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XR2022-3091 - Permits
F��WPoRr City of Newport Beach 6 Community Development Department- Building Division �� 100 Civic Center Drive, Newport Beach, CA 92660 ,r Permit Counter Phone: (949) 644-32B8 .s. Inspection Requests Phone: (949) 644-3255 ,4".0.�"P newportbeachca.gov/inspections Combination Type - SFP ELEC MECH PLUM Work Class - Addition/Alteration iiiiiiiii1 II COMB Permit : XR2022-3091 Plan Check No: PC2022-2959 Issued Date : 04/27/2023 Inspection Area : 5 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 : 223 ORCHID AVE Legal Desc : A TR RESUB OF CORONA DEL MAR BILK 141 LOT 19 Description : SFR INTERIOR REMODEL 2921 SF & ADD 124 SF "_54cpwar4-, v 3 -lt t H Owner: ORCHID AVENUE PROPERTIES LLC Address: 3972 SAN BONITO AVE LOS ALAMITOS, CA 92651 Phone: (713)689-9097 Applicant : ANDRADE STANLEY Address : 2880 S COAST HWY LAGUNA BEACH, CA 92651 Phone: (949)715-7474 Owner/Builder : Address : Phone Contractor: BERK CUSTOM HOMES INC Address : 428 OLD NEWPORT BLVD NEWPORT BEACH, CA 92663 Phone : (949) 300-5152 Con State Lic : 1017631 Lie Expire : 08/31/2024 Bus Lie: BT30057033 Bus Lie Expire : 10/31/2023 Workers' Compensation Insurance Carrier: STATE COMPENSATION INSURANCE FUND Policy No : 9212219 W. C. Expire: 6/8/2023 Architect : ANDRADE STANLEY Address: 2880 S COAST HWY LAGUNA BEACH, CA 92651 Phone: (949)715-7474 State Lie Engineer: SIAMAKVAHDAT Address: 4000 BARRANCA PKWY #250 RIVERSIDE, CA 92504 Phone: (949)654-0858 Designer Address Phone: Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $300,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 124 Occupancy Groups : R-3 No of Units: 1 Alteration sq. ft. Bldg : 2,921, • • - Bldg Height : No of Stories : 2 Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 124 Building Setbacks : Front: 20, Side: 3, Side: 3, Rear: 5 - Flood Zone : X Use Zone : R-1 - Single -Unit Residential PROCESSED BY: SPECIAL CONDITIONS: HAULER: TIGHT QUARTER HIGH DENSITY ZONE - 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 checkmarli I have placed next to the applicable itarri ;Seclion 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 the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and orofessions 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 not more than five hundred dollars 11500). 7 I, as owner of the property, or my employees with wages as their sole compensation, will do U 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 70,44, Business and Professions Code: The Contractors' Stale 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). 0 I am exempt from licensure under the Contractors' State License Law for the following reason: By 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 legal,, sell a structure that I have built ns 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 704A of the Business and Professions Code„ is available upon request when this application is submitted orat the following Web site,hV:liwww.leginfo.ca.gov/calavchtml, Signature of Property Owner or Authorized Agent _ _ ate LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that. I am licensed under provisions of Chapter 9 (commencing with Section 700 ) o Dh sio pf the Business and Profs to od and m license is In full force and effect. License Class License No Dai 2 7 Contractor Signature WORKERS' COMPENSATION DECLARATION ,NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRRdINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUS D DOLLARS ($100.000), IN ADDITION TO THE COST 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 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 th p9irformance, 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' compensatio In ranee carrier and policy number are: :artier Policy Number Expiration Date dame of Agent Phone # —1l 00rtify trial, in the Pe of a 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 hat, if I should becomes his 4 the orkers' compansation provisions of Section 3700 of the Labor Code, I shall forthwith Comply with those provisions. } signature or Applicant _. Date C 21 3ECfARATFON RfiGAR 1 OIN �T ENCY hereby affirm under penalty o perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). -ender's Name Lender's Address 3y my signature b&ICY., I certify to each of the following: I am the prope,ly a,vner or authorized to act on the property owner's behalf. I ha& read tIJI, Jopiication and the information I have pr ided is correct. I agree to camp r e.tCr all applicable city and county dl nces and state taws relating tobuilding construction. I autkorize representalives of this city or county to rite he above -Identified prope ,for inspection purposes. 3i nature of Pro e'ty Crnar or Authonzed Agent Print Pro arty Owner's or Authorized Agent's Name Date J ACTION DATE BY D WnONOF ANCE W17H CODE OF FEDERAL FOR OFFICE USE ONLY ft UtAT - ART S1 OF TITLE 40 AND AOMQ RULE 1 ' PEf ii EXPIRED 1 SUBMITTED ASBESTOS NOTIFICATION TO Fc'CEilEC >O EPA PERb91i EXTEN_DED OAO.MD CERAF CFlME OF ASBESTOS NOTIFI 11ON IS NOT APPLICABLE TO PROPOSED DE N OCCUPANCY i5SOED i SIGNATURE