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HomeMy WebLinkAboutXR2023-1352 - PermitsaEwPoRr City of Newport Beach III�I��III�IIIII���IIIIIIIIII�I�I� II Community Development Department- Building Division X R 2 0 2 3 1 3 5 2 COMB Permit : XR2023-1352 F 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : 2783-2019 > S Permit Counter Phone: (949) 718-1888 Issued Date : 05/2212023 newportbeachca.gov/civic Inspection Area : 8 sci coati` Combination Type - SFP Work Class - Alteration 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 : 605 KINGS PL Legal Desc : N TR 1218 BLK LOT 46 Description: SFR CHANGE OUT 8 WINDOWS AND 1 FRENCH DOOR *ADDITIONAL SCOPE* }� N Owner: DEREK BOORN Contractor: BURKHART BROTHER'S CONSTR INC Architect Address : 605 KINGS PL Address : 12 BALBOA COVES Address NEWPORT BEACH, CA 92663 NEWPORT BEACH, CA 92663 `1 Phone : Phone : (949) 508-8478 Phone : �'- Con State Lic : 905510 State Lie Lie Expire : 10/3112023 Applicant : BURKHART BROTHER'S CONSTR INC Bus Lie: BT30026859 Engineer : JOHN DINH TRAN Address : 12 BALBOA COVES Bus Lie Expire : 03/31/2024 Address : 11251 GARDENAIRE LN NEWPORT BEACH, CA 92663 GARDEN GROVE, CA 92841 Phone: (949) 508-8478 Workers' Compensation Insurance Phone: (714) 815-2356 Carrier: SECURITY NATIONAL INS CO Owner/Builder : Policy No: SNP1426534 Designer: MARIO SOTO Address : W. C. Expire : 2/1/2024 Address : 30 CORSICA DR NEWPORT BEACH, CA 92660 Phone : Phone: (949) 300-3967 Code Edition : 2022 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 : R-3 No of Units : 1 Alteration sq. ft. Bldg : Bldg Height: No of Stories: 1 Added/New sq. ft. Garage : 0 TOTAL sq. ft. 0 Building Setbacks : Front: 20, Side: 4, Side: 4, Rear: 10 Flood Zone: X Use Zone : R-1 - Single-UnitResidential PROCESSED BY: SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the mason(s) indicated below by the checkmark(s) I have placed next to the applicableitem(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' Stale 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 properly, or my employees with wages as their sole compensation, will do (_) all of or (_) 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). © I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Slate License Law does not 11 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' 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 legalll sell 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 copy of the applicable law, Section 704A of the Business and Professions Code, is available upon requestwhen this application is submitted Drat the following Web site:http:/iwww.leginfo.ca.gov/calaw.html. Signahue of Property Owner ar Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penally of perjury that I am licensed under previsions of Chapter 9 (commencing with Section 0 ) of Test n 3 of the Business and Pr ssi s Cod , �Id my license is In full force and effect. License Class License No Date Z Z 2 Contractor Signatur WORKERS' COMPENSATION DECLARATION NARKING: 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 [5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEE5_ Inhereby affirm under penally of perjury one of the following declarations: :1 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. Jlluye 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' comporeatiol 4urance carrier and policy number are: Policy Number Date me of Agent rnone rr I certify that, in the performance of a work fa whi this permit is issued, I shell not employ any person in any manner so as to become subject to the workers' compensation laws of California and agre L if I should become sub' ct to th /prorkers' m nsation provisions of Section 3700 of the Labor Code. I shall forthwith comply With those provisions. 2 nature of Applicant _ Z7 Cat �'22/21 CLARATION F k ING RU ON NDING AGENCY areby affirm under penalty of p rjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil ode). lder's Name Lender's Address 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 eo ct. I agree to comply with all applicable city and county ordln cars an state laws relating to building construction. / I authorize representatives of this city or countyo ghter"a v -identified property for inspection purposes. I / 4, /� _ mature of ProDertv Owner or Authorized Agent J , /i � Print Property Owner's or Authorizetl Agent's Name Y �"`�`l S �-£ te .- i ' / ` 5 ACTION DATE. BY DFOLAMTION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY ✓ j RF.61.ATIONS PART 51 OF TITLE 40 AND AQWID RULE 1403 PERMIT EXPIRED PERMIT CANCELLED I E; PERMIT EXTENDED PERMIT FINAL �C -72 LL [ ASRI CERTIFICATE OF GJ i! PR 0`. OCCUPANCY ISSUED _ SIGNA TO ISNOTAPPUCABLE TO