HomeMy WebLinkAboutXR2024-0605 - Permits�E.waoRr City of Newport Beach I 111�1 I��pI�� 111111111111111p1111111111111111111111111111111COMB Permit : XR2024-0605
Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2024-0498
>� = Permit Counter Phone: (949) 718-1888 Issued Date : 04/02/2024
... newportbeachca.gov/civic Final Date:
C9<<FOR��P Combination Type - MFP Permit Status: Issued
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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 : 1870 16TH ST, L 216 Legal Desc : P BK 15 PG 36 PAR 2
Description: MFR R/R INSULATION AND DRYWALL 770 SF
Owner: UDR NEWPORT BEACH NORTH LP
Address : 1745 SHEA CENTER DR STE200
HIGHLANDS RANCH, CO 80112-9
Phone: (720) 283-6120
Applicant: PABLO SAUCEDO
Address: 7221 ORANGEWOOD AVE
GARDEN GROVE, CA 92841
Phone: (714)737-7089
Owner/Builder :
Address :
Contractor:
WESTROCK RESTORATION
Address :
7221 ORANGEWOOD AV
GARDEN GROVE, CA 92841
Phone:
(714)737-7082
Con State Lie
: 986693
Lie Expire :
09/30/2025
Bus Lie:
BT30071857
Bus Lie Expire : 05/31/2024
Workers' Compensation Insurance
Carrier: STARR INDEMNITY & LIABILITY COMPANY
Policy No : 10000056410
W, C. Expire : 10/16/2024
Architect
Address
Phone:
State Lie
Engineer: LOVELACE MILES T
Address: 10509 VISTA SORRENTO PKWY, #102
SAN DIEGO, CA 92121
Phone: (858)535-9111
Designer:
Address :
Phone:
Phone:
Code Edition :
2022 Fire Sprinklers:
NO
Construction Valuation :
$850.00
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 :
770
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
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable items)
Becfion 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
1e 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
'rofessions Code) or that he or she is exempt from licensors 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
of more than five hundred dollars ($500).
3 I, as owner of the property, or my employees with wages as their sole compensation, will do C_) ah of or L) portions of the work, and the structure is not intended or offered for safe (Section 7044,
;usiness 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
nprovements 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
Ttproved for the purpose of sate).
1 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
pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' Stale License Law).
I I am exempt from licensors under the Contractors Slate License Law for the following reason: _ _-
y 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 covered by this permit, I cannot legally
ell 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 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:ltwww.legnfo.ca.gov/calaw.html.
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profession my license is in full force
nd effect. License Class License No Date G- -2k Contractor Signature;
VORKERS' COMPENSATION DECLARATION
!ARMING: 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 ($100,0001, IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS 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 370D of the Labor Code, for thr
erforrnance 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 Cade, for the performance of the work for which this permit is issued. My workers`
rance carrier and policy number are:
Policy Number Expiratic
of Agent Phone #
Date
JI 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 agrer
rat, if I should become sub' w ;ors' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant Date �-[' - 1 Lf ,-._....____
IECLARATION REGARDING CONSTRUCTION LENDING 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 Code).
enders Name Lender's Address
Iy 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 hale 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 anthorize representatives of this city or county toe for, ryth�rtbo--deptified property for inspection purposes. ^� 1
ianatore of Prooertv Owner or Authorized Agent, Print Property Owner's or Authorized Aaent's Name i Pn`'.� t, (S 5 G (A OC k(Date
ACTIOK I DATE I BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40AND AQMD RULE.
PERMIT rANCEI.I.ED {
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ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
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