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Home My WebLink AboutU2024-5300 - Permits�EwaoRa City of Newport Beach IIIIIIII� II�II�III�I III'I IIII�II�I��II�II�� II� II COMB Permit : U2024-5300 Community Development Department - Building Division U 2 9 2 4 5 3 0 0 F 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: Permit Counter Phone: (949) 718-1888 Issued Date : 10/2412024 � -- newportheachca.govlcivio- Final Date: ��/FORN�P Combination Type - Permit Status: Issued Work Class - Addition/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 : 2676 BAY SHORE DR Legal Desc : A TR IRVINE SUB.BLK 54 LOT 171 IRVINE SUB LOT 171 Description: SFR TEMP SHORING (REV2024-1936) Owner: 8 BAYSHORE PARTNERSHIP LP Contractor: PMR CONSTRUCTION INC Architect : SKURMAN ANDREW Address : 5100 CAMPUS DR STE300 Address : 145 MAIN ST W, 200 Address : 3654 SACRAMENTO ST SAN FRANCISCO, NEWPORT BEACH, CA 92660 TUSTIN, CA 92780 CA 94118 Phone: Phone: (714)754-4111 Phone: (415) 440-480 Con State Lic : 716745 State Lie : CO23797 Lic Expire : 0212812026 Applicant : DAN KELSAY Bus Lie: BT30053615 Engineer: JAFARI MASOUD Address : 145 W MAIN ST Bus Lie Expire : 01/3112025 Address : 23 ORCHARD #250 TUSTIN, CA 92780 LAKE FOREST, CA 92630 Phone: (949) 375-5495 Workers' Compensation Insurance Phone: (949) 206-9929 Carrier: HARTFORD CASUALTY Owner/Builder : Policy No : 72WECANGMPH Designer: Address : W. C. Expire : 8/24/2025 Address Phone: Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation :. $10,000.00 Type of Construction : Fire Hazard Zone : NO -Added/New/TI sq. fL Bldg: 0 Occupancy Groups : U - No of Units: Alteration sq. ft. Bldg: 0 Bldg Height: No of Stories: Add/New sq. ft. Garage: 0 TOTAL sq. ft.: 0 Building Setbacks: Front: 10, Front: 10, Side: 4, Side: 4 Flood Zone: AE, 8 FT; X Use Zone: R-1. - Single -Unit Residential -. PROCESSED BY: o' o e e� a SPECIAL CONDITIONS: REV2024-1936 ono 000 00 0 o e " ao I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable Iteri (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 he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division of the Business and Professions Code) or that he or she is exempt from licensors 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 (5500). ❑ 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. Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effod, 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 w,as 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 LI,onse 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' Stale 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 1 p it, I cannot legalq sell a structure that I have built as an owner -builder it it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 D sines antl Professions Code. is available upon request when this application is submitted or at the following Web site:http:ff"v+.leginfo.ca.govtcalaw.html. Signature of Property Owner or Authorized Agent _ Dale LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 o DrV1SIO 3 of the Busine and of sions a l full force and effect. License Class License No Oat (. Contractor WORKERS' COMPENSATION DECLARATION ICI' �II WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FREE UP TO ONE HUNDRED THOUSAND 00LLAR5 {S1aD,DDD)', I ..mON TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 37H OF THE LABOR CODE- INTEREST, AND ATTORNEYS FEES. I 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 Ifllh]l Libor Code, for th erformance 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 compensatiol t -or ce carder and policy number are: [! 'Cartier Policy Number Expiration Date III Name of Agent Phone ri it 1:11 certify that. in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensationl,la 611 31ifomia, and agre that. if I should beco I C a1tT�w a ens ton visbns of Section 3700 of the Labor Code, I shall forthwith comply With those provisions. I ! Signature of Applica �-+,�! ___ Dalero DECLARATION REGA S UC N L DI G 1 hereby affirm under penalty of perjury that there is a Construct I ing agency for the performance of the work for which this permit is issued (Section 3097, Code). i 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 properly 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 count finances and stale lay relating to building construction. I authorize representatives of this city or co. 1 ntffe p erty for inspection purposes. I Si nature of PropertyOwner or Authorzed en t Property Owner's or Authorized Ag nl's Na Dale b - ACTION IDATE BY Y NJELECLARATION OF COMPUA ITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OFT E 40 AND AQMD RULE 114403__ PERMIT EXPIRED U I SUBm,TTED. SRFST0_ S NOTIFICATION TO PERMIT CANCELLED PERM? EXTENDED - AQMD h PERAAIT FINAL �/ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF Z /�.✓�' PROPOSED DEMOLITION OCCUPANCY 155UED SIuNHTLAE.