HomeMy WebLinkAboutXR2023-1114 - PermitsCity of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit : XR2023-1114
Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : 0427-2022
= Permit Counter Phone: (949) 718-1888 Issued Date : 05123/2023
newportbeachca.gov/civic Inspection Area : 1
cqG/F00.�\P Combination Type - SFP ELEC
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: 1 BAY ISLAND Legal Desc : S TWP 6 RGE 10 SEC 34
Description: SFR *ADDITIONAL SCOPE* ENERGY STORAGE SYSTEM
Owner: JOHN ODOM
Address : 11400 SE 8TH ST #300
BELLEVUE, WA 98004
Phone
Applicant:
INTERIOR ELECTRIC INCORPORATED
Address:
747 N MAIN STREET
ORANGE, CA 92868
Phone :
(949) 295-5896
Owner/Builder
:
Address :
Contractor: INTERIOR ELECTRIC INCORPORATED
Address : 747 N MAIN STREET
ORANGE, CA 92868
Phone :
(949) 295-5896
Con State Lie
: 449124
Lie Expire :
11/30/2023
Bus Lie:
BT30047860
Bus Lie Expire : 07/31/2023
Workers' Compensation Insurance
Carrier: TRAVELERS PROPERTY
Policy No: UB8T8627932326G
W. C. Expire: 1/1/2024
IN?,_ ',,
Architect
Address
Phone:
State Lie
Engineer: TRUONGPHONG
Address : 3000 E BIRCH ST
BREA, CA 92821
Phone: (949)254-2751
Designer:
Address :
Phone: Phone
Code Edition : 2022
Fire Sprinklers :
NO
Construction Valuation :
$10,000.00
Type of Construction : V-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg :
0
Occupancy Groups : U
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
Flood Zone: AE, 8 FT
Use Zone : RM - Multiple Residential, RM - Multiple Residential, RM - Multiple Residential, RM - Multiple Residential, OS - Open Space, OS - Open Space, RM -
PROCESSED BY:
SPECIAL CONDITIONS:
7C��a;`�
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OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable Items)
Section 70315, Business and Professions Code: Any city or county that requires a permit to Construct, altar, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
Io permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Low (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
'rofessions Code) or that he or she is exempt from HCerl 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
of more than five hundred dollars 1$500).
3 I, 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 intended or offered for sale (Section 7044,
USiness 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
nprovemenls 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
nproved for the purpose of sale).
3 I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7D44, Business and Professions Code: The Contractors' State License Law does not
poly to an owner of property who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I I am exempt from licensors under the Contractors' Stale License Law for the following reason:
Iy 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 Iegall)
oil a structure that I have built as an owner -builder if it has not been constructed in [is entirety by licensed contractors. I understand that a copy of the applicable Saw, Section 7044 of the Business and
Tofessions Code,, is available upon request when this application is submitted or at the following Web site:http:/lwww.leginfo.ca..govlcalavehtml.
signature of Property Owner or Authorized Agent ___m_.___ Date _
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7 O) of ivisioh 3 of the Business and prof ion de d my license is In full force
nd effect. License Class License No Da Contractor Signature
VORKERS' COMPENSATION DECLARATION
rARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED OUSAND DOLLARS (E100,0001, M ADDRION TO THE
DST OF COMPENSATION, 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:
] 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 th
BrfoMlasca 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'
carder and policy number are:
Policy Number
of Agent
Date
-11 certify that, in the pert rm. rice 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 workers' compensation laws of California, and Agra
not, if I should becon s bje a orkers compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions,
lignsture of ApplicanKI�eTF0NUij_01NGAGE_NC_Y,
Date ZIECLARATION REGhereby affirm under rjury that there is a construction lending agency for the performance of the work for which this permit Is issued (Section iv1 Code).
ender's Name _ Lender's Address
ly my signature below. I cerlify 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 Pave provided is correct.
I agree to comply with all applicable city and co ty rdinan s and state laws relating to building construction.
I authorize representatives of this city or coo o to bove-identified property for inspection purposes. ft A illf,�1l/jI O I'I/1� yQ ^-(��,�J, ([L,%J
iianature of Proeertv Owner or Authorized Aoeatl �/ / Print Property Owner's or Authorized Agent's Nara / II 11 hl vr' `U,( t .V ftrt:Itaate 577.3
ACTION
DATE I
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( LARATION OF COM P LIANCE WITH CODE OF FE DERAIL
FOR OFF I CE USE O N LY V
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