HomeMy WebLinkAboutXR2023-3555 - PermitsaEWPO/7T City of 14ewport Beach ����p��� 1111111111111111111111111111111111111111111 111� 111 COMB Permit : XR2O23-3555
D� -1 Community Development Department- Building Division X R 2 0 2 3 3 5 5 5
F n100 Civic C nter,Drive, Newport Beach, CA 92660 Plan Check No: PC2023-3015
Permit Cour ter Phone: (949) 718-1888 Issued Date : 12/1912023
newporthea hca.gov/civic Final Date:
C4C/FOR�`P Combination Type - SFP Permit Status: Issued
Work Clas - Alteration Inspection Area : 4
PERMITS EXP RE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTI N RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address: 27 RUE CAS NES Legal Desc : N TR 7519 BLK LOT 13
Description: SFR - R/R 81 WINDOWS AND 1 SLIDING DOOR.
Owner: RONALD MCD
VITT
Contractor: RENEWAL BY ANDERSEN OF OC
Architect
Address : 27 RUE CANN
S
Address : 22982 ALCADE DR, 100
Address
NEWPORT BE
4CH, CA 92660
LAGUNA HILLS, CA 92653
Phone:
Phone: (714)259-5120
Phone:
Con State Lie : 990416
State Lie
Lie Expire : 07/31/2025
Applicant : RENEWAL BY
ANDERSEN OF OC
Bus Lie : BT30046925
Engineer
Address : 22982 ALCADE.
DR, 100
Bus Lie Expire : 04/30/2024
Address
LAGUNA HILLS,
CA 92653
Phone: (714) 259-512C
Workers' Compensation Insurance
Phone:
Carrier: OLD REPUBLIC INSURANCE COMPANY
Owner/Builder :
Policy No : MWC31415821
Designer
Address :
W. C. Expire: 10/1/2024
Address
Phone:
Phone:
Code Edition : 20
2
Fire Sprinklers : NO
Construction Valuation : $13,500.00
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/Ti sq. ft. Bldg : 0
Occupancy Groups : U,
-3
No of Units : 1
Alteration sq. ft. Bldg :
Bldg Height :
No of Stories : 1
Added/New sq. ft. Garage: 0
TOTAL sq. ft. 0
Building Setbacks : Frc
nt: 10, Side: 5, Side: 5, Rear: 15
Flood Zone : X
Use Zone : PC
- Big Canyon _ -
PROCESSED BY:
SPECIAL CONDITIONS:
u
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable htearts)
(Section 7031.5, Business arld 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
the 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
Professions Code) or that he or she is exempt from ]!censure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500).
El 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,
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 wilh 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 licensure under the Contractors' State License Law for the foilmving reason
By my signature below l 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 built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I undorstand that a copy of the applicable law, Section 7044 of tho Business and
Professions Code., is available upon request when this application is submitted or at the following Web site:http:llwww.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent __._..___,_._.,. Date
LICENSED CONTRACTOR'S DECLARATION
f hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Di...5o 3 of the Business and Professions Code, and. Icense is full force
.and effect. License Class License No Date T �01�.-� Contractor Signature
(WORKERS' COM'.PENSATION DECLARATION
(WARNING: 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 t5100,000j. IN ADDITION TO THE
'..COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'9 FEES_
hereby affirm under penalty of perjury one Of the following declarations:
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 the
o Ance 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' compensatior
ranee cam r Olicy�numb r jj r8:"�, / ^7
far C�� lKer�x ,, Policy Number y' lW L U1 Expiration Date Ja ^/ ^ �ZU 2c—r
of Agent
certify that, in the performance of the work for which this permit is issued'.., I shall notemploy any person in any manner so as to become subject to the workers' compensation laws of California, and agial
if I should become subject to the workers' mpansaIf revisions of Section 3700 of the Labor Code, i shell forthwith comply with those provisions. Q s�
Ialure or APPlir,ant�— _..�— ..___. Data�(2-
Ireby 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).
slar's Name, Lenders 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 an tale Paws relating to building construction.
I authorize representatives of this city or county to enter the. -Identified property for inspection purposes. (\
nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name i(/.i +"
ACTION GATE j BY DF.CCARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQNID RULE
1403
PERMIT EXPIRED I:SUBMITTFn ASBFSTOS NOTIFICATION TO
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PERMIT CANCELED �. CPA
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PERMIT FXTENOdD QMD
PERNt7T F1JJA1 �J ASBESt OS NOT ]FICA tIUN 15 NOT EICABL'E TO
CERTIFICATE OF j� 1 PROPOSED DEMOLITION
OCCUPANCYf55UEA _ _ SIGNATURE;