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Home My WebLink AboutXC2022-1946 - Permits�EWPoRT City of Newport Beach II IIII I I II I II I II I I IIII II Community Development Department- Building Division COMB Permit:XC2U22-1946 > _ 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check NO : PC2022-2297 ~ Permit Counter Phone: 949 ( ) 644-3286 Issued Date: U c \P T Inspection Requests Phone: (949) 644-3255 Inspection Area : 7 gr.,Fca� newportbeachca.gov/inspections Combination Type - PLUM Work Class - Demolition 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 O NDAY AND HOLIDAYS IN ALL AREAS CON"F?UCTION Nnig Job Address : 106 22ND ST - - - - - Legal Desc : A TR NEWPORT-BEACH CITY-BLK 21 LOT 9 Description : DEMO MIXED USE BLDG. 1176 SF. 1 BEDROOM. SEWER CAP INCLUDED Owner: MCFADDEN PLACE LLC Address : 3334 E COAST HWY #418 CORONA DEL MAR, CA 92625 Phone: Applicant: PAUL CERNICH Address: 101 SHIPYARD WAY, A NEWPORT BEACH, CA 92663 Phone: (949)723-0147 Owner/Builder: Address : Phone Contractor: D B A C INC Address : 101 SHIPYARD WAY #A NEWPORT BEACH, CA 92663 Phone: (949)723-0147 Con State Lie : 637651 Lie Expire: 02/2912024 Bus Lie: BT00016282 Bus Lie Expire : 10/31/2022 Workers' Compensation Insurance Carrier: INS CO OF THE WEST Policy No : WSD5051828 W, C. Expire : 1111112022 Code Edition : 2019 Fire Sprinklers : Type of Construction : V-B Fire Hazard Zone Occupancy Groups : R-3,B No of Units: Bldg Height: No of Stories Building Setbacks : Flood Zone : X Use Zone : MU-W2 - Mixed -Use Water PROCESSED BY: SPECIAL CONDITIONS: TIGHT QUARTERS TO HAUL DEBRIS Architect Address Phone: State Lie ON 7-NE WEEKEND Engineer: CRAFT PAUL DOMINICK Address: 8512 0XLEY CIR HUNTINGTON BEACH, CA 92646 Phone: (714)270-3311 Designer Address Phone: NO Construction Valuation : NO Added/New/TI sq. ft. Bldg 1 Alteration sq. ft. Bldg : 2 Added/New sq. ft. Garage $10,000.00 0 E 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 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' Slate 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 fora 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 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. 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). ❑ 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 Ely 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). ❑ 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 prior to completion of the improvements covered by this permit, I cannot legal sell a structure that 1 have built as an owner -builder if it has not been constructed in its entirely by licensed contractors. I understand that a copy of the applicable law. Section 7044 of the Business and Professions Coda, is available upon request when this application is submitted or at the following Web site:http:llwww.leginfo.ce.gov/calow.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penally of perjury that I am licensed under provisions of Chapter g (commencing with Section 7000)offf Division 33o"f the Business and Pro(essio Co a of ce se is In full force and effect. License Class License No Date , I ' I ryContractor Signal) y) WORKERS' COMPENSATION DECLARATION r�L 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 THOUS LLA t 100,000), IN AAUOfrION TO TH COST OF COMPENSATION, DAMAGES As PROv10ED FOR IN SECTION 7709 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: I 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 brmance of the work for which this permit is issued. Policy No. _ ave and will maintain workers' compensation surance, as required b Section 3700 of the Labor Code, for the performance of the work for which this permit. is isjued.My workers' compensatio rance carder and policy number are: C. rrier Policy Number 5 05051 U Z Ci Expiration Date < < 1 k 2 Name of Agent _ Phone 8 I certify that, in the perfor4CN f the work f r hick this per it is iss - I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agra that, if I should become subje workers' pensation pr visions f action 3700 of e b ode, I shall forthwith comply with (hose provisions. /r(1'-///�/ % DECLARATION of TION Applicant _ _ Da C- J OECLAI'tATtGN REGA. ' NOSTRUCTI N LENDING AGE CYI hereby affirm under penaltyry that e e is a construction ndin gency for the performance of the work for which this permit is issued (Section 3097, Cl II Code). Lenders Name L darts Address By my signature below, i certify toe f the f flowing: 1 am the property owner or authorized (o aot n the proper Dwnfatea� I have read this application and the informailo have pr etl I agree to comply with all applicable city and county Ord' a Gas to building construction.I authorize representatives of this city Or county to en r th aboor inspection purposes. Signature of Property Owner or Authorized A ens Print Pro ertOwner's or Authorized Agent's Nama `mil V • ''v Date I `h ACTION DATC BY DECLARA O EC MP WfTNCODE OF FEDERAL FOR OFFICE USE ONLY ULATIONS ITAR7 6. OF TITLE 40 AND ACIVID RULE _ .'L /17 PERMIT EXPIRED JUFhl-TED ASBESTOS NOTE ICITO PERMITC4INCECLED4 -PA PERMITEXTENDED _ IIVID PERMIT FINAL �y 'I �,� �R SBESTOS NOTIFlCA" NI N T P;LIC BLE TO CERTff7CATE OF VIO P O OSEOOEMOLITION OCCUPANCYISSUED ( Sib AT`DRE: ___