HomeMy WebLinkAboutXR2023-0921 - PermitsCity of Newport Beach
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Community Development Department- Building Division
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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.gov/inspections
Combination Type - MFP
Work Class - Alteration
IIIIIIi III IIIII IIIII IIIII II IIIII IIIII IIIII III II
COMB Permit : XR2023-0921
Plan Check No :
Issued Date: 04/11/2023
Inspection Area : 2
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 : 500 CAGNEY LN, 2 Legal Desc : N TR 10587 BLK LOT 1. UN 1 TR 10587 LOT 1 UNIT 1 OF PROJECT L OCATED ON AP
Description: MFR R/R BALCONY SLIDER DOOR *NO CHANGES TO SIZE`
Owner: Ela Grigorian
Address : 500 Cagney Lane PH2, PH2
Newport Beach, CA 92663
Phone: (949)500-7792
Applicant : Ela Grigorian
Address : 500 Cagney Lane PH2, PH2
Newport Beach, CA 92663
Phone: (949)500-7792
Owner/Builder
Address:
Phone
Code Edition:
Type of Construction
Occupancy Groups:
Bldg Height :
Building Setbacks
Flood Zone:
Use Zone :
PROCESSED BY:
2022
V-B
U,R-2
X
PC - Versailles on the Bluff
SPECIAL CONDITIONS: LANDSLIDE
Contractor: HARDY WINDOW COMPANY
Address : 1639 E MIRALOMA AVE
PLACENTIA, CA 92870
Phone:
(714)996-1807
Con State Lic
: 904342
Lic Expire :
10/31/2023
Bus Lic:
BT30061762
Bus Lic Expire : 01/31/2024
Workers' Compensation Insurance
Carrier: MIDDLESEX INSURANCE COMPANY
Policy No: A0109380004
W. C. Expire : 7/31/2023
Fire Sprinklers :
NO
Fire Hazard Zone :
NO
No of Units:
1
No of Stories :
3
Architect
Address
Phone:
State Lic
Engineer:
Address
Phone:
Designer:
Address
Phone:
Construction Valuation : $8,700.00
Added/New/TI sq. ft. Bldg : 0
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage : 0
TOTAL sq. ft.: 0
I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' Stale License Law for the mason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s)
;action 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
Is permit to file a signed statement that he or she is licensed pursuant to theprovisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Tofessions 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 for a permit subjects the applicant to a civil penalty of
of more than five hundred dollars ($500),
11, 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,
usinoss 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
nprovements are not Intended or offered for sale. If. however, the bu9ding or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
nproved for the purpose of sale).
11, 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
9ply 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).
1 am exempt from licensors under the Contractors' Slate License Law for the foltovong reason ______.._
q 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 legall)
all 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, $action 7044 of the Business and
Tofessions Code, isavailable upon request when this application Issubmitted or at the fallowing Web site:http:ll w .leginfo.ca.gov/calaw.htm(.
ignature of Properly Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
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 Professions Code, a e d-rcenae I In full force
nd effect. License Class License No Date Q 1 1-1 Contractor Signatu%—,�--- — C�
VORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS uAD0,000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, ANOATTORNEY'S FEES,
hereby affirm under penalty of perjury one of the following declarations:
3 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
erformance of the work for which this permit is issued. Policy No.
It 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' compensatiol
Isurance carrier and policy number are:
Policy Number _. _. _..Expiration Date
of Agent
certify that. in the performance of the work for which this permit Is issued, I shalt not employ any person In any manner so as to become subject to the workers' compensation laws of California, and
, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
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hereby affirm under penalty of perjury that there is a construction lendin"ency fbF4be.t�zrformance of the work for which this permit is issued (Section 3097, Civil Code)
antlers Name Lender's Address
y 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 reed 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 r.,{.nrsentalives of this city or county to enter the abo roperty for inspection purposes.
ianature of PuucKv Owner or Authorized Aqont s fi r`. Print Property Owner's or Authorized Agent's Name F_� L G ra I Lk We I
.YCiION
DATE
BY
DECLARATION OF COM'RLMNCE WIT I�DE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
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PER,VVT EXPIREf1
SSqU0N4ITT_F_D ASBESTOS NOTIFICATION TO
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SIGNATURE:
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