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Home My WebLink AboutXR2023-1010 - Permits_Wpo", City of Newport Beach II III II I I IIII IIII III II IIII II III II COMB Permit : XR2023-1010 0 A Community Development Department- Building Division X R 2 0 2 3 1 0 1 0 u s 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-0904 ^ PPP ermit Counter Phone: (949) 644-3288 Issued Date : 04/20/2023 Inspection Requests Phone: (949) 644-3255 Inspection Area : 2 CgiicoflN�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: 2821 BAY SHORE DR Legal Dose: N TR 1014 BLK LOT 28 Description: SFR - INSTALL NEW FIREPLACE IN MASTER BEDROOM Owner: SCHEETZ KEVIN BERNARD SCHEETZ FAMILY TR Address : 829 BARRON AVE PALO ALTO, CA 94306 Phone : (714) 612-7678 Applicant: ARTHURFERNANDEZ Address : 12345 Ventura Blvd., Suite H Studio City, CA 91604 Phone: (818)754-2030 Owner/Builder : Address : Phone TR K & C Contractor Address Peter Black 32565 B Golden Lantern, 176 Dana Point, CA 92629 Phone : (714) 612-7678 Con State Lie : 692383 Lie Expire : 08/31/2024 Bus Lie: BT00003226 Bus Lie Expire : 04/30/2023 Workers' Compensation Insurance Carrier: EXEMPT Policy No: EXEMPT W. C. Expire: Architect Address Phone: State Lie 0' Engineer : SAEED BANAIE Address : 6734 WHITE OAK AVE VAN NUYS, CA Phone : (424) 248-0636 Designer: ARTHURFERNANDEZ Address : 12345 Ventura Blvd., Suite H Studio City, CA 91604 Phone: (818)754-2030 Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $30,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 Occupancy Groups : R-3 No of Units : 1 Alteration sq. ft. Bldg : Bldg Height : No of Stories : 2 Added/New sq. ft. Garage : 0 TOTAL sq. ft. : 0 Building Setbacks : Front: 10, Side: 4, Side: 4, Rear: 10 Flood Zone : X Use Zone : R-1 - Single -Unit Residential BY: PROCESSED SPECIAL CONDITIONS: 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 toits 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 g (Commencing with Section 7000) of Division 3 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 applicantfoe a permit subjects the applicant to a civil penalty of not more than five hundred dollars (WO). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_.) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Coda: The Contractors' State License Law does not apply to an owner of property who, through employeesor 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 I, as owner of the property, am exclusively contractingwith 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). I am exempt from 6ceasure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal rasidonce in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal], 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 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;http_liwww.#egin#o.Da.gov/calaw:html. Signature of Property Owner or Authorized Agent__ � Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 8 (commencing with Section 0) of D -of�he Business and Prof ons Code, an .i I • Ise is In full force and effect. License Class License No Date ntract, Signatura COMPENSATION DECLARATION tARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO Cf DST OF COMPENSATION, DAMAGES As PROVIDED FOR iN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'$ FEES, hereby affirm under penalty of perjury one of the following declarations: LS r AND CIVIL FINES UP TO ONE NUNtlREO)HOUSANO DOLLARS cHIM 600t, IN ADDITION TO THE I have and will maintain a certificate of consent (aself-insurefor workers` compensation, issued by the Director of industrial Relations as provided for by Section 3700 of the Labor Code, for ormance 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' compensai ranee carrier and policy number are: Policy Number of Agent Date 14 rofy diet, in the performance of the wor 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 Agra k, :TT should becom u act tD the wor mpnnsatinn provisions of Section 3700 of the Labor Code, I shall tartitwllh comply with (hose provisions. ➢/ nature of Apollo anf _ Date CLARATION R€OA tN m STRU ON LENDING AI!uw aroby affirm under penalty of perjury tea there is a construction lending agency for tfia performahca of th®work for vfiich this permit. is Issued (Section 3097, CI it Coda). ,dot's Name Leader's Address my signature below, I certify to each of the following; I am the property owner or authorized to act on the prop" owner's behalf. I have read this application and the Information I.have provided is cifirrect. I agree to comply with all applicable city and cailinty ordinances a state laws relating to building construction. I authorize representatives of this city or county rater toe riffled property for Inspection purposes. nature of Property Owner Or Authorized Anent Print Procartv Owner's or Authorized Aoent's Nama ACTION I DATE 6Y !`DTlARr ION Or COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY / r REGULA�•IONS PART 61 OF T'ITtE 40 AND AQr4D RUIE 1403 PERMI r EXPIRED I SUDMMERASOESTOS NOTIF[rATtON TO PERMIT EXTENDED L_AQm OT9FiCATI O FpLICAeLE TO PER7MTT FINAL CERTlF1CATE OF ,�4%.Z3 PROPOSE OLITIO OCCUPANCY ISSUED ( `u ATURF,