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Home My WebLink AboutXR2022-2190 - PermitsCommunity ityoDeeloppiOet DepartmeCOMB Permit : XR2022-2190 Becnt- Building Division II III I I I II I II I III II III II II 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : 1453-2022 U _ Permit Counter Phone: (949) 644-3288 Issued Date : 08/17/2022 .x. Inspection Requests Phone: (949) 644-3255 Inspection Area : 5 C4C/Fo0.N�P newportbeachca.gov/inspections Combination Type - SFP 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 : Description Owner: Address Phone: Applicant: Address : Phone 102 ARCHIPELAGO DR Legal Desc : N TR 16431 BLK LOT 12 DELTA 2 **ADD SCOPE** - REPAIR POWDER RM SLAB AND REPLACE FIREPLACE (REV2022-1438) MIRIAM MOORE Contractor: BURKHART BROTHERS CONSTR 102 ARCHIPELAGO DR NEWPORT COAST, CA Address : 12 BALBOA COVES NEWPORT BEACH, 92657 CA 92663 Phone: (949)375-6725 Con State Lic : 905510 BURKHART BROTHERS CONSTR Lie Expire : 10/31/2023 12 BALBOA COVES NEWPORT BEACH, CA Bus Lie: BT30026859 92663 (949)375-6725 Owner/Builder: Address Phone: Architect Address Phone: State Lie Engineer Bus Lie Expire : 03/31/2023 Address Workers' Compensation Insurance Phone: Carrier: SECURITY+NATIONAL+INSURANCE+COMPA NY Policy No : SWC1373426 W. C. Expire: 2/1/2023 Designer: Address Phone: CASTILLO MARGARITO 1205 PINE AVE LONG BEACH, CA (562)961-5600 Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : Type of Construction : V-B Fire Hazard Zone : Yes, as determined by the state. Added/New/TI sq. ft. Bldg Occupancy Groups : R-3 No of Units : 1 Alteration sq. ft. Bldg : Bldg Height : No of Stories : 2 Added/New sq. ft. Garage Building Setbacks : Flood Zone : X Use Zone : PC - Newport Coast PROCESSED BY: SPECIAL CONDITIONS: $12,000.00 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 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 he 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 ticensure 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 ($500). EJ 1, 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 intendedor 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 arenot intended or offered for sale. If, however, the budding 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 Elapply 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), IJ I an axernpt from licensors 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 legal]) SO][ a structure that I have built as an owner-buldor if it has not been constructed in its entirety by licensed contractors. I understand that copy of thG 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:http:lfwww,leginfo.ca.gov>calow,html. Signature of Property Owner or Authodzed 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 O) of Division 3 of the Business and Profe ns C and qry It ce 's in full force and effect. License Class License No Date Contractor Signature %rA��i NORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ANO CIVIL FINES UP TO ONE HUNDRED THO SAND DOLLARS J$ID0,000I, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37DS OF THE LABOR CODE., INTEREST, AND ATTORNEY's FEES. hereby affirm under penalty of perjury one of the following declarations: 7 J 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 III )grformance of the work for which this permit is issued. Policy No. andwill 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' carrier and policy number are: of Agent Policy Number Expiration Date Phone 9 I certify that, in the pertgnmence 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 woXrs" mpensaticn laws ofCalifornia, and al rat, If I should Deco S bje' the workersrs' co bon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.�i��I,gnature of AppfiLan@�_DC.[IECLARATION REGA DIN NSTRUCTICIN LENDING AGENCY Ohereby affirm under penalty of perjury thatthere is a construction lending agency for the performance of the work for which this permit is issued {Section 309ode). enders Name _ _ Lenders Address Iy my signature below, I certify to each of the following: I am the property owner or authorized to act on lha property owner's behalf. I have read ihrs application and the information I have provided is correct. I aq.ae to comply with all applicable city and county ordinances and stale laws relating to building construction. I au,horize :eprese-Ja0ves of this city or cou to enter a above-Ide.. ed preps y for inspection purposes, �i 'denature of ProDertv Owner or Authorized ADen T Print Prnoerry Owner's or Authnrized Anants Nama\X// �r 1- "' d '),V. DATE {' BY J DEC—LATIATIONOF COMPLIANCE WITH CODE OF FEDERAL € i RFGUI.ATIONS PART 61 OFTITLF, 40 AND AQMD RULE 'fEd.✓:T'EXAlHE� I iLJ I,SUBMITTE,D ASBESTOS NOTIFICATION TO f'6r4w TCANCELL£D i EICPA PFRmf7 EXTENDED !�! "SIGNATURE PEPMR FINAL 2ZZ'sf O/TIFICATION 15 NOT APPLICABLE TO LbRIIfiCATE OF I iOUTIO JCLLF'ANCYISCUED ( L__.._. FOR OFFICE USE ONLY All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shall be in place prior to approval to fill pool/spa & shall remain in place & be maintained for the life of the pool.