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Home My WebLink AboutXR2023-2822 - Permitsrwuo,T City of Newport Beach 11111111111111111111111111p1111111111111111111111111111111COMB Permit : XR2O23-2s22 �e Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-2454 q Permit Counter Phone: (949) 718-1888 Issued Date : 10/1112023 newportbeachca.gov/civic Final Date: C"9CrF00.N�P Combination Type - MFP ELEC PLUM ... a +-' " ➢ Permit Status: Issued Work Class - Other Inspection Area : 4 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 : 106 HARTFORD DR, 63 Description : MFR SUB SLAB DEPRESSURIZATION Owner: BATEMAN PAUL W TR PETER Address: 1733 MONROVIA AVE STIED COSTA MESA, CA 92627 Phone: Applicant: GREG SHERMAN Address : 7171 WARNER AVE STE B-404 HUNTINGTON BEACH, CA 92647 Phone: (760)803-9389 Owner/Builder : Address : Legal Desc : N TR 11604 BLK LOT 3 UN 59 TR 11604 LOT 3 UNIT 59 Contractor Address ENGINEERING AND ENVIRONMENTAL Architect: CONSTRUCTION INC 7171 WARNER AVE STE B404 HUNTINGTON BEACH, CA 92647 Phone: (760)803-9389 Can State Lie: 883727 Lie Expire : 0913012024 Bus Lie: BT30082135 Bus Lie Expire : 07/31/2024 Workers' Compensation Insurance Carrier: ACE AMERICAN INSURANCE COMPANY Policy No : C51450152 W. C. Expire: 10/1/2024 Address : Phone : State Lie Engineer: CHARLES BLANCHARD Address : 555 12TH ST STE 215 OAKLAND, CA 94607 Phone: (925)580-2754 Designer: Address Phone: Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $40,00000 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 Occupancy Groups : U.R-2 No of Units : 1 1 Alteration sq. ft. Bldg : , Added/New sq. ft. Garage: 0 Bldg Height: No of Stories : TOTAL sq. ft. 0 ' Building Setbacks Flood Zone : X Use Zone : PC - Aeronutronic Ford PROCESSED BY: SPECIAL CONDITIONS: DECLARATION I hereby affirm under penally of perjury that Iam 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 the permit to file a signed statement thathe or she is licensed pursuant to the provisions of the Contractors' Stale 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 licensors 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), ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do C_) 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 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). 0 I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Slate 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). ❑ 1 am exempt front licensure under the Contractors' Slate 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 legail; sell a structure that I have built as an owner-buildor 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:llwww.leginfo.ca.govlcalaw.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 9 (commencing with Section 7000)_Af D)vi 'rye of the Business and Profess eras de Icense is in full torte and effect. License Class License No Date 'v (\ I ''S Contractor Signature WORKERS' COMPENSATION DECLARATION NARNING FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100, 000), IN ADDITION TO THE COST of COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE. INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: I 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 in Jerfo�76nce of the work for which this permit Is issued. Policy No. 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' carrier and policy number are: Policy Number of Agent Date certify that, in the performance of the work for' Which this permit is issued, I shall not employ any person in any manner so as t0 become subject to the workers' compensation laws of California, and agre t, if I should: become sub act to the wort ker�pensation provisions of Section 3700 of the Labor Code, i shalt forthwith comply with those provisions. nature of Applicant �— _ CLARATION REGARDING CONSTRtJCT10N LENDING AGENCY -' „ ___.___._......_..._, Date-_ Z J 23 Bracy affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). met s Name Lender's Address my s'ignaluro below, ]certify to each of the following: ' 'In the property owner or authorized to act on the property owner's behalf. I have read tiffs application and the information I have provided is correct. I ac ree to comply with all applicable city and county Ordinances and state laws relatin uilding construction, I authorize rE reseltatives of this city or county to filer t id ntjfl artfor inspection purposes. 1 1f nails e of Property Cwner or Authorized Agent y Pmil Prooertv Owner's or Authorized Aaent.s Name �"'Ck. w`�"afWhl n.Id 0f 1 d2,X BY DECtARATION OF COPotPUANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY i RFGUI„ATIONS PART 61 OF TITLE 40 AND Al RULE AhN,i /:h'PlNf f7 _ LEI SUWAITTFDA$RESTOS NOTIFICAThONTO YERNi7T CANCF!!E:? CPA PERMIT LNTGNDFJ____ - / _ L„rgCtM D_ PERMIT FlNA! �� ( O/ITIJ��I+SBEiTU5 u01`I PICATI ON I S NOT APPLICA CERTIFICATE OF I((7/ PROPOSPD CE410I.ITtO OCCUPANCY ISSUED !. SIGNATURE: