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Home My WebLink AboutXR2023-1949 - Permits4 �£W PORT City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XRZOZ3-1949 o @ Community Development Department- Building Division X R 2 0 2 3 1 9 4 9 P ickno tee Civic Center Drive, Newport Beach, CA 92660 Plan Check No Permit Counter Phone: (949) 718-1888 Issued Date : 07/18/2023 U y newportbeachca.gov/civic r , ' o„* r �`°q �, Final Date: Cq<I FOM1N�P Combination Type - SFP `--_ Permit Status: Issued ': Work Class - Alteration , �9 " it Inspection Area : 8 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 : 1620 KINGS RD Legal Dead: N TR 1221 BLK LOT 12 Description: DELTA 7 REVISION & ADD'L SCOPE TO ADD GUARDRAIL DETAILS & REPLACEMENT TO SCOPE Owner: FOROUTAN RAKHSHAN/SOLTANI SANAZ K Contractor: BURKHART BROTHER'S CONSTR INC Architect Address : 1620 KINGS RD Address : 12 BALBOA COVES Address: NEWPORT BEACH, CA 92663 NEWPORT BEACH, CA 92663 Phone: Phone: (949)508-8478 Phone: Con State Lic : 905510 State Lic Lic Expire : 10/31/2023 Applicant : JASON RICHART Bus Lid: BT30026859 Engineer : GHAZLANI ANDY Address : 1041 18TH W, Al06 Bus Lic Expire : 03/31/2024 Address: 4202 ATLANTIC AVE #204 COSTA MESA, CA 92627 LONG BEACH, CA 90807 Phone: (949) 422-9191 Workers' Compensation Insurance Phone: (562) 253-2385 Carrier: SECURITY NATIONAL INS CO Owner/Builder : Policy No : SNP1426534 Designer : JASON RICHART Address : W. C. Expire: 2/1/2024 Address : 1041 18TH W, A106 COSTA MESA, CA 92627 Phone: Phone: (949)422-9191 Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $2,500.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg: 0 Occupancy Groups : U,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: 20, Side: 4, Side:4, Rear: 10 = Flood Zone: X , Use Zone : R-1 - Single -Unit Residential PROCESSED BY: Y/ SPECIAL CONDITIONS: Re JZI10q ?— I369 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 applicableitem(s) (Section 7031.5. Business end Professions Code: Any city or courtly 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 signedstatement that he or sheds 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 Iicensure 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 (8500). O 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of fire work, and the structure Is not intended or 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 properly, 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 ail—n}'roved for the purpose of sale). Ll 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code, The Contractors' State License Law does not �iapply 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 Iicensure 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 legally 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 sitethttp://wv.'w.leginfo.ca.govicalaw.htmi, 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) f Di ision 3 of the Business and Profes s Co , ,� d my license is in full force and effect. License Class License No Date % Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: 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 ISW0,000k IN AODMON TO THE COST OF COMPENSATION, DAMAGES AS PROVIOEO FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. l hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self4risure for workers' Compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for IN performance 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 Cade, for the performance of the work for whichthis permit Is Issued. My workers' Compensator Trance carrier and policy number are: rier Policy Number Expiration Dale ne of Agent Phone # certify that in the perform nee of t e w k 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 agree , if I should become subj to the or rs compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions, iature of Applicant Cate -1 kJZ3 hereby affirm under penalty of perjurythat there Is a construction lending agency far the performance of fire work for which this permit is issued (Section 3097, Civil Code).. tinder's Name Lenders Address _ y my signature below, I certify to each of the following: I am the preonrty owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided Is correct. f agree to compiv with all applicable city and County rdmancas and state laws relating to building construction. t authori.e r.;presentatives of this city or county to eT the aIj.,�,f'e-identified property for inspection purposes. rizedOwner's 1 / n ig.lature of Property Owner or AuthoAgent /t—, - /l ) Print Preoerly Ownei s or Authorized Anent's Name v, ION DATEI BY I DECLAR TION OP IPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY i REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1 1403 PcPMfT EXXP90 0 I SUBMITTED ASBESTOS NOTIFICATION TO ^ ^P BIT EXTENDED LtgOMD PERMIT FlNA CiPTIf(CATE OF p 1 `Z3 __._— ...... ........_..___.. `f'7�BES 00SNOTIFICATIONI' NOTAPPLICABLE TO ^Ep M P OPOSED OEM ITION /{b DCCdPANCY a5UE0 V SIGNATURE _ _A 1� Date