HomeMy WebLinkAboutXR2023-0822 - PermitsCity of Newport Beach
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Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone: (949) 644-3288
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Inspection Requests Phone: (949) 644-3255
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newportbeachca.govlinspections
Combination Type -
Work Class - Alteration
��111����������11111111111111111111111111111111111COMB Permit : XR2O23-0822
Plan Check No
Issued Date : 0312812023
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 : 123 43RD ST Legal Desc : A TR RIVER SECTION BLK 43 LOT 19
Description: DUPLEX APPLY DECK COATING **[CC ESR-2701** 554 SF
Owner: CYNTHIA SCHAFFER
Contractor: CRANK WATERPROOFING
Architect
Address : 322 KAREN AVE UNIT3607
Address : 134 COMMERCIAL WY
Address
LAS VEGAS, NV B9109
COSTA MESA, CA 92627
Phone :
Phone : (949) 646-9356
Phone
Con State Lie : 1038420
State Lie
Lie Expire: 04/30/2024
Applicant: OC Permit Services
Bus Lie: BT30063958
Engineer:
Address : 2029 Via Scions
Bus Lie Expire: 06/30/2023
Address
San Clemente, CA 92673
Phone: (949) 412-0595
Workers' Compensation Insurance
Phone:
'
Carrier: FALLS LAKE FIRE AND
CASUALTY
COMPANY
Owner/Builder :
Policy No: FLA01345003
Designer
Address :
W. C. Expire : 1/26/2024
Address
Phone:
Phone:
Code Edition : 2022
Fire Sprinklers : NO
Construction Valuation :
$15,000.00
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/TI sq. ft. Bldg :
0
Occupancy Groups : U
No of Units : 2
Alteration sq. ft. Bldg :
554
Bldg Height :
No of Stories : 2
Added/New sq. ft. Garage :
0 ..
TOTAL sq. ft.:
0 ..
Building Setbacks : Front: 10, Side: 3, Side: 3, Rear: 5
Flood Zone: X
Use Zone : R-2 - Two -Unit Residential
PROCESSED BY:
NO CONSTRUCTION M018- E
SPECIAL CONDITIONS: HIGH DENSITY ZONE; LIQUEFACTION
ON THE WEEKEND .:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s)
(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 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).
I, as owner of the property, or my employees With wages as their sole compensation, will do L) all of or L) 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. It, 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 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of properly 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 licensure 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 poor to completion of the improvements Covered by this permit, I cannot legal)
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 site:http:/1www.leginfo.ca.gov/cal8w.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 7000) of Division 3 of the Business and Profegions Code, andp++TT)),,y license is In full force
and effect License Class License No Date �; nG Contractor Signature \\�,� %o:� QXiI,�1
WORKERS' COMPENSATION DECLARATION m
WARNING: FAILURETO SECURE WORKERSCOMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 of THE LABOR CODE, INTEREST, ANDATTORNEY'S FEES.
I 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
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 Code, for the performance of the work for which this permit is issued. My workers' compensatio
insurance carrier and policy number are:
Carver Policy Number Expiration Date _..
Name of Agent Phone #
❑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 California, and agre
that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply With those provisions.
Signature of Applicanl%�Date 312�/23
DECLARATION REGARDING CONSTRUC tON LENDING AGENCY
I hereby affirm under penalty of perjury that there Is a construction lending agency for the performance of the work forwhich this permit Is issued (Section 3097, Civil Code).
Lenders 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 ;:tie Eaptication and the information I have provided is correct..
I agree to ccTp!y with all applicable city and county ordinances and state laws relating to building construction.
I a'dhorize representatives of this city or coup enter the abo property for inspection purposes.
Signature of Prooerl Owner or Authorized A ent -identified Print Property Owner's or Authorized Agent's
Name C'1 .S Date
'ACTIOrt DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLF 40 AND AQMD RULE
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