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Home My WebLink AboutXR2024-5553 - Permits"EWPO".T City of Newport Beach 111IIIpIIIIII IIIII IIIII 111111111111111111111111111111 111� 111 COMB Permit : XR2O24-5553 0 6 Community Development Department- Building Division X R 2 0 2 4 5 5 5 3 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : 0242-2022 U Permit Counter Phone: (949) 718-1888 Issued Date : 06/25/2024 S newportbeachca.gov/civic Final Date: 06/25/2024 Combination Type - Permit Status: Issued Work Class - ADDITION/ALTERATION Inspection Area : 6 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 : 717 POINSETTIA AVE Legal Desc : A TR CORONA DEL MAR BILK 742 LOT 17 Description : DESCRIPTION CHANGE DUPLEX TO CONDOS Owner: LA21 G LLC Contractor: T J C HOME BUILDERS LLC Architect : FALESE DEBRA S Address : 26880 ALISO VIEJO PKWY, 200 Address : 26880 ALISO VIEJO PKWY, 200 Address : 2943 PULLMAN ST STE A SANTA ANA, CA ALISO VIEJO, CA 92656 ALISO VIEJO, CA 92656 92705 Phone : Phone : (949) 281-0482 Phone : (949) 553-8919 Con State Lic : 1025507 State Lic Lic Expire : 04/30/2025 Applicant: NELLIE MONTEJANO Bus Lic: BT30059037 Engineer : NGUYEN HUAN Address : 26880 ALISO VIEJO PKWY, 200 Bus Lic Expire : 05/31/2025 Address : 15 STUDEBAKER ALISO VIEJO, CA 92656 IRVINE, CA 92618 Phone: (949) 669-5118 Workers' Compensation Insurance Phone: (949) 752-1612 Carrier: TECHNOLOGY INSURANCE CO INC Owner/Builder : Policy No : TWC4395303 Designer: �s Address : W. C. Expire : 3/1/2025 Address : ,p°^ �,... Phone: Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $0.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 Occupancy Groups : R-3 No of Units : 0 Alteration sq. ft. Bldg : 0 Bldg Height : No of Stories : 0 Add/New sq. ft. Garage : 0 TOTAL sq. ft. 0 Building Setbacks : Front: 20, Side: 3, Side: 3, Rear: 5 Flood Zone: X Use Zone : R-2 -Two-Unit Residejiti PROCESSED BY: SPECIAL CONDITIONS: OWNER -BUILDER 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 checkmark(s) I have placed next to the applicable item(s) 'action 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 Ie 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 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 of more than five hundred dollars ($500). 11, 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, 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 nproved 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 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' State License Law). 1 am exempt from licensure under the Contractors' State 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 legal all 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 she:http://wvvw.leginfo.ca.gov/calaw.html. ignature 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 Sectio 0 Djlo Business and Pro s e a d y lice a is in full force nd effect. License Class License No Da ll�i.� Contractor Signature COMPENSATION DECLARATION 'ARNING: 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 ISID0.000), IN ADDITION TO THE DST 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' erformance 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 Name of Agent Phone # Date I certify that, in the perfo ante of r f r ich this p is issu , I shall not employ any person in any manner so as to become subject to the workers Compensation la of Cali omia, and agre that, if I should become u to the k parse ion io s lion 3700 of the Labor Code, I shall forthwith comply with those provisions. �1 Signature of Applicant Dat _ DECLARATION REG ING STRUCTION LENDING AGENCY I hereby affirm under ally of perjurya there is a construction lending cy for the performance of the work for which this permit is issued (Section 309 Ci '1 Code). Lenders Name Lenders Address By 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 co ty .r inan a state la vela' g to building construction. I authorize representatives of this city or county o met e v id nti d Pop for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Na ACTION DATE BY DEC ATION COMPL ANCE TH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 NO AOMD RULE 1403 PERMITEXPIRED rI S-IURMITTEO ASBESTOS NOTIFICATION TO PERMIT CANCELLED JEPA PERMTTEXTENDED OL�MP — PERMITFINAL ❑ASBESTO5 NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATEOF 6]yj�yy �s PROPOSED DEMOLITION OCCUPANCY ISSUED Y-J� SIGNATURE'