HomeMy WebLinkAboutXR2023-3096 - PermitsCity of Newport Beach Community Development Department- Building Division X R 2 0 2 3 3 0 9 6 COMB Permit : XR2023-3096
> 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-2663
' ? Permit Counter Phone: (949) 718-1888 Issued Date : 1013112023
a., newportbeachca.gov/civic Final Date:
C9�IFp AN�P 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 : 919 BAYSIDE DR, H3
Description: MFR- INTERIOR REMODEL 600 SF
Owner: HPI 919 BAYSIDE LLC
Address: 4751 WILSHIRE BLVD, 110
LOS ANGELES, CA 90010
Phone : (818) 990-5999
Applicant:
LIGHTHOUSE PROPERTY SERVICES INC
Address :
417 S ASSOCIATED RD, 105
BREA, CA 92821
Phone:
(714)904-8327
Owner/Builder
:
Address :
Phone:
Legal Desc : P BK 185 PG 9 PAR 1 PM. 185-09 PAR. 1 AND IRVINE S
Contractor: LIGHTHOUSE PROPERTY SERVICES Architect:
INC
Address:
417 S ASSOCIATED RD, 105
BREA, CA 92821
Phone:
(714)904-8327
Con State Lie
: 844945
Lie Expire :
04/30/2025
Bus Lie:
BT30081760
Bus Lie Expire: 06/30/2024
Workers' Compensation Insurance
Carrier: EXEMPT -NO EMPLOYEES
Policy No: EXEMPT
W. C. Expire:
Code Edition : 2022
Fire Sprinklers :
NO
Type of Construction : V-B
Fire Hazard Zone :
NO
Occupancy Groups : R-2
No of Units :
1
Bldg Height:
No of Stories :
2
Building Setbacks
Flood Zone : AE, 8 FT; X
Use Zone: PC - Bayside Residential
PROCESSED BY: - !
SPECIAL CONDITIONS:
Address
Phone:
State Lie
Engineer:
Address
Phone:
Designer:
Address
Phone:
Construction Valuation : $15,000.00
Added/New/TI sq. ft. Bldg: 0
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage : 0
TOTAL sq. ft. : 0
OWNER -BUILDER 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-ftem(s)
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, derrtoliah, 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 licensure 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).
1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) 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)..
El 1, 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 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
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 legalll
sell a structure that I have built as an ownar-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
Professions Code, is available upon request when this application is submitted or at the following Web site:hltp:ll"%.leginfo.ca.govjcalavr.html.
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of pequry that I am licensed under provisions of Chapter 9 (commencing with Section 7000 of{{visi n f the Business and Professions de, ' m. lice " In full force
and effect License Class License No Date 5 Z Contractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREO THOUSAND DOLLARS (S100.0001.IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIaEO FOR IN SECTION 370S OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
11 1 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 far 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 permitis issued. My workers'
ranee carder and policy number are:
ertify that, in the performanC€
if I should become subject to
Policy Number
Date
this per ' ' issued, I shal of employ any person in any manner so as to become subject to the workers' compensation laws of California, and
Dn pro ' " - on 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant ____ ____/_. _,_,__, Date_____
ECLARATION 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).
endsr's 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 ody ow at's half.
I have read this application and the information I e provided or Gt.
I agree to comply with all applicable city and county ordinance and fate laws relating to building construction.
I authorize representatives of this city or county to enter the. ov Identified pryporly for inspection purposes. I/
Of PI ODertv Owner or Authorized
DECLMfATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE40 AND AQMO RULE
PERMIT CANCFLLEP !-EIEpp_—
PER,Vi7EXTEMOEr' -ILJAQ #JCA
— �
PfRYfIT FINAr Z'ZO �ZZ `0 ZWTO N-I NISNOT
CERTIFICATE OF PROPOSED OEM0
OCCUPANCYISSUED I SIGNATURE:
p�3
Date