BUILDER DECLARATION 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 checkrnark(s) I have placed next fo the applicable items) Section 7031.5, Business and Professions Code: Any city or county ihat 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 of the Business and rofesslons Code) or that he or she is exempt from )!censure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of of more than five hundred dollars 1$500). 3 I, 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, lusiness 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). 1 1, as owner of the property, am exclusively contracting with licensed Contractors to constructthe project (Section 7044, Business and Professions Code: The Contractors' State License Law does not pply 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). I I am exempt from licensure under the Contractors' Stale License Law for the following reason 1y my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one prior rior to completion of the improvements covered by this permit, 1 cannot legalll Y 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 copyof the applicable law, Section 7044 of the Business and 'rofesslons Code., is available upon request when this application is submitted or at the following Web site:http:/iwwv✓.leginfo.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 0) of Division 3 of the Business and Pro Slone de dm Itcense.is in full force nd effect. License Class License. No Dat A '< 2i Contractor Signatur VORKERS' COMPENSATION DECLARATION IARNING: 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 tSID0,0001, IN ADDITION TO THE .DST OF COMPENSATION, DAMAGES AS PROVIDED FOR W SECTION 3T06 OF THIS LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a cediTicate 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 :gyr,formance of the work for which this permit is issued. Policy No. �' Fave 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 Isurance carrier and policy number are: Policy Number of Agent Date 11 certify that, inthe performance of i work for which this permit Is. issued, I shall not employ any person in any manner $o as to become subject to the workers' compansalfon laws of Calffomia, and agre hat, if I should becomes ect to the orke rope a-{ viSiens-aFSeCline 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of Applicant D )ECLARAT€ON REGA ING CO RUCTION LENDING AGENCY t 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. C vil Code). .enders Name Lender's Address 9y my signature below, I certify to each of the following: 1 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 cow ordinances and state laws relating to building. construction. I authorize representatives of this city or count. enterth b miffed r0 e for iospectlon purposes, ��/ it mature of Property y Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name P" ��if%�✓ ate y Z� ACTION DATE. BY OECLARATloN. OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY ✓ ! REGULATION5 PART 61 OFTITLE 40 AND ACIMC RULE _ 1403 PERMITEXPIRED ISUBMITTED 581PS10S ,NOTIFICATION TO PERMIT C4ACELLED — — -IT A — .__.._ __ _____ PERMii EXTENDED trM PERMiTFINAL-BE1,105 '01 FICAPON 15 NOT APPLICABLE TO CERTIFICATE OF �I2 _ PR OSEO E OLIT100 OCCUPANCY ISSUED �1i1/�7. SIGNi.TURE;.