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HomeMy WebLinkAboutXR2024-0010 - Permits��EWPoR� City of Newport Beach p. Q Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 ram+ = Permit Counter Phone: (949) 718-1888 a.. newportbeachca.gov/civic Cq<rFORN�P Combination Type - MFP Work Class - Alteration ��III��III11111111111111111111111111111111111111 jj COMB Permit : XR2024-0010 Plan Check No : PC2024-0004 Issued Date: 01/02/2024 Final Date: '- Permit Status: Issued Inspection Area : 8 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: 2115 SHERINGTON PL, D 112 Legal Desc : P BK 15 PG 36 PAR 1 Description: MFR ALT R/R DRYWALL AND INSULATION 42 SF Owner: UDR NEWPORT BEACH NORTH LP Address : 1745 SHEA CENTER DR STE200 HIGHLANDS RANCH, CO 80112-9 Phone : (720) 283-6120 Applicant: TIM WARREN Address: 7221 ORANGEWOOD AV GARDEN GROVE, CA 92841 Phone: (714)737-7082 Owner/Builder : Address : Phone Code Edition : 2022 Type of Construction : V-B Occupancy Groups: U,R-2 Bldg Height: Building Setbacks Contractor: WESTROCK RESTORATION Address : 7221 ORANGEWOOD AVE GARDEN GROVE, CA 92841 Phone : (714)763-4153 Con State Lie : 986693 Lie Expire : 09/30/2025 Bus Lie: BT30071857 Bus Lie Expire : 05/31/2024 Workers' Compensation Insurance Carrier: STARR INDEMNITY & LIABILITY COMPANY Policy No : 1000002994 W. C. Expire : 10/16/2024 Fire Sprinklers : Fire Hazard Zone No of Units : No of Stories Flood Zone : X Use Zone : PC - Oakwood Apartments - UP1370, UP 1405 PROCESSED BY. vkw7S SPECIAL CONDITIONS: Architect Address Phone: State Lie Engineer: LOVELACE MILES T Address: 10509 VISTA SORRENTO PKWY, #1 SAN DIEGO, CA 92121 Phone: (858)535-9111 Designer: Address Phone: NO Construction Valuation : $1,100.00 NO Added/New/TI sq. ft. Bldg : 0 1 Alteration sq. ft. Bldg : 42 3 Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 0 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that t 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 items) (Section 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 the permit to filea 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 Professions 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 not more than five hundred dollars ($500). ❑ 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 intendedor offered for sale (Section 7044, Business 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 improvements 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 improved for the purpose of sate). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct (fie project (Section 7D44, Business and Professions Code: The Contractors' State. License Law does not apply to an owner of property who builds or improves thereon. and who contracts for the projects with a licensed Contractor pursuant to the Contractors' Slate License Law). ❑ I am exempt from licensure under the Contractors' Slate License Law for the fallowing 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 legali sell 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 Professions Code, is available upon request'. when this application is submitted or at the following Web site:http:l/www.leginfo.ca.govicalaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penally of perjury that l am licensed under provisions of Chapter 9 (commencing with Section 70� Di 20 f the Business and Professio y Itoerise is In full force and effect. License Class License No Data L G Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE le UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDR HOUSAND DOLLARS ($100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3T05 OF THE LABOR CODE, INTEREST', AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: El 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 ih ormance of the work for which this permit Is issued. Policy No. have and will maintain workers' compensationinsurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' comper io irsurance carrier and policy number are: Carder Policy Number Expiration Date Name of Agent Phone ff ❑1 certify that, in the performance of the work or 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 agra that, if I should become subject to the worke, Iensilstion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. % Signature of Applicant __w___..�_� _..... _ _ _ � Date-� � / z / Z� DECLARATION REGARDING CO TRU -110N LENDING AGENCY I hereby affirm under penalty of per at there is a construction lending agency for the performance of 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 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 state laws relating to building construction. I authorize representatives of this city or county to enie tified property for inspection purposes. 1r�, `1 Si nature of Property Owner or Authorized A ent Print Property 1r' i, Owner's or Authorized Agent's Name l) YLA " "a f (ems Date _ Il z l Z ACTION DATE BY D- LAPATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY RFCULATIONS PART 61 OF TITLE 40 AND AQMO RULE 1403 PERMIT EXPIRED ,.0 I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT FINAL j D LO CERTIFICATE OF /771'Y0i PROPOSED DEMO OCCUPANCY ISSUED SIGNATURE: