HomeMy WebLinkAboutXR2022-2577 - PermitsCity of Newport Beach I I I I I I III
Community Development Department -Building Division
100
Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255T
newportbeachca.govlinspections i"" T C
Combination Type -
Work Class - Other
COMB Permit : XR2022-2577
Plan Check No :
Issued Date: 09/27/2022
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 : 205 AMETHYST AVE Legal Desc : A TR BALBOA ISLAND SEC 3 BILK 19 LOT 26
Description: NEW SFR W/ATT GARAGE 2,322/384 SF —CHANGE OF CONTRACTOR***
Owner:
BOHLINGER PETER Y TR
Address :
1140 HIGHLAND AVE
MANHATTAN BEACH, CA 90266
Phone:
Applicant :
BRYCE SANTANIELLO
Address:
3419 VIA LIDO UNIT 115
NEWPORT BEACH, CA 92663
Phone:
(714)600-3719
Owner/Builder :
Address :
Phone
Contractor:
BRYCE SANTANIELLO
Address:
3419 VIA LIDO UNIT 115
NEWPORT BEACH, CA 92663
Phone:
(714)600-3719
Con State Lic
: 1070607
Lic Expire :
11/30/2023
Bus Lic:
BT30078093
Bus Lic Expire : 02/28/2023
Workers' Compensation Insurance
Carrier :
Policy No : EXEMPT
W. C. Expire:
Architect
Address:
Phone :
State Lic:
Engineer: FORBES DALE L
Address : 1800 E 16TH ST #B
SANTA ANA, CA 92701
Phone : (714) 835-2800
Designer: SIBEL KONAK
Address: 2627 SEAVIEW AVE
NEWPORT BEACH, CA
Phone : (415) 306-4332
Code Edition :
2019 Fire Sprinklers :
NO
Construction Valuation : $0.00 0 0 0
Type of Construction :
V-B Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg : 0
Occupancy Groups :
U,R-3 No of Units :
1
Alteration sq. ft. Bldg : 11 1
Bldg Height :
No of Stories :
3
Added/New sq. ft. Garage: 0 a o"
Building Setbacks :
Front: 10, Side: 3, Side: 3, Rear: 5
Flood Zone :
X
i, , U
Use Zone :
R-BI - Two -Unit Residential, Balboa Island
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PROCESSED BY:
o
SPECIAL CONDITIONS:
***CHANGE OF CONTRACTOR FOR PERMIT X20211303
TO:
QQ,
BRYCE SANTANIELLO***
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt. from the Contractors' State License Law for the reasons) 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 sho Is licensed pursuant to the provisions Of the Contractors' State License Law (Chapter g (commencing with Section 7000) of Division 3 of the Business and
Irofossions Code) or that he or she is exempt from licensure and the basis far the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of
lot more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness and Professions Code: The Contractors' Slate License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
mprovements 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
tproved for the purpose of sale).
J 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
I�rply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors Stale License Law).
J I am exempt from licensors under the Contractors' Slate License Law for the Following reason ._ _ ___-_------ _�__....... ........ _. __.... ._—_.__ . _ ...-.._.._.....
ly my signature below I acknowledge that, except for my personal residence in which I must have insided for at least one year prior to completion of the improvements covered by this permit, I cannot legally
all a structure [hat I have built as an owner -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
Irofessions Code, is available upon request when this application Is submitted or at the following Web site:http:/Iw .leginfo.ea.gov/calaw.html.
Signature of Property Owner or Authorized Agent s_ _ Date^i
.ICENSED CONTRACTOR'S DECLARATION �
hereby affirm under penally of perjury that I an) licensed under provisions of Chapter 9 (commencing with Section 700) f ision 3 of the Business and Proles . an¢my)iGrease is in full force
ind effect. License Class License No Date ��'Z Contractor Signalure
'1►--®—
YORKERS' COMPENSATION DECLARATION
DARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER To CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE FUND T USANO DOLLARS IS100,0001, IN ADDITION TO THE
:DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES.
hereby affirm under penalty of perjury one of the following declarations:
J 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
)erformance of the work for which this permit is issued. Policy No.
-11 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My Workers' compensaboi
nsurance carrier and policy number are:
)amier Policy Number Expiration Date
Jame o 1 Phone #
I certify that, in the performance of Ih w rk 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 ogre
hat, if I should become subject a ers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
3lgnalure of Applicant, e T Date C/ ' Z
_
)ECLARATION REG C STRUCIDON LENDING AGENCY /
hereby affirm Lrhr p nalty erjurythat there fs a construction lending agency for the performance of the Work for which this permit is issued (Section 3097, Civil Code .
-enders Name Lender's Address
°y my signature below, I certify to each of the following:
I am the proped7 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 ordas and slate laws relating to building construction.
aulhorze reprHsentatives of this city or county to a ab -Ida party far inspection purposes,
;i nature of Property Owner or Authorized A ant Print Pro a Owner's or Authorized Agent's Name «— a' Date 2s g
ACTION DATE B F DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART ES OF TITLE 4D AND ADMIT RULE
PERMT EXPWED
FERMITCAN,aLLEG
^ERMI7EXTkIWEd
PERMIT FINAL I �BESTOS NOTIFICATION 15 NOT APPLICABLE TO
CERTIFICATE OF '�'?? PROPOSED DEMOLITION
OCCUPANCY ISSUED 77 I SIGNATURE:
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