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Home My WebLink AboutXR2023-0027 - Permits�,EWPoRr City of Newport Beach II III III I II I III IIIIIII IIIIII III II D � Community Development Department- Building Division x R 2 0 2 3 0 e 2 7 > 100 Civic Center Drive, Newport Beach, CA 92660 u i Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 C9(/F00.N�P newportbeachca.gov/inspections Combination Type - SFP Work Class - Other COMB Permit : XR2023-0027 Plan Check No : 1345-2022 IPssued Date: +k 17 Ins ection Area : Lt 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 : 1943 PORT RAMSGATE PL Legal Desc : N TR 6624 BILK LOT 106 Description : TEMPORARY SHORING Owner: CHRISTINAFENMORE Contractor: GONTERMANCONSTRUCTION Architect: ERICOLSEN Address : 1943 PORT RAMSGATE PL Address : 502 30TH ST, UNIT A Address : 2728 E COAST HWY, STE A CORONA DEL NEWPORT BEACH, CA 92660 NEWPORT BEACH, CA 92663 MAR, CA 92625 Phone: Phone: (949)697-0746 Phone: (949)887-8856 Con State Lic : 858073 State Lic Lic Expire : 04/30/2023 Applicant: ERIC OLSEN Bus Lic : BT30048414 Engineer : FORBES DALE L Address : 2728 E COAST HWY, STE A Bus Lic Expire : 09/30/2023 Address : 1800 E 16TH ST #B CORONA DEL MAR, CA 92625 SANTA ANA, CA 92701 Phone: (949) 887-8856 Workers' Compensation Insurance Phone: (714) 835-2800 Carrier: STATE COMPENSATION INSURANCE FUND Owner/Builder : Policy No: 9259518 Designer Address : W. C. Expire: 8/22/2023 Address Phone: Phone: •-.:. Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $5,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 Occupancy Groups : U No of Units : 0 Alteration sq. ft. Bldg : e Bldg Height : No of Stories : 0 Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 0 Building Setbacks Flood Zone : X Use Zone: PC - Harbor View ills 9 PROCESSED BY: - _ — i SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION € 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 applicableiteTI (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 the 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 Professions Code) or that he or she is exempt from lieensureand 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 LS500). 1, as owner of the property, or my employees with wages as their sole compensation, will do f_) all of or i_) portions of the work, and the structure is notintended 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 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 the purpose of sale). ❑ 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 apply 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). 11 1 am exempt from licensure under the Contractors' State License Law for the following reason. By my signature below I acknewt adgo 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 Canine I log all) sell a structure that I have built as an owner -builder if it has not boon constructed in its entirety by licensed contractors. I undorstand 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 site:http:llwww.leginfo.ca.gov/calaw.html, Signature of Property Owner or Authorized Agent Date _ LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under previsions of Chapter 9 (commencing with Section 7000) of l i bn 3 of the Business and Professions C y license is In full force and effect. License Class License. No Date /ih �'� 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 TOONE HUNDRED THOUSAND DOLLARS 13100,000)., IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY-S FEES. I hereb affirm under penalty in a certificate perjury one of the following declarations: ❑ have and will maintaertificate Of consent to seiNnsure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th, Orri-vance, of the work for which this permit is issued. Policy No. ve :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' compensatior rice carrier and policy number are'. r Policy Number Expiration Date of Agent Phone k _ I 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 Califomia, and agre, iat, if I should become subject to the workers' Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply Wth those provisions. / iignalure of Applicant ./ ,/_. r n0�+^ Date%— )`u ��y3 HECLARATION REGARDYI7GCONSTRUCTION LENDING AGENCY —X` 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). ender's Name Lenders Address Iy 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 bove-identi operty for inspection purposes. ? dariature of Prooartv Owner or Authorized Aaent l '� �'Y*�ev— Print Prooertv Owner's or Authorized Aoent's Name b e-'J Date ACTION DATE. BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY � REGULATIONS PART 61 OF TITLE 40 AND AQNID RULE 1403 PERMITEXPiRED I SUBMITTED ASBESTOS NOTIFICATION TO ' PERMIFCANCELCED _ PFRM7T FXTFNDED -0EPA PERVRT PlNiL CERTIFICATE OF ,- '� / T�r'13AQMD t,,,.IASBESTOS NOTIFICATION 15 NOTAPPOCASLE TO PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: