HomeMy WebLinkAboutXR2023-3304 - Permits4 ��WPORT City of Newport Beach 111 ���III�� III 11111111111111111111111111111111111111111111COMB Permit : XR2023-3304
O is Community Development Department- Building Division
F �•. ;'i �' 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-2812
Permit Counter Phone: (949) 71 B-1888 Issued Date : 1112212023
r newportbeachca.gov/civic Final Date:
°g4voaN�P 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 : 1890 16TH ST, K 205 Legal Desc : P BK 15 PG 36 PAR 2
Description: MFR -WATER DAMAGE REPAIR IN KITCHEN 80 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 Lie : 986693
State Lie
Lie Expire : 09/30/2025
Applicant: TIM WARREN
Bus Lie: BT30071857
Engineer
Address : 7221 ORANGEWOOD AV
Bus Lie 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 :
$1,124.00
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 - UPI
370, UP 1405
PROCESSED BY:
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 item(s)
Section 7031-5. Business and Professions Code: Any city or county Ihat 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 of 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
�rofassions 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 for a permit subjects the applicant to a civil penalty of
tot more than five hundred dollars ($500).
1 I, as owner of the property, or my employees With wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
3usiness 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
mprovements are not intended or offered ;for sale. If, however, the building orfmprovement is sold within one year of completion, the Owner -Builder will have the burden of proving that B was not built or
mproved for the purpose of sale).
1, as ownerof 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 improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
D I am exempt fromlicensure under the Contractors' State License Law for the following reason:
By my sighetore below I acknowledge that, except for my personal residenca in which I must have res[do d for at least one year prior to completion of the improvements covered by this permit, I cannot Iegail!
salt 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 taw, Section 7044 of the Business and
Professions Code„ is available upon request when this application Is submitted or at the following Web site.http:flwww.leginfo.ca.goNIcalaw,html.
Signature of Property Owner or Authorized Agent -. ......... ^ _ _ Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700Q7 f slgr� jf the Business and Professions Cc in 1 Be is In full force
and effect. License Class License No I 1 (C l Contractor Signature
nORICERS' COMPENSATION DECLARATION.
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED SAND DOLLARS tS1D0,000), IN A➢¢nION TO THE
C09T OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 570E OF THE LABOR CODE, INTEREST, AND ATTORNEY'% FEES.
hereby affirm under penalty of perjury one of the following declarations:
I 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
'ormance of the work for which this permit is issued. Policy No.
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
of Agent
Date
certify that, in the performance of the work for which 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
if I should become subject to t vti ka. Ipensatier provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ' f '
)ature of Applicant _ _. ___-- ___ Date -_�II 12 7IC —5
areby affirm under perlalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097
)der s Name, Lender's Address
my signature below, I certify to each of the following:
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 state laws relating to building construction.
I authorize representatives of this city or county to ente>� identified property for inspection purposes.
Civil Code).
I/J4rle
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ACTION
DATE
4 BY �, CLARATIONOF COMPLIANCE WITH CODE OF FEDERAL
II +. REGULATIONS PART 61 OF TITLF 40 AND AQMD RULE
3 1403
FOR OFFICE USE ONLY
PERMiTEXPIFED
L01 SUBMITTED ASBFSIOS NOTIFICATIONTO
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