HomeMy WebLinkAboutXR2023-3298 - Permits��WPoRr City of Newport Beach 111IIIIIIII111111111111111111111111111111111 ��������� jj COMB Permit : XR2O23-3298
0 -) R� Community Development Department- Building Division X Id 2 8 2 3 3 2 8 8 Plan Check No: PC2023-2812
100 Civic Center Drive, Newport Beach, CA 92660
u= Permit Counter Phone: (949) 718-1888 Issued Date : 11/22/2023
<s. newportbeachce.gov/civic Final Date:
Combination Type - MFP Permit Status: Issued
Work Class - Alteration Inspection Area : 8
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 : 1655 SHERINGTON PL, Z 109 Legal Desc : P BK 15 PG 36 PAR 2
Description: MFR -WATER DAMAGE REPAIR IN BATHROOM 96 SF
Owner: UDR NEWPORT BEACH NORTH LP
Contractor: SIGNAL RESTORATION SERVICES
Architect
Address : 1745 SHEA CENTER DR #200
Address : 7221 ORANGEWOOD AVE
Address
HIGHLANDS RANCH„ CO 80129
GARDEN GROVE, CA 92841
Phone: (720)283-6120
Phone: (714)763-4153
Phone:
Con State Lic : 986693
State Lic
Lic Expire: 09/30/2025
Applicant: TIM WARREN
Bus Lic: BT30071857
Engineer
Address : 7221 ORANGEWOOD AV
Bus Lic Expire : 05/31/2024
Address
GARDEN GROVE, CA 92841
Phone: (714) 737-7082
Workers' Compensation Insurance
Phone:
Carrier: STARR INDEMNITY & LIABILITY COMPANY
Owner/Builder :
Policy No : 1000002994
Designer
Address :
W. C. Expire: 10/16/2024
Address
Phone:
Phone:
Code Edition : 2022
Fire Sprinklers : NO
Construction Valuation : $2,420.00
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/Ti sq. ft. Bldg : 0
Occupancy Groups : U,R-2
No of Units : 1
Alteration sq. ft. Bldg :
Bldg Height:
No of Stories : 3
Added/New sq. ft. Garage: 0
TOTAL sq. ft. : 0
Building Setbacks :
Flood Zone : X
Use Zone : PC - Oakwood Apartments - UP1370, UP 1405
PROCESSED BY: 904
SPECIAL CONDITIONS:
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 checkrnark(s) I have placed next to the applicable items)
(Section 7031.5, Business and Professions Cade: Any city or county Dist requires a permit to construct, alter, improve, demolish,, or repair any structure, prior to its issuance, also requires the applicant for
the permit to file a signed statement that ho or she is licensed pursuant to the provisions of the Contractors' Stale 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 l censure 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
not more than five hundred dollars ($500).
1, as owner of the property, or my employees with wages as their sole compensation, will do I_) all of or U 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).
❑ 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),
❑ 1 am exempt from lieensureunder the Contractors' State License Law for the following reason _
By my signature below V acknowledge that, except for my 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 legally
sell a structure that I have builtas an owrmr-builder if it has not been constructed in Its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 ofthe Business and
Professions Code„ is available upon request when this application is submitted or at the following Web site:hltp:liwww.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent ____,__ Date T_
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (Commencing with Section 701 of the Business and Professio my license is In fall force
Viand effect. License Class License No rate- t t GpfJ} vi rp G Contractor SignatUr
WORKERS' COMPENSATION DECLARATION
(WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP To ONE Il D THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
I have and will maintaln 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
ormance 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' compensa
Trance carrier and policy number are:
to of Agent
certify that, in the performance of the work for
if I should become subject to the workers' c
Iature of Applicant
Policy Number
Date
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 agrea
EIons of Suction 3700 of the Labor Code, I shall forthwith comply with those provisions. ] ? ------ Date.—
baby affirm under penalty of perjury ttTatth(ere is a construction lending agency for the performance of the work for which this permit is issued (Section 3097
Ides s Name Lender's Address
my signature below, I certify to each of the followirg:
I am the property owner or authorized to 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 ordinances and slate laws relating to building construction.
I authorize representatives of this city or county to enter tified properly for inspection purposes.
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