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Home My WebLink AboutXR2023-2209 - Permits'EWPORT City of Newport Beach II III I I IIIII I IIIIII IIIIIII I IIIIIII jj COMB Permit : XR2023-2209 D� Qp Community Development Department- Building Division X R 2 0 2 3 2 2 0 9 �^ 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-1936 U �}ra, 2 Permit Counter Phone: (949) 718-1888 Issued Date : 09/15/2023 e: newportbeachca.gov/civic Final Date: C'4(�F00.N`P Combination Type - SFP ELEC MECH PLUM Permit Status: Issued Work Class - Alteration i _ _.�_.--' "' 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: 17 PALAZZO Legal Desc : N TR 15517 BLK LOT 36 Description: SFR BATHROOM REMODEL (276 SF), REMOVE AND RELOCATE BATHROOM WINDOW Owner: ANNIE HAAS Contractor : JOHN CHRISTOPHER CONSTRUCTION Architect INC Address : 17 PALAZZO Address : 17632 METZLER LN UNIT 103 Address NEWPORT BEACH, CA 92660 COSTA MESA, CA 92627 Phone: (925)899-6324 Phone: (949)415-4534 Phone: Con State Lic : 1001495 State Lie: Lic Expire : 11/30/2023 Applicant : TRAVIS CLARK Bus Lic: BT30073589 Engineer : MOBED MEHDIABADI SASAN Address : 6851 BERRY AVE Bus Lic Expire : 11/30/2023 Address : 3842 HENDRIX ST BUENA PARK, CA 90620 IRVINE, CA 92614 Phone: (949) 887-6936 Workers' Compensation Insurance Phone: (310) 433-7927 Carrier: STATE COMPENSATION INSURANCE FUND Owner/Builder: Policy No: 9239073 Designer: KEYVONMOBED Address : W. C. Expire; 10/2/2023 Address: 1600 DOVE ST, 101 NEWPORT BEACH, CA 92660 Phone: Phone: (310) 433-7959 Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $59,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 Occupancy Groups : U,R-3 No of Units : 1 Alteration sq. ft. Bldg : 276 , Bldg Height : No of Stories : 2 Added/New sq. ft. Garage: 0 TOTAL sq. ft. 0 Building Setbacks : Front: 15, Side: 5, Side: 5, Rear: 5 _ ... Flood Zone: X Use Zone : PC - Bonita Canyon PROCESSED BY: SPECIAL CONDITIONS: IRSD OWNER -BUILDER DECLARATION i hereby affirm under penalty of perjury that E am exempt from the ContractorsState License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable Harris) Section 7031.5, Business and PfofeSeons Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair anystructure, prior to its issuance, also requires the applicant for is parmit to file a signed statement that he or she is licensed pursuant to the previsions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 'rofessions Code) or that he or she is exempt from ficensure 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 ($500). L as owner of the property, of 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 7G44, FUSineSS 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 rlprovements 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 of nproved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not �rply 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). J I am exempt from lieensure under the Contractors' Slate License Law for the following reason ...... ry 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 =voted by this permit I cannot legmI% ell a structure that I have built as an owner-buildor 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 Web site:http:liw ,leginfo.ca.gov/calaw.html. fignature of Property Owner or Authorized Agent ,. Date _ .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penally of perjury that { am licensed under provisions of Chaplet 9 (commencing with Section 7000 of Division 3 of the Business and Prate S ii s _ode,�aDd my'fic n e is in full force rid effect. License Class License No Data 1r Contractor Signature ,�fiLlil/ /b 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 i$100,0001, IN ADDITION TO THE DST OF COMPENSATION, DAMAGES 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 dec€arations: 3 1 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 th erferrance of the work for which this permlt 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 ratios carrier and pollcy number are: Policy Number Expiration Dale of Agent J1 certify that, in the performance of the work for which this permit is Issued, I shaft not employ any person in any manner so as to become subject to the workers' compensation laws of California. and agre tat, if I should become subjec be w rkers compensation provisions of Section 3700 of the Labor Code. I shall forthwith comply With those provisions. .Ignalurs of Applicant ,_ IECLARATION REGARDI. 3 CO' STR CTION LENOIN6 AGENCY 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, Civil Gode). ender's Name Lender's Address ._ :y my signature below, i certify to each of the following: I am the proDerty owner or authorized to act on the property owner's behalf. I have red,] this application and the information f have provided is correct. I agree to comply wiUi all applicable city and county ordinances and state laws fei ting tbuilding construction. I tulhorize represrniatives of this city or county toe to the abpvg-igegiified ro hyt(fof inspection purposes. I:^sign iiure, of Property Owner or Authorized Agent P - ropertl ACT ON DATE BY DECLARATION OF COMPLIANCI ANTH CODEOF FB:DERAL RFGIILATIONS PART 61 OF TITLE 40 AND ACMD RULE 1403 PFRMIT EXPIF:L LJ I SURMITTED ASBESTOS NOTIFICATION TO I °FPMITCANC l.LEfv CEPA I ?�PMIT EXTENDfJ OMD _ PERO W Fli'M �� E A$13EMS NONFILa11ON 15 NOT PPUCAaU TO CFPORCATE 0, q7 i (wf i PROPOSED DEMOU1ION L OCCUPANCY'SSUED SIGNATURE. FOR OFFICE USE ONLY Date