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Home My WebLink AboutXR2022-2798 - PermitsQ ��WPORT City of 0 Community 100 Civic C Permit Cow u o- Inspection F CSL/F00.N�P newportbea Work ewport Beach evelopment Department- Building Division ter Drive, Newport Beach, CA 92660 �r Phone: (949) 644-3288 ❑uests Phone: (949) 644-3255 iType -SFP - Alteration jjiI��III��III��III�IIII��III111111111111111111111111111111COMB Permit: XR2022-2798 Plan Check No : 0629-2021 issued Date : 11/17/2022 Inspection Area : 1 PERMITS EXP RE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCT, N RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address: 1576 i Description: SFR - Owner : DANIEL KAI Address : 1615 S DEb SALT LAKE Phone: Applicant: GAMBOA U Address: 3347 W FAI ANAHEIM, f Phone: (714) 797-4' Owner/Builder : Address : Phone Code Edition : Type of Construction Occupancy Groups: Bldg Height: Building Setbacks Flood Zone Use Zone: PROCESSED BY: SPECIAL CONDITI 20 09 BLVD Legal Desc : N TR 518 BLK I LOT 20 'E/REBUILD EXIST'G ROOF AT MSTR BDRM/(2) NEW WINDOWS (REV2022-1931) UTTER Contractor: GAMBOA MARK dIRE DR Address : 3347 W FAIRCREST DR UT 84108 ANAHEIM, CA 92804 Phone: (714)797-4129 Con State Lic : 826496 Lic Expire : 08/31/2023 Bus Lic: BT30061850 :ST DR Bus Lic Expire : 01/31/2023 Workers' Compensation Insurance Carrier: FALLS LAKE FIRE COMPANY Policy No: FLA01374802 W. C. Expire: 3/1/2023 9 Fire Sprinklers : NO V Fire Hazard Zone : NO No of Units : 1 No of Stories : 2 9, Side: 3, Side: 3, Rear: 0 - Single -Unit Residential Architect Address Phone: State Lic Engineer Address Phone AND CASUALTY Designer Address Phone: TABAR MEHRDAD 14252 CULVER DR #349 IRVINE, CA 92604 (714) 725-0017 .... Construction Valuation : Added/New/TI sq. ft. Bldg: Alteration sq. ft. Bldg : Added/New sq. ft. Garage TOTAL sq. ft. : $19,000.00 0 0 0 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the ressori indicated below by the checkmark(s) I have placed next to the applicable items) (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 licensors and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to civil penalty of not more than five hundred dollars ($500). 13 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, 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). El 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 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), 1 am exempt from licensure under the Contractors' State 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 legal) sell a structure that I have built as an owner -builder if ithas 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 site;http:IiVmw.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 provisions of Chapter 9 (commencing with Section 700 of -vision 3 of the Business and Prefab ns e, an my cense is I full force and effect. License Class License No Date Contractor Signature��q�Q WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TG SECUf,E WORKERS COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS [$100,000L IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR 1N SECTION 370E OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I he^rby 2ffirm under penally of perjury one of the following declarations: Q I have and will main:am 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 E c-marca of the work for which this permit is issued. Policy No. have and will 'naintr,.in 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' compensatio surance carrier and policy number are: Carrier_ Policy Number Expiration Date Name of Agent Phone # 11 ce-t f that, in the performance of the work for which this permit is issued. I shall notemploy any person in any manner so as to become subject to the workers' compensatio, laws of California, and ogre that, d I snould bacome subject tttot/t1hee/)*orker comp�rt;.alion pr visiJons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / � 5'gnaw, r of Applicant Z " / i' / /An �ii/1�'4 Q / / DE;.:_A"RATION M' ECA MG ON IR ON LENDING AGENCY "'r'C' I hereby affirm under enalty 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). Lender's Name Lender's Address By 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 coo enter the above -identified property for inspection purposes. ,r Si nature of Props Owner or Authorized Age count Print Property Owner's or Authorizetl A enf's Nam r' �.4- Date.' ACTION DATE ofy DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY 7 REGULATIONS PART 61 OF TITLE 40 AND AOMO RULE /- 1403 PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED 0EPA ..._.___.__ _.�__^. _ tt--7T_�____._�_______��—.. PER,YfIT EXPENDED ugCtmp PERMIT RI SBESTOS NOTIFICATION IS OT PUCARL TO CERTIFICATE OF ]� /JO-'7� _ POSED EMO T OCCUPANCY155UED I ((r G i IGNATURE: �(�-�n