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Home My WebLink AboutXR2023-0159 - Permits�EwaoRr City of Newport Beach p� d Community Development Department- Building Division COMB Permit : XR2023-0159 �y 100 Civic Center Drive, Newport Beach, CA 92660 X R 2 a 2 3 6 1 5 s ._ S Permit Counter Phone: (949) 644-3288 Plan Check NO Inspection Requests Phone: (949) 644-3255 Issued pate : 12/14/2022 c9G/FOAN`P newportbeachca.gov/inspections Inspection Area : 3 Combination Type - SFP ELEC MECH PLUM Work Class - Addition/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 : 1600 ANITA LN Legal Desc : N TR 3800 BLK LOT 27 Description: SFR ADD 232 SF, REMODEL 3,522 SF- CHANGE OF CONTRACTORS Owner: Matthew & Danielle Shaw Address : 1600 Anita Ln Newport Beach, CA 92660 Phone : (949) 351-9903 Applicant: ELEVATED BUILDING GROUP INC Address: 4905 RIVER AVE NEWPORT BEACH, CA 92663 Phone : (845) 825-2376 Owner/Builder : Address : Phone Contractor: ELEVATED BUILDING GROUP INC Address : 4905 RIVER AVE NEWPORT BEACH, CA 92663 Phone : (845) 825-2376 Con State Lic : 1092782 Lic Expire : 06/30/2024 Bus Lic : BT30079030 Bus Lic Expire : 06/30/2023 Workers' Compensation Insurance Carrier : Policy No: EXEMPT W. C. Expire: Code Edition : 2019 Fire Sprinklers : YES Type of Construction : V-B Fire Hazard Zone : NO Occupancy Groups : U,R-3 No of Units : 1 Bldg Height : No of Stories : 2 Building Setbacks : Front: 20. Side: 6, Side: 6, Rear: 6 Flood Zone : X Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area) PROCESSED BY: a�_ . SPECIAL CONDITIONS: HAULER: CC&R Architect Address Phone : State Lic Engineer: GHAZLANI,ANDY Address: 4202 ATLANTIC AVE #204 LONG BEACH, CA 90807 Phone : (562) 253-2385 Designer: JASON RICHART Address : 1041 18TH W, A106 COSTA MzSA, r.A 92C27 Phone : (949) 422-9191 Construction Valuation Added/New/TI sq. ft. Bldg : 232 Alteration sq. ft. Bldg : 3,522 Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 232 OWNER -BUILDER DECLARATION the € hereby affirm under penalty of perjury that am exempt from the Contractors' lae10 consd uct se ralterr impruve,ldemol the skructurekpriorho�iksPssueanceXal�oheq applicable 1 heaaipplicant for seonon 7031-5. Business end Professions Gode: Any city or county that t the permit the permit to Tito a signed statement that he or she is liconsea pursuant to the p€ovisions of the Contractors' State n of S c Law (Chapter a (commencing r a Section 7000) of Division 3 t Lhe Businessslt and Professions Code) or that he or she is exempt from licensure 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).. 1, as owner of the property, or my employees with wages as their sole compensation, will do t_) all of or I_) portions of the work, and the structure Is not intended or offered for safe (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 thepurpose of sale). [11, as owner of the properly, am exclusively contracting with licensed Contractors to construct the pa Beet (Section Contractor Businessrnt and Professions Coda: 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). ❑1 em exempt from licensure under the Contractors' te License Law for the following reason: _—..—_ y of the applicable law, Section 7044 of ih permit, I a and g By my signature below I acknowledge that, except form personal residence m which I must have resided For at ctor one year understand to completion the the im ove law. covered 6 this eBusi I cannot le all sell a structure that I have built as an owner-buitdor if it has not been constructed in as entirety by licensed contractors. I understand that e copy Professions Code, is available upon request when this application is submitted or at the following Web site:http:liwww.leginfe.Ca.gav/calaw.htmi. _ Date Signature of Property Owner or Authorized Agent_ LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) IF Division 3 of the Business and Professions de�R laenses In lull force and effect. License Class License No Date Contractor Signatu / IORKERS' COMPENSATION DECLARATION N EMPLOYER TO ORT ARNIOF COMPENSATIONIRTSECURE WERNE S' COOED FORTIN SECTION bGE IS OF UNLAWFUL LABOR CODE, SHALL S EST, AND AT70RNEY'S F5ESaIMINAI PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 15100,000J, IN ADOn10N hereby affirm under penalty of Tanury ine of the following declarations: 3 1 have and will :cil,ta:n a cellifcale of consent to self -insure far workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code erformance of the work for whie't this permit is issued. Policy No. -1I 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` Carl isurance carrier and on,icy numher sr : Expiration Date 1arrlar _ Policy Number for Fof Agent _- rtify that, in the performance 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 Califomda, and agra f I should become rutI:act h' ' work a' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �3 Date iECLAR of.Applicant— kC I � - hereb affirm der pent C rj .T JCTION Is a construction AGENCY hereby 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 309 Otte Code). enders Name Lenders Address .y 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 slate laws relating to building construction. I authorize representatives of this city or county io gnter abo entified property for inspection purposes. (" rC� G Dat��Z S%L� cionemro of PmnRrtv Owner or Authorized Agent s Pont Property Owner's or Autliarized Agent's Name ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDEI p REGULATIONS PART 61 OF TITLE 40 AND AQMO RULE I 1 1403 PERMIT EXTENDED - 7�fa.yt�trvw ,_.. PERMiP FWAL Z Y j{' AS13ESTOS NOTIFICATION 15 NOT APPLFCAEitE TO CERTIFICATE Of VROPOSELL'NDEMO ON� OCCUPANCY F55UED _ SIGNATURES\ FOR OFFICE USE ONLY L u a a, m r O a N z 0 a u O t0 N 01 u t u (O d co v 0 O. v z co 4 N N O N x E a C u V C 0 f0 E O s 3 0 L N ' C� 3 v � �V L I