HomeMy WebLinkAboutXR2023-3275 - Permits�Fwno�T. City of Newport Beach jj�liilwli111111111111111111111111111111111111111111111111I COMB Permit : XR2O23-3275
e Community Development Department- Building Division
>� '�': 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No . PC2023-2804
> ,_y Issued Date: 12/01/2023
r n Permit Counter Phone: (949) 718-1888
r.. newportbeachca.gov/civic Final Date:
Combination Type - SFP Permit Status: Issued
Work Class - Alteration Inspection Area: 6
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 : 3 AMADOR Legal Dead: N TR 15491 BLK LOT 17
Description: SFR ALT (E) 2 WINDOWS INTO 1 FOLDING DOOR
Owner: RAYMOND W STOCKSTILL
Address : 3 AMADOR
NEWPORT COAST, CA 92657
Phone: (949)622-0232
Applicant:
BEN MEDINA
Address:
31225 LA BAYA DR
WESTLAKE VILLAGE, CA 91362
Phone:
(818)735-7876
Owner/Builder:
Address :
Phone:
Code Edition :
Type of Construction
Occupancy Groups:
Bldg Height:
Building Setbacks
Flood Zone
Use Zone :
2022
V-B
U,R-3
Front: 10, Side: 5, Side: 5, Rear: 10
X
PC - Newport Coast
Contractor:
WINDOW DESIGN GROUP
Address :
1336 NORTH MOORPARK RD #226
THOUSAND OAKS, CA 91360
Phone:
(805)426-3584
Con State Lie:
993370
Lie Expire :
06/3012024
Bus Lie:
BT30075207
Bus Lie Expire : 05/31/2024
Workers' Compensation Insurance
Carrier : (—Oro tcro` Co.SVo l F%A ZYng .
Policy No: (3NNVVJGa)5i.30 t
W.C.Expire: 2/1$/Ztj
Fire Sprinklers :
Fire Hazard Zone
No of Units :
No of Stories
Architect
Address
Phone:
State Lie
Engineer:
Address :
Phone
Designer: WINDOW DESIGN GROUP
Address: 1336 NORTH MOORPARK RD #226
THOUSAND OAKS, CA 91360
Phone: (805)426-3584
NO Construction Valuation : $29,000.00
YES Added/New/TI sq. ft. Bldg : 0
1 Alteration sq. ft. Bldg :
2 Added/New sq. ft. Garage : 0
TOTAL sq. ft. : 0
PROCESSED BY: ^ei
SPECIAL CONDITIONS: IRWD; VHFSZ ✓�
f�. •e
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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 checkmarl 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 construct, alter, improve, demolish, or repair any structure, poor 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 licensure 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).
I, as owner of the property, or my employees with wages as their sole compensation, will de U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
tSusiness 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, am exclusively contracting with licensed Contractors to constructthe project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply 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).
El I am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature below I acknowledge that, except form �- '-'-----"- -----------------------.-. g p y 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:
soil a structure that I have built as an owner-bulldar if It has not been constructed in its entirely 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:li"w v.legmfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Daie _
LICENSED CONTRACTOR'S DECLARATION _"'""-"v-'""""—"""—"' ----- ----
i hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000jj of ivi i➢n of the Business and Pr Io Cade, and my license is In full force
and effect. License Class License No Date 12 Contractor Signature _
WORKERS' COMPENSATION DECLARATION
NARNING: 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 tsl DOAW), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES Ae PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
-11 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 IN
rformance 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'
ranee carrier and policy number are:
p amer Policy Number Expiration Date
'Name of Agent
Phone p
[l certify that, in the performance of the work for which this permit its issued. i shall notemploy any person in any manner so as to become subject to the workers' compensation laws of California, and agre
that, if I should become subject t0. a workers' compen�• ' revisions of Section 3700 of the Labor Code, Ishall forthwith comply with those provisions.
Signature of Applicant, Data
DECLARATION REGARDING TRICTION LENDING AGENCY
I hereby affirm under of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code),
Lender's Name Lender's Address
By my signature below, I certify to each of the following:
I am the property owner or authorized 10 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 .rdi cos and state la% Ing to building construction.
I authorize representatives of this city or county to e er the above-' led .,.party for inspection purposes.1��Signature of Pro ert Owner or Authorized A ent Print Pro erty Owner's or Authorized A em's Nam 0l/"��' ` Date
ACTION DATE. BY LARATION OF COMPLIANCE Will CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 6t OF TITLE. 40 AND AOMD RULE.
., 1403
PERMIT EXRRED i SURMITTED A58FSTO5 NOTIFICATION TO
PFAMIT CANCELLED_.-,.._i___—__._
LJr PA
PER LrIT EXTENDED
PER7vIlTffNAL ,�tT S 9 'TOSNOTiFlCA'It IS ND1`APPL)CAe TO
CERUPANCYICATE Of ISSUED OCCUPANCY PROPOSED DEMO
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