HomeMy WebLinkAboutXR2023-3323 - Permitsalts�ipjj
City of Newport BeachCOMB Permit XR2U23-3323
Community Development Department- Building Division X R 2 0 2 3 3 3 2 3F100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-2841
Permit Counter Phone: (949) 718-1888 Issued Date : 1112212023
unewportbeachca.gov/civic Final Date:
Combination Type - MFP Permit Status: Issued
Work Class - Alteration 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 : 1870 16TH ST, L 101 Legal Desc : P BK 15 PG 36 PAR 2
Description: MFR -WATER DAMAGE REPAIR IN KITCHEN AND BATH 64 SF
Owner: UDR NEWPORT BEACH NORTH LP Contractor: SIGNAL RESTORATION SERVICES Architect
Address : 1745 SHEA CENTER DR #200 Address : 7221 ORANGEWOOD AVE Address
HIGHLANDS RANCH„ CO 80129 GARDEN GROVE, CA 92841
Phone: (720)283-6120 Phone: (714)763-4153 Phone:
Con State Lic : 986693 State Lic
Lic Expire : 09/30/2025
Applicant: TIM WARREN Bus Lic: BT30071857 Engineer:
Address : 7221 ORANGEWOOD AV Bus Lic Expire : 05/31/2024 Address
GARDEN GROVE, CA 92841
Phone: (714) 737-7082 Workers' Compensation Insurance Phone:
Carrier: STARR INDEMNITY & LIABILITY COMPANY
Owner/Builder : Policy No : 1000002994 Designer
Address : W. C. Expire : 10/16/2024 Address:
Phone: Phone:
Code Edition : 2022 Fire Sprinklers : NO Construction Valuation
Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg
Occupancy Groups : U,R-2 No of Units : 1 Alteration sq. ft. Bldg :
Bldg Height : No of Stories : 3 Added/New sq. ft. Garage
TOTAL sq. ft.
Building Setbacks
Flood Zone : X
Use Zone : PC - Oakwood Apartments - UP1370, UP 1405
PROCESSED BY: , l�
SPECIAL CONDITIONS:
$1,207.00
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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 item(sj
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
1c 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
'rofesslons Code) or that he or she is exempt from kcensure 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 ($500).
3 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U 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
nprovements 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).
1 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
.poly 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).
y 9 p 9 P YP
I am exempt from licensors under the Contractors' State License Law for the tollDe+nn9 reasal
my signature below I acknowledge that, except form 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 legall%
ell a structure that I have built as an ownervbuilder if it has not boon constructed in its entirely by licensed contractors, I understand that a copy of the applicable law, Section 7044 of tho Business and
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.btmi.
lignature of Property Owner or Authorized Agent _�,�,_,___ _ _,_, Date _
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700,p% f D' 's" f the Business and Professions y license is In full force.
,nd effect. License Class License No °Date 1 2 Contiractorslgnature
COMPENSATION DECLARATION
tARNING: FAILURE TO SECVRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER To CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 15100,0001, IN ADDnION TO''.
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3T06 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
3 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
erfrt mance 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 Code, for the performance of the work for which this permit is issued. My workers'
Brice carrier and policy number are:
Te of Agent
certify that, in the performance of the work for
if I should become subject to the workerVcp
Policy Number
Date
this permit is issued., I shall not employ any person it) any manner so as to become subject to the workers' compensation taws of California, and agre
n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions
_. Dauer l 1 /-t % Z 3
hereby affirm under penalty of perjury at there is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil Code)
ender's Name Lender's 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 state laws relating to building construction.
I authorize representatives of this city or county to enter th ntlflad property for inspection purposes.^�
.;nnw1� rrra „ f Prnnarry Ciwnar nr Aolhhrued Agent Print. Prooeme Owner's or Authorized Aoem's Name It
ACTION
PERMITCANCELLkD
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PERM7T EXTErVD'h
PER'M7TFlNAL_W .
CERTIFICATE OF
OCCUPANCY ISSUED
f0ARATION OF COMPLIANCE wires CODE OF FEDERAL FOR OFFICE USE
REGIILAI"IONS PART 61 OF TITLE 40 AND AQMD RULE.
1403
U i SUBMITTED ASBESTOS NOTIFICATION TO
S, I!!l`ASBESTOS NOl 1:HCAr N IS NCIT APP41CABLE TO
PROPOSED DEMOLITIOP
I. SIGNATURE
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