HomeMy WebLinkAboutXR2023-2303 - PermitsagvraoRT City of Newport Beach 111111111111111111111111111111111111111111111111111111111 II
p4 ,; Community Development Department - Building Division X R 2 0 2 3 2 3 e 3 COMB Permit : XR2023-2303
y 100 Civic Center Drive, Newport Beach, CA 92660
/ z Permit Counter Phone: (949) 718-1888 Plan Check No : PC2023-2023
newportbeachca.gov/civic Issued Date : 09/1212023
cq</coa��P Combination Type - SFP Final Date:
Work Class -Alteration Permit Status: IssuedInspection 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 : 1979 VISTA CAUDAL Legal Desc : N TR 5435 BLK LOT 68 TR 5435 (L.L.84-214024) PAR 6
Description: ATT SFR - RE -SHEET DECK, NEW DECK WATER -PROOFING SYSTEM. STUCCO REPAIR RELATED TO THE DECK
Owner: THIELEN RONNE L TR
Contractor: MAKI CONTRACTOR SERVICES
Address : 1977 VISTA CAUDAL
Address : 10101 CUTTY SARK DR
NEWPORT BEACH, CA 92660
HUNTINGTON BEACH, CA 92646
Phone : (714) 814-1384
Phone : (949) 872-8855
Con State Lic : 970168
Lic Expire : 02/28/2025
Applicant: ADAM MAKI
Bus Lic : BT30082157
Address : 10101 CUTTY SARK DR
Bus Lic Expire : 07/31/2024
HUNTINGTN BCH, CA 92646-4303
Phone: (949) 872-8855
Workers' Compensation Insurance
Carrier: NORGUARD INS CO
Owner/Builder :
Policy No : ADWC433270
Address :
W. C. Expire : 1/17/2024
Phone:
Code Edition : 2022
Fire Sprinklers : NO
Type of Construction : V-B
Fire Hazard Zone : NO
Occupancy Groups : U,R-3
No of Units : 1
Bldg Height :
No of Stories ; 1
Building Setbacks :
Flood Zone : X
Use Zone : R-1 - Single -Unit Residential
PROCESSED BY:
SPECIAL CONDITIONS:
Architect
Address
Phone :
State Lic
I� u�CZ
Engineer :
KALEN WILSON ; " 11
Address :
23022 LA CADENA DR, 201
LAGUNA HILLS, CA 92653,
Phone :
(714) 576-6524
Designer:
Address :
Phone:
Construction Valuation : $20,000.00
Added/New/TI sq. ft. Bldg : 0
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 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)
(Section 7031-5, Business and Professions Code: Any city or county that requires a Permit to cohslmct, alter, improve, demolish, 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 with 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 fora permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500).
M 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or 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 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, the Owner -Builder will have the burden of proving that It was not built or
improved for the purpose of sale).
0 1, as owner of the property, ane exclusively contracting with licensed Contractors to construct the project (Section 7044, 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' State License Law),
I am exempt from Iicensure under the Contractors' Slate 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 t.
all a structure that I have built as an owner -builder if it has not been constructed in its entiroty by licensed contractors. I understand that a copy of the
'rofessions Code„ is available upon request when this application is submitted or at the following Web site;htip:li"m.leginto.ca,govlcalaw.himl
signature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm Under pe tally of pury that I am licensed under provisionhapt r ( meriting with echo f 'vP13 the Busl
,nd effect License Class License No e Contractor
menls covered by this permit, I cannot
law, Section 7044 of the Business and
Date
is In full force
VORKEP..S' COdtPEN3ATION DECLARATION
fARNING: FAILURE TO I -CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMIN L PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS IEtOQ6OOl. IN ADOrTION TO THE
:091 OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3766. OF THE LABOR CODE, INTEREST, AND ATTORNEye FEES.
-hti_�mby ,.fflrm under penalty of perjury one of the following declarations:
as L.have and will malnt"n 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
I a Ice of the work Inc which this permit is issued. Policy No.
have end will me ntnio 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
Tsurance carrier and uolicy nljmber are:
Te of Agent _
cerfifv .hat in the
. If I should bet cr
lalure of Applic
Policy Number Expiration Date
for which this permit is issued. I shall not employ any person in any manner so as to become subject to the workers' comp nsation I ws of California, and agree
e atIon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provislons.
E y� / __l/[�1
1 L DI AG/[%xa�s �--
hereby affirm under I%enatiy of perjury that there is a construction len. In agency for the performance of the work for which this permit is issued (Section 3097, Civil de).
.ender's Name Lenders Address
3y my signature below, I Certify to each of the following:
I am the property owner or authorized to act or, the properl wner's ahelf.
I have read this application and the information I have pr id Of is c rect
I agree to comply with all applicable city and- outty ord' an a n s to laws relating to building construction. r /q
1 authorize representatives of this city or county nt the b v id of prop for Inspection purposes. ' ( N ) to
Sigdature of PropertyOwner or Authorized Agent Print P'd any Owner's or Authorized Agent s Na e
ACTION DATE. OF RATION OF COMPUTNf_E WITH C FEDERAL FOR OFFICE USE ONLY
I — REGULATIONS PART 91 OF TITLE40 AND AONID RULE
NOTIFICATION TO
PERMIT
.._-...... .____.__.._....
PERMIT FINAL A' ESTOS NOTIFICATION IS NOI'ANPLICAetE TO
CERTIFICATE OF IA P SED DEMO)11`
OCCUPANCYISSUED y sl A RE'