The URL can be used to link to this page

Home My WebLink AboutXR2023-0870 - PermitsaEWPoRr City of Newport Beach 1111111111111111111111111111111111111111111111IoIIii11I COMB Permit : XR2023-0870 p4 Community Development Department - Building Division x R 2 0 2 3 0 8 7 0 Plan Check No : PC2023-0764 y. 100 Civic Center Drive, Newport Beach, CA 92660 u }+^ S Permit Counter Phone: (949) 718-1888 Issued Date : 05/12/2023 newportbeachca.gov/civic Inspection Area : 6 cgtiFOR�`P 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 : 11 VENETO Legal Desc : N TR 15078 BILK LOT 18 Description: SFR RMV INTERIOR WALL IN FAMILY ROOM, ADD NEW BI-FOLD DOOR Owner: FIELD RICHARD TR Contractor: BENJAMIN R MATYSZUK Architect Address : 11 VENETO Address : 2 JARANO ST RANCHO MISSION VIEJO, CA 92694 Address NEWPORT COAST, CA 92657 Phone : (949) 689-9893 Phone Phone : Con State Lic: 1039697 State Lic Lic Expire : 05/31/2024 Bus Lic : BT30081542 Engineer : GHAZLANI ANDY Applicant: BENJAMIN R MATYSZUK Bus Lic Expire : 05/31/2024 Address : 4202 ATLANTIC AVE #204 , Address : 2 JARANO ST LONG BEACH, CA 90807 RANCHO MISSION VIEJO, CA 92694 Workers' Compensation Insurance Phone : (562) 253-2385 Phone: (949) 689-9893 Carrier Policy No: EXEMPT Designer : NASIM NAD Owner/Builder: W. C. Expire: Address Address : FOOTHILL RANCH, CA 92610 Phone: (714) 213-0148 Phone: Fire Sprinklers : NO Construction Valuation : $27,000.00 Code Edition: 2022 Fire Hazard Zone : YES Added/New/TI sq. ft. Bldg: 0 Type of Construction : V-B No of Units : 1 Alteration sq. ft. Bldg : Occupancy Groups : U,R-3 No of Stories : 2 Added/New sq. ft. Garage: 0 Bldg Height : TOTAL sq. ft. 0 Building Setbacks : Front: 10, Side: 5, Side: 5, Rear: 10 Flood Zone : X Use Zone: PC - Newport Coast PROCESSED BY: 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, dernohsh, 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 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 9031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). II J I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the 3usinass and professions Code; The Contractors' State License Law does not apply to an owner of property who, through eml mprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of complete mproved for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Bu: ipplply to an owner of property who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pu. ..1 1 am exempt from licensure under ale Contractors' State License Law for the following reason: 3y my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year Ioli a structure that I have built as an owner -builder if It has not been constructed in its entirely by licensed contractors. I under 'rofessions Code, is available upon request when this application is submitted or at the following Web sfte;http:7lWww.Ieginto.c Signature of P-cpe�ty Owner or Authorized Agent___ .ICENSED CONTRACTOR'S DECLARATION ILrJI)y affirm under penallyof perjury [hot I am licensed under provisions of Chapter 9 (commencing with Section 70 0 of D', and effect. Licansc Class License No Date VORKERS' r.OMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES UST OF COf'PE45ATiON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: I I have and WH' maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Int erformance of the! work for which this permit is issued. Policy No. 4; have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perfor isurance carrar ^nd policy number ara: -- Policy Number of wgent certify that, inthe performance of the work for which this permit is Issued'.. I shall not employ any person in any manner so , if I should become ct t ,fie workers' 7compensation provisions of Section 3700 of the Labor Code, I shall forthwith c miure of ApDlican — !reby affirm under penalty of perjury thd(there is a construction lending agency for the performance of the work for which ides Name Lender's Address my signature below. I certify to each of the following: I am the property 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 ordinances and state laws relating to building construction. I authorize representatives of this city or county tto above -identified property for inspection purposes, nature of PropeRy Owner or Authorized Agent Print Property Owner's Or Autl ACTION PERMIT EXPIRED DATE BY �FCLAIlAT1ON OF COA1 REGULATIONS PART 61. WITH CODE OF FEDERAL 40 AND AQNID RULE ly}I ASBESTOS NOT IFICATION 15 NOT APPLICABLE TO CERTIFICATE Of 'a'?"aS p�� /p1�OPO5E00E OCCUPANCYISSUED I I urmnrilo- lei./ k, and the structure is not Intended or offered for sale (Section 7044, ees' or personal effort, builds or improves the property, provided that the the Owner -Builder will have the burden of proving that it was not builtor and Professions Code: The Contractors' State License Law does not to the Contractors' State License Law). rD UU113PIeLlan or me Improvements covered by this permit, I cannot that a copy of the applicable law, Section 7044 of the Business and Date n 3 of the Business and Profiess' �s —(C�ode, and my license is in full force Contractor Signatura `;7 :7 CIVIL FINES UP To ONE HUNDRED THOUSAND DOLLARS 4100A00), IN ADDITION TO THE Relations as provided for by Section 3700 of the Labor Code, for of the work for which this permit is issued. My workers' Date to become subject to the workers' compensation laws of California, and ply with those provisions. Date_ - 1 1Z%7 Z, permit Is issued (Section 3097, Civil Code). FOR OFFICE USE ONLY