HomeMy WebLinkAboutXR2023-2661 - PermitsO�agW PpaT City of Newport Beach 111 IIIpIII 111111111111111111111111111111111111111111 111� 11COMB Permit : XR2O23-2661
Community Development Department- Building Division X R 2 9 2 3 2 6 6 1
F y 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-2319
Permit Counter Phone: (949) 718-1888 Issued Date : 12/13/2023
G s newportbeachca.gov/civic Final Date:
. Combination Type - MFP ELEC MECH PLUM Permit Status: Issued
Work Class - Alteration Inspection Area : 2
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 : 2 IMA LOA CT
Description: MFR - ALT REMODEL 1386 SF
Owner: KOJIMA JULIE A TR J A
Address : 6275 CALLE FUEGO
PLEASANTON, CA 94566
Phone :
Applicant: BRIANJOHNSON
Address : 2531 colby place
costa mesa, CA 92626
Phone: (949)371-3940
Owner/Builder :
Address :
Phone
Code Edition : 2022
Type of Construction : V-B
Occupancy Groups: U,R-2
Bldg Height :
Building Setbacks :
Flood Zone : X
Use Zone : PC - Newport Crest - UP1585
PROCESSED BY: 9-M
SPECIAL CONDITIONS:
Legal Desc : N TR 7817 BILK LOT 3 UN 135 TR 7817 LOT 3 UNIT 135
Contractor: JOHNSON CONSTRUCTION
Address : 2531 COLBY PLAC
COSTA MESA, CA 92626
Phone:
(949)371-3940
Con State Lic
: 853350
Lic Expire :
01/31/2025
Bus Lic :
BT30077895
Bus Lic Expire : 02/29/2024
Workers' Compensation Insurance
Carrier: EXEMPT
Policy No : EXEMPT
W. C. Expire:
Fire Sprinklers :
NO
Fire Hazard Zone :
NO
No of Units :
1
No of Stories :
3
Architect
Address
Phone:
State Lic
Engineer: ASKARIAN KYLE
Address : 17595 HARVARD AVE #C-734
IRVINE, CA 92614
Phone: (310)404-1834
Designer:
Address
Phone:
Construction Valuation :
$165,000.00
Added/New/TI sq. ft. Bldg :
0
Alteration sq. ft. Bldg :
1,386
Added/New sq. ft. Garage :
0
TOTAL sq. ft. :
0
OWNER -BUILDER DECLARATION
€ hereby alrm under penalty of perjury that I am exempt from the Contractors' Stale License Law for the reasan(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
the permit to file a signed statement that ha 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 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
not more than five hundred dollars (3500).
I, as owner of the property, or my employees with wages as their sole compensation, will do L) 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 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of properly 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' Slate 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 legall
sell 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
Professions Code, is available upon request when this application is submitted prat the following Web site:http:i/www.leginfo.ca,gov/caiaw.html.
Signature of Property Owner or Authorized Agent _ _ Date
LICENSED CONTRACTOR'S DECLARATION /
I hereby affirm under penalty of perjury that. I am licensed under provisions of Chapter 9 (commencing with Section 7 is' n 3-of the Business and Profession rate nd my license is In full force
and effect. License Class License No Dale Contractor Signature r, 1
WORKERS' COMPENSATION DECLARATION
✓YARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 19 UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 13100,000j.. IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3F06 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
-hereby affirm under penalty of perjury one of the following declarations:
T
- 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, for th
performance of the work for which this permit is issuad. 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 polle y number are:
Policy Number
of Agent
Date
certify that, inthe performance of t " 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
L if I should become subject to the o kers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions -
nature II,�,
of Applicant _ _ _ __ _Date LZj__),,,;___
CI.ARATION REGARDING TRLICTION LENBING AGENCY __ //
areby 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).
Idar's Name _ Lender's Address
my signature below, I certify t0 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 Crap nces and state laws relating to building construction.
I authorize representatives of this city or county to e r a above -Identified property for inspection purposes. \ ' ` �.
nature of Prooertv Owner or Authorized Aoenl Print Property Owner's or Authnri7.n d A.nt's Nam�.1 . i rTNSC'Ll riot. l7If?
ACTION DATE BY 'DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AONID RULE
PERMIT EXPIRED
!
LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERiL7jTC PrCELLEt•
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P€RM7T EXTENDED.
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