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Home My WebLink AboutXR2023-2141 - Permits�gWPO,gT City of Newport Beach 11�1 111111111111111111111111111111111111111111111111111 111� 11COMB Permit : XR2O23-2141 D� @Community Development Department- Building Division X R 2 0 2 3 2 1 4 1 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2023-1870 Permit Counter Phone: (949) 718-1888 Issued Date : 08/03/2023 ¢ newportbeachca.gov/civic Final Date: c94FoaN�P Combination Type - MFP Permit Status: Issued Work Class - Alteration Inspection Area : 7 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: 3121 COAST HWY W, SA Legal Desc : N TR 919 BLK LOT L UN HOLD TR 919 LOT L ELY1/2; HO Description: MFR WINDOW/DOOR CHANGE OUT (5/2)'123-0015" Owner: CARLOS CHACON Contractor : Architect Address : 1285 YOCUM ST Address : Address PASADENA, CA 91103 Phone : Phone : Phone Con State Lic : State Lic Lic Expire Applicant: GEORGE THIRET Bus Lic : Engineer Address : 3121 COAST HWY E Bus Lic Expire : Address NEWPORT BEACH, CA 92625 Phone : (303) 882-1111 Workers' Compensation Insurance Phone Carrier : owner/Builder : CARLOS CHACON Policy No : Designer Address : 1285 YOCUM ST W. C. Expire: Address PASADENA, CA 91103 Phone: Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation Type of Construction : V-B Fire Hazard Zone : NO Added/New/Ti sq. ft. Bldg Occupancy Groups : R-2 No of Units : 1 Alteration sq. ft. Bldg : Bldg Height : No of Stories : 8 Added/New sq. ft. Garage TOTAL sq. ft. Building Setbacks Flood Zone : AE, 8 FT; X; X Use Zone : MU-W 1 - Mixed -Use Water BY: PROCESSED SPECIAL CONDITIONS: �jyA $15,000.00 0 I OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason($) indicated below by the checkmark(s) I have placed next to the applicable taints) Section 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 io 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 Ifcensure 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). 1 I, as owner of the property, or my employees with wages as their sole compensation, will do t_) 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. I I, 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 ply 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). I am exempt from licensure under the Contractors' State License Law for the following reason iy my signature below I acknowledge that, except for my persona ideI in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I Cannot legall} oil a structure that have built as anequest when t i it has not -e submitted m' entirety by 11eensoecontractors, I info.ca, o that a copy of the applicable law, Section 7044 usin professions Code, is available upon request when This appiccati s submitted or ' ite:http:Iiwww.Ieginfo.ca,govlcalew.htmi. lignature 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 Sec111II ri 7 00) of Division 3 of the Business and Professions Code, and my license is In full force rid effect. License Class License No DContractor Signature UORKERS' COMPENSATION DECLARATION ' 1 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS (S100,000), 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 I have and wilt maintain a certificate of consent to sell -insure for workers' compensation. Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th erformanca 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' ranee carrier and policy number are: Policy Number Date ie of Agent Phone u certify that, in the performance of the work for which this permit la issued, I shall notemploy any person in any manner so as to become subject to the workers' compensation laws of Calffomia, and , 1f I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions, :ignalure of Applicant ,_ ___,....._.__.__.-_._..__.__._..____._...__.___..._. �.� Date_ _ 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). ender's Name __ — Lender's Address ly my signatureow, I Ce belrfify 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 pr Ided is correct. I agree to comply with all applicable city and county or _,es and slate laws relating to building construction. I authorize representatives of this city or county to a th above-Acrilffied property for inspection purposes. Tonature of Prooertv Owner Or Authorized Apart Print Prooertv Owner's or Authorized Aaent's Name rsS S ACTION ( DATE. II BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 FOR OFFICE USE ONLY PERMrTEXPiHED t [ IaURMITT6)ARFSOS NOTIFICATION TO PERMIT CANCELLED PA ......... .. PERYflF EXTENDED ...._... ._ . ,... ..... 1. IN PERMIT PERMIT FINAL rr�', _j .� ASBESTOS NOT IF ICA'I'ION 15 NOTAPPLICABLE TO CERTIFICATE OF [,�I�j l-T l I PROPOSED DEMOLITION OCCUPANCYfSSUED I i.. SIFNATURE