HomeMy WebLinkAboutXR2023-3310 - Permits�gWPpa� City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit XR2023-3310
p� @ Community Development Department- Building Division X R 2 0 2 3 3 3- t 0
H 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2023-2835
Permit Counter Phone: (949) 718-1888 Issued Date: D210812024
it Ya newportbeachca.gov/civic Final Date:
C4Q FORr��P Combination Type- SFP ELEC MECH PLUM .- Permit Status: Issued
Work Class -Alteration Inspection Area : 6
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
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Job Address : 35 OVERLOOK DR Legal Desc : N TR 15400 BLK LOT 49 TR NO 15400 LOT 49 AND POR 0
Description : SFR INTERIOR REMODEL 2390 SF
Owner:
PATRICK BOLTER
Address :
35 OVERLOOK DR
NEWPORT BEACH, CA 92657
Phone :
(949) 246-1117
Applicant:
JAMESGONZALES
Address :
22 CORPORATE PARK
IRVINE, CA 92606
Phone:
(949)955-3282
Owner/Builder :
Address :
Contractor: HENRICKSEN HOMES INC
Address : 54 TESLA
IRVINE, CA 92618
Phone: (949)355-5479
Con State Lie : 1051381
Lie Expire : 12/31/2024
Bus Lie: BT30082812
Bus Lie Expire : 10/31/2024
Workers' Compensation Insurance
Carrier: EXEMPT -NO EMPLOYEES
Policy No: EXEMPT
W. C. Expire:
Architect :
TAJUDIN AMAT K
Address :
22 CORPORATE PARK, 200 IRVINE, CA
92606
Phone:
(949)955-3282
State Lie
Engineer: XIAOQIANG
Address: 1520 BROOKHOLLOW DR #45
SANTA ANA, CA 92705
Phone : (714) 662-0510
Designer:
Address :
Phone:
Phone:
Code Edition :
2022
Fire Sprinklers :
NO
Construction Valuation :
$262,900.00
Type of Construction :
V-B
Fire Hazard Zone :
YES
Added/New/TI sq. ft. Bldg :
0
Occupancy Groups :
U,R-3
No of Units :
1
Alteration sq. ft. Bldg:
2,390 ..
Bldg Height :
No of Stories:
2
Added/New sq. ft. Garage:
0 ...
TOTAL sq. ft.:
0 ,
Building Setbacks
Flood Zone :
X
,
Use Zone:
PC - Newport Coast
Q:s
PROCESSED BY:
SPECIAL CONDITIONS: HAULER: TIGHT QUARTER
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 Items)
(Section 7031.5, Business end 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 statemont that he or she is licensed pursuant to the provisions of the Contractors' State License Low (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).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) 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 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 buillor
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 ownerof property who builds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law),
L-1 i am exempt tram licensure under the Contractors' State License Law for the following reason:
By my signature below I acknowledge that, except far my personal residence in which I must have resided foral least one year prior to completil
sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy
Professions Code, is available upon request when this application IS submitted orat the following Web aile:htip:l/www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION
mans Covered by this peril, I cannot
law, Section 7044 of the Business and
Date
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division of the Business and Prof 'ens o ae y license is In full force
and effect. License Class License No Date �r Contractor Signature`s
WORKERS' COMPENSATION DECLARATION
WARNING; FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FRIES UP TO ONE HUNDRED THOUSAND DOLLARS 11100.000), IN ADDITION To THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3703 OF TI4E LABOR CODE, INTEREST, AND ATTORNEY-S FEES.
1 hereby affirm under penalty of perjuryone of the following declarations:
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 IN
performance of the work for which this peril 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 [his permit is issued. My workers'
ranee carrier and policy number are:
to of Agent
certify that. in the performance
if I should become subject to
of
Policy Number
Date
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
kim�j compensation provisions of Section 3700 of (he Labor Code, I shall forthwith comply with those provisions.
CLARATION REGARDING CONSTRUCTION LENDING AGENCY Date_ Ztty
neby afFlr under penalty of perjury that there Is a construction lending agency for the performance of the work for which this permit is Issued (Section3097, Civil Code).
ider's Name Lender's Address
my signature bnlrna I certify to each or the following:
I am the properly owner or authorized to act on the property owner's behalf.
I have read this apnfcation and the Information I have provided is correct.
I agree to co,nely whh all applicablecity and county ordinances and state laws relating to building construction.
I authorize representatives of this city or county to enter th ov identified property for inspection purposes.
na,we of Properly Owner or Authorized Agent � _ Print PfODertV Owner's or Authorized AonnPs Name
DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDEI
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
f E.i,l,i EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO
RER,✓ol CANCELLED l� ran
PERMIT FINAL
CEROHCATE OF
OCCUPANCYISSUED
jn
PROPOSED
NOTIFICATION IS NOT APPLICABLE TO
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Date