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Home My WebLink AboutXR2022-2544 - Permits (3)¢a�WPoRr City of Newport Beach @ Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 u fir. S Inspection Requests Phone: (949) 644-3255 °^rcrcoaN`P newportbeachca.gov/inspections Combination Type - MFP ELEC MECH PLUM Work Class - Alteration �1111 11111111111111111111111111111111111111111111111111 11111COMB Permit : XR2O22-2544 Plan Check No : PC2022-2381 Issued Date : 02106/2023 Inspection 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: 421 VISTA ROMA Legal Desc : N TR-6996 BLK LOT 55 Description: MFR CONVERT (E) DETACHED GARAGE TO ADU 457 SF Owner: VISTA ROMA LLC Address : 1807 PORT TIFFIN PL NEWPORT BEACH, CA 92660 Phone Applicant: IHAB HOSH Address : 9744 MAPLE ST BELLFLOWER, CA 90706 Phone : (562) 866-3625 Owner/Builder Address: Contractor: GROUND TO GABLE INC Address : 23151 ALCALDE STE C-8 LAGUNA HILLS, CA 92653 Phone : (949) 395-8333 Con State Lic : 888721 Lic Expire : 12/31/2024 Bus Lic: BT30080636 Bus Lic Expire : 02/29/2024 Workers' Compensation Insurance Carrier: EVEREST PREMIER INS CO Policy No: 7600020526221 W. C. Expire : 6/1/2023 Architect Address: Phone: State Lic Engineer: Mid -Cities Engineering Address : 9744 MAPLE ST#101 BELLFLOWER, CA 90706 Phone : (562) 866-3625 Designer: Address : Phone: Phone: Code Edition : 2019 Fire Sprinklers: NO Construction Valuation Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg: Occupancy Groups : R-2 No of Units : 6 Alteration sq. ft. Bldg : Bldg Height: No of Stories ; 1 Added/New sq. ft. Garage: TOTAL sq. ft. : Building Setbacks Flood Zone : X Use Zone: R- Ingle -Unit Residential PROCESSED BY: SPECIAL CONDITIONS: $60,000.00 0 0 0 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that t am exempt from the Contractors' State License Law for the reasen(s) Indicated below by the checkmark(s) I have placed next to the applicable items) 5echon 7031.5. Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior tops issuance, also requires the applicant for to 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 rrofesslons Code) or that he or she is exempt from iicansure 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 ($500). 1 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work; and the structure is not intended or offered for sale (Section 7044, :usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employeesor personal effort, Builds or improves the property, provided that the nprovements are not intended or offered for sale. If, however, the building or improvement is Sold within one year of completion, the Owner -Builder will have the burden or proving that it was not built or nproved for the purpose of sale). 1 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project ($action 7044, Business and Professions Code: The Contractors' State License Law does not poly to an owner of property who builds or Improves thereon, and who contracts for theprojects With a licensed Contractor pursuant to the Contractors' State License Law). 3 1 am exempt from iicensure under the Contractors` Stale License Law for the following reason: ly my signature below I acknowledge that, except for my personal residence in which I must bave resided for at least one year prior to completion of the improvements covered by this permit, I cannot legailt 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 Webstie:title.Ihvw�v.leginro.ca.gov/caiaw.html. lignatum 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 70tl f ivi ion f the Business and Pro fe Cade, my "arise is In full force nd affect. License Class License No Date Contracto€ Signature VORKERS' COMPENSATION DECLARATION "ARNINGi FAILURE TO SECURE WORKERS` COMPENSATION COVERAGE 19 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND COLLARS ($100,0001, IN ADDITION TO THE DST OF COMPENSATION, DAMAGE$ AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 3 1 have and will maintain o 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 dance of the work for which this permit is issued. Policy No..__________,____�T 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' carrier and policy number are: Policy Number Expiration Date of Agent Phone Is— JI certify that, in the performance of the k for h 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 agre rat, if I should become subjec, to he wor 'con nsation provisions of Section 3700 of the labor Code,' I shall forthwith comply with those provisions. ignature of Appin. __ Data + IECLARATION REGAR T UCTIt3 LE OING AGENCY hereby affirm under penalty of perjury that there Is a construction lending agency for the performance of the workfor which this permit is issued (Section 3097, Civil Code). ender's Name Lender's Address �y my signature below, I certify to each of the following: I am file property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is rrect. 1 agree to comply with all applicable city and county ordi noes statehs relating to buildingconstruction.I authorize representatives of this city or county to ent}e ater 'entiffproperty for inspection purposes. ACTION PERMIT EXPIRED CERTIFICArEOF OCCUPANCYISSUIED DATE BY i DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR. OFFICE USE ONLY REGULATIONS PART 51 OF TITLE 40 AND AQUID RULE 1403 —� ,UEMITTEOASBESTOSNOTiftCATIONTO UASBESTOS NOTIFICATION 15 NOT APPLICABLE TO PROPOSED DEMOLITION 3113NA71JIf:€: