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HomeMy WebLinkAboutXR2023-1216 - Permits�a_WPO City of Newport Beach 111���III��111111111111111111111���������������������11111COMB Permit : XR2O23-1216 d Community Development Department- Building Division );j n100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-0422 Permit Counter Phone: (949) 718-1888 Issued Date : 0511112023 .s. newportbeachca.gov/civic Inspection Area : 8 'I", RCombination Type - SFP ELEC MECH PLUM Work Class - Alteration 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: 20 CAPE WOODBURY Legal Desc : N TR 15012 BLK LOT 59 Description : SFR *REV2023-0872 ADDITIONAL SCOPE* REPLACE ALL WINDOWS AND DOORS, EXTERIOR SIDING Owner : NEAL GARY A TR Contractor: PETE BLACK CONSTRUCTION INC Architect : DAVID DILETTOSO Address : 20 CAPE WOODBURY Address: 32565 B Golden Lantern, 176 Address : 3090 BRISTOL ST, 4TH r-L COSTA MESA, NEWPORT BEACH, CA 92660 Dana Point, CA 92629 CA 92926 Phone : Phone : (714) 612-7678 Phone : (949) 204-0076 .. Con State Lic : 692383 State Lic Lic Expire : 08/31/2024 Applicant: DAVID DILETTOSO Bus Lic : BT00003226 Engineer : RICHARDS GEORGE LEWIS ; Address : 3090 BRISTOL ST, 4TH FL Bus Lic Expire : 04/30/20214 Address : 2211 MICHELSON DRAIE SUITE 450 COSTA MESA, CA 92926 IRVINE, CA 92612 Phone: (949) 204-0076 Workers' Compensation Insurance Phone: (949) 752-0601 Carrier: NO EMPLOYEES ; Owner/Builder : Policy No: EXEMPT Designer : - , , , Address : W. C. Expire: Address : • • , , Phone: Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $220,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/Ti sq. ft. Bldg : 0 Occupancy Groups : R-3 No of Units : 1 Alteration sq. ft. Bldg : Bldg Height: No of Stories : 2 Added/New sq. ft. Garage : 0 TOTAL sq. ft. : 0 Building Setbacks : Front: 10, Side: 5, Side: 5, Rear: 10 Flood Zone : X Use Zone: PC - Upper Castaways PROCESSED BY: SPECIAL CONDITIONS: REV2023-0872 a yp �" j.. �T , 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 checkmark(s) I have placed next to the applicable items) 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 is permit to file a signed statement that he or she is liconsod pursuant to the provisions of the Contractors' State License Low (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and trofessfons 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 (5500). 1 I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure Is not intended or offered for sale (Section 7044, iusiness 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 bulk or nproved for the purpose of sale). 1 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does not poly 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 I am exempt from licensure under the Contractors' State License Law for the following reason. _ y my signature below 1 acknowledge that, except for my personal residence in which I must have fesidedfor at least one year prior to completion of the improvements covered by this permit, I cannot legal, oil a structure that I have built as an owner-buildor 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 orat the following Web site:http:liwvnv.leginfo.ca,govlcalaw.html. 'signature of Property Owner or Authorized Agent Date ACENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 0) of vi. ion 3 of the Business and Prof ssions Cod y license is in full force rd effect License Class License No Date fr 2 Contractor Signature i'ORKE2S' C(II0PENSATION DECLARATION 'APNINC- FAILURE 10 SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIIWINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 16100,000j, IN ADDITION TO THE -ST OF COMPENSATION, DAMAGES AS PROVIDED FOR 1N SECTION 070E Or THE LABOR coca, INTEREST, AND ATTORNEY's FEES_ hereby affirm under peralty of perjury one of the fallowing declarations: 1 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, forth erformance of the work for which this permit is issued. Policy No, hrre 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` crane carrier and policy number are: Policy Number Agent Date �i wi ' teat, d.t tYe performance of e 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 should becom subject to t orkers' compensation provisions of Section 3700 of the Labor Code I shall forthwith comply with those provisions. Ignalure of Applicant DaI ��' A IECLARATION REGARDING WNSTRUCTION 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 y 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. agree to comply with all applicable city and county ordinances state laws relating to building construction. I authorize representatives of this city or cm imy tp enter -identified property for inspection purposes. �n IA. 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