HomeMy WebLinkAboutXR2023-2852 - Permits (2)O��EWPO�,T City of Newport Beach
e Community Development Department - Building Division
-r 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 718-1888
S newportbeachca.gov/civic
Combination Type - SFP ELEC MECH PLUM
Work Class - Alteration
COMB Permit : XR2023-2852
Plan Check No : PC2023-2480
Issued Date : 10/20/2023
Final Date:
Permit Status: Issued
Inspection Area : 1
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 : 1313 BALBOA BLVD E
Description: SFR REMODEL (2) BATHROOMS (260 SF)
Owner: COHN KENNETH TR AMANDA M
Address : 3007 ELVIDO DR
LOS ANGELES, CA 90049
Phone:
(310)701-4591
Applicant :
Andre Gerard Tardif
Address :
21587 Lost River Court
Lake Forest, CA 92630
Phone:
(714)412-0371
Owner/Builder
Address :
Phone
Legal Desc : A TR BALBOA TR EAST SIDE ADD BLK 22 LOT 7
Contractor:
ADAR BUILDERS INC
Address :
7659 LOUISE AVE
NORTHRIDGE, CA 91325
Phone:
(818)938-3260
Con State Lie
: 1051859
Lie Expire :
03/31/2025
Bus Lie :
BT30082168
Bus Lie Expire : 07/31/2024
Workers' Compensation Insurance
Carrier: STATE COMPENSATION INSURANCE FUND
Policy No : 9255778
W. C. Expire: 6/14/2024
Architect
Address
Phone :
State Lie
Engineer:
Address
Phone
Designer : Andre Gerard Tardif
Address : 21587 Lost River Court
Lake Forest, CA 92630
Phone : (714) 412-0371
Code Edition :
2022
Fire Sprinklers :
NO
Construction Valuation : $21,600.00
Type of Construction :
V-B
Fire Hazard Zone
: NO
Added/NeWITI 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: 8, Side: 3, Side: 3, Rear: 0
Flood Zone:
X
"
Use Zone :
R-1 - Single -Unit Residential
'
PROCESSED BY:
NO CONSTRUO N
WORK.
SPECIAL CONDITIONS:
HIGH DENSITY ZONE
ON SATURDAYS
OWNER -BUILDER DECLARATION
I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the resson(s) indicaled below by the checkmark(s) I have placed next to the applicable flemfs)
(Section 7031.5. Business and Professions Code: Any city or covnty that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicent for
the permit to file a signed statement that lie 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
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 U all of or U portions of the work. and the structure is not Intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' Stale 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
Irm�roved for the purpose of sale).
LJ I, 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
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 taw).
❑ I am exempt from Iicensure under the Contractors' Stale 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 Iegall;
Sall a structure that I have built as an owner -builder if it has not been constructed in its entirely by licensed contractors. I understand that a copyof 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:J/www,leginfo,c .govlcalaw.htmi..
Signature of Property Owner or Authorized Agent _._ .__. Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty o�f.erjury that I am ticansed under provisions of Ch pleb 9 (commencing with Section 7000) f Division 3 of the Business and Professions Code nd 'tense is in full force
and effect. License Class G.S G/./ �,�. S� License No AO iiBS`� Dale 3 Contractor Signature
WORKERS' COMPENSATION DECLARATION I
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 3706 OF THE LABOR CODE. INTEREST, Me 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
aorformance 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 whichthis permit Is issued. My workers'
Fence carrier and policy number are:
Policy Number
of Agent
Date
.,II 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 to become subject to the workers' Compensation laws of California, and agre
fat, if I should be vme subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shelf forthwith comply with those provisions.
Ignature of Applicant,_ _ _ _ _ _ Date lcil�dSJ_'��
IECLARATION REGAF2pING CD STR N LENDIN4 AGENCY v v �� m T
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 3097, Civil Code).
enders Name Lender's Address ...._.__.
ry 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 rear INS 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 r„ pr aintatves of this city or county to nter the above identified property for inspection purposes.
.ignature of Plo,)Lr:y Owner or Authorized Agent i ZL Print Property Owner's or Authorized Auenl's Name
DECLARATION OF COMPLIANCE WITII CODE OF FEDERAL FOR OFFICE USE ONLY
REGUTATIONS PART61 OF TITLE 40 AND AOMO Rl7LE
PEFMITCANC.EII P L JEPA
PERMi1T EXTENDED ( - �,gQMD
._...._... . �{^ ....... ........
'ERMIT FINAL �p pJ 58i,5IOS NOfIFILAi ION is NO] APPUCABLE TO
CERAFICA7E OF .pp.Z ! PROPOSED DEMOLITION