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Home My WebLink AboutXR2024-0500 - Permits�EwvoRT City of Newport Beach II III III I II I II IIIII IIIIIII II III II COMB Permit : XR2O24-0J00 Community Development Depadment- Building Division X R 2 0 2 4 0 6 0 0 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2023-1916 D r = Permit Counter Phone: (949) 718-1888 Issued Date : 02/29/2024 .s. newportbeachca.gov/civic Final Date: °"e.iroa� P Combination Type - SFP Permit Status: Issued Work Class - Alteration 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 : 1619 ARCH BAY DR Legal Desc : N TR 15222 BLK LOT 19 Description: SFR R/R (2) WINDOWS @ MASTER BDRM, FRENCH DOOR @ THE DINING RM AND DOOR @ THE LAUNDRY AREA Owner: ANDREW POLSKY Address : 1619 ARCH BAY DR NEWPORT BEACH, CA 92660 Phone : Applicant: ROSEMARY SWEENEY Address : 2763 N BUTLER ST ORANGE, CA 92865 Phone: (949)302-4146 Owner/Builder: ROSEMARY SWEENEY Address : 2763 N BUTLER ST ORANGE, CA 92865 Phone : (949) 302-4146 Contractor: OWNER/BUILDER Address : Phone: Con State Lic : OWNER/BUILDER Lie Expire Bus Lie : Bus Lie Expire Workers' Compensation Insurance Carrier : Policy No W. C. Expire Architect Address Phone : State Lie Engineer: YAGHI SHUCRI I Address : 112 E. CHAPMAN #D ORANGE, CA 92866 ' Phone : (714) 997-9120 Designer: 3JK DESIGN Address : 1907 WOODSIDE ST ORANGE, CA 92865 . . " Phone: (714)709-7934 Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $6,800.00' 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 : Bldg Height: No of Stories : 2 Added/New sq. ft. Garage : 0 TOTAL sq. ft. 0 Building Setbacks : Front: 10, Side: 5, Side: 5, Rear: 10 Flood Zone : Use Zone : PC - Newporter North PROCESSED BY: SPECIAL CONDITIONS: REV2024-0374- O/B SCANNED W/XR2023-2181 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 cheokmark(s) I have placed next to the applicableitem(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, prior to its issuance, also requires the applicant for he permit to file a signed statement that he or she is licensed pursuant to tho provisions of the Contractors' Stale 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 ticensure 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 rot 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(_) portions of the work, and the structure is not intended or offered for sale (Section 7044, s and Professions Code: The Coniractors' State License Law does not apply to an owner property who, through employees' or personal effort, builds or improves the. property, provided that the god o menu 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 ofor 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 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 ticensure under the Contractors' State License Law for the following reason:,_,., —__-_—_— By my signature below I acknowledge that, exce t for my personal reside -i which I must have resided for at least one year prior to completion of the Improvements covered by this permit, I cannot legalif sell a structure that I have built as an owmo bu or ff it has not boon c Dtro In its anbre y sod Contractors. I understand that a copy of the applicable t action 7044 of the Business and Professions Code, is available upon request ne"T�..F._ ^Rr. 7��.nem,. site:http:llwww.Ieginfo.ea.gov/calaw.btml. �,9 n Q Signature of Property Owner or Authorized A nt _ _ __._.___ .__ D I w -1 LICENSED CONTRACTOR'S DECLA. A D I hereby atfi•.rm under penalty of perjury that am I ensed under provisions of Chapter i th Section 7000) of Division 3 of the Business and Professions Code, andmy license es in full force and effect. License Class License No Date Contractor Signature NORKERS' COMPENSATION DECLARATI NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES OF TO ONE HUNDRED THOUSAND DOLLARS ($101i ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3704 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under .�^nalty of perjury one of the following declarations: II, I have and w i, ,nantain a Certificate of consent to self,irl for workers' compensation. Issued by the Direclor of Industrial Relations as provided for by Section 3700 of the Labor Code, for th pLr'cn )c,lce of tine wor:c for which this permit is issued. Policy No. DI hays and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code. for the performance of the work for which this permitis issued. My workers' compensatio InauraneG carrier and policy number are: Carrier _ _ Policy Number Expiration Date Nom/ad Ot Agent Phone If IRI'lj fe.iay that, ir; the performance of the this permit is issued'., I shall not. employ any person in any manner so as to become subject to the w�Jrkers' compensation laws of California, and agni I, if I sno be cme subject to worke ensat revisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisi / /\ Sqn-pure of Ap I •ant __ ______ ate (.JT D TCLARATIO VZLiGARDING Co STRUCIrION LENL%I G AGENCY I tc my zifirm under penalty of perjury that there Is a o struction lending agency for the performance of the work for which this permit is issued (Section 3097, At Code). Lerde« Name Lenders Address By my signature beluw, I Certi ollowirig- I am the property owner or authorized to act on theproperty owners behalf. I have read this application and the information I have prove I agree to comply with all applicable city and ount Zan state Yoe relating to building construction. I authorize representatives of this city at c my to above -Ile Ified pr erty for inspection purposes. Signature of Property Owner or Authonze rt Print Property Owner's Or Authorized A en Kame ��L`,-C C i LL Dale ACTION DATE. ` Y DECLARATfON OF CO LIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY ( REGULA710N5. I OF TITLE 40 AND AD RULE. PERMiF EXPIRED u I SURFAITTF.D ASBESTOS NOTIFICATION TO PERMIT CANCELLED _ _ 44A QMD FINAL EST SNOTIFICAT11 5-fii41" 8kI,1C TO CERTI ICATE OF SE OCCUPANCYISSUW II h