HomeMy WebLinkAboutXR2023-0047 - Permits�EWPORT City of Newport Beach II II IIIII IIIII II I IIII II IIII II IIIIIII II COMB Permit : XR2023-0047
Q
O @ Community Development Department- Building Division X R 2 0 2 3 0 0 4 7
f 100 Civic Center Drive, Newport Beach, CQ 92660 Plan Check No : PC2023-0047
6 2 Permit Counter Phone: (949) 644-3288 Issued Date : 0112312023
c e+< r Inspection Requests Phone: (949) 644-3255 Inspection Area : 3
gG�F�pN� newportbeachca.gov/inspections
Combination Type - SFP ELEC MECH PLUM
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 : 20351 CYPRESS ST Legal Desc : N TR 706 BLK LOT 157 TR 706 LOT 157 SWLY1/2
Description: SFR REMODEL TO KITCHEN AND BATHROOM 400 SF AND NEW RAISED DECK 408 SF
Owner: RENEE DELLAR
Contractor: LOFGREN CONSTRUCTION
Architect
Address: 20351 CYPRESS ST
Address : 3095 GINGER AVE #B
Address
NEWPORT BEACH, CA
COSTA MESA, CA 92626
Phone : (415) 572-6301
Phone : (949) 439-8053
Phone
Con State Lic : 962889
State Lic
Lic Expire: 07/31/2023
Applicant : LOFGREN CONSTRUCTION
Bus Lic : BT30060150
Engineer
Address : 3095 GINGER AVE #B
Bus Lic Expire: 08/31/2023
Address
COSTA MESA, CA 92626
Phone: (949) 439-8053
Workers' Compensation Insurance
Phone: r
Carrier: NORGUARD INSURANCE COMPANY
Owner/Builder :
Policy No: MIWC326602
Designer: OSCAR ALMENDAREZ
Address :
W. C. Expire : 11/9/2023
Address: 31234 W NINr llk
LAGUNA NIGUEL, EA 9267` c
Phone:
Phone: (951) 990-4834� o . ^
OJUOO
Code Edition : 2022
Fire Sprinklers : NO
Construction Valuation ::: _ $50,000,00
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/TI sq. ft. Bldg%: 0.
Occupancy Groups : U,R-3
No of Units : 1
Alteration sq. ft. Bldg : 490
Bldg Height:
No of Stories : 1
Added/New sq. ft. Garage-::..Q - - -
TOTAL sq. ft. 0
Building Setbacks : Front: 20, Side: 5, Side: 5, Rear: 25
Flood Zone : X
Use Zone : SP-7 - Santa Ana Heights Specific Plan
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 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
to permit to Tile a signed statement that lie Or she is licensed pursuant to the provisions of the Contractors' Stato License Law (Chapter 9 (commencing with Section 7000) of Division 3.of the Business and
'rofessions 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
of more than five hundred dollars ($500).
3 I, as owner of the property, 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
nprovements are not intended or offered for sale. If, however, file building or Improvement is sold within one year at completion, the Owner -Builder will have the burden of proving that it was not built or
nproved for thepurpose 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
ply 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' State License Law for the following reason
sy 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 Cannotlegalll
oil a structure that I have built as an ownor-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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:liwww.leginfo.ca.gov/calaw.html.
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed underprovisions of Chapter 9 (commencing with Section 7000 of Div Sion 3 of the Business and Professio and ly censa is In full force
nd effect. License Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
PANNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAN LABS (SiDO,OWj, iN ADDITION TO THE
DST OF COMPENSATION DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
I 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 th
erformance of the work for wMch this permit is issued. Policy No..
51,have :and will maintain wc.kers' :ompensation insurance, as required by Section 3700 of the Labor Code,. for the performance of the work for which this permit is issued. My workers` compensation
Isurance carrier nnri rin,,cy number ate:
Policy Number
of Agent _
Date
certify that, in t :3 performance oa'the work for which this permit is Issued, I shall not employ any person in arty manner so as to become subject to the workers' compensation laws of Califomia, and Agra
t, if I should bccom, sub/iecy1� "} o�wWkers'poor�peensatlon provisions of Section 3700 of the Labor Code, I shall forthwith comply With those provisions.
nature of Applicant_://r!'Y iy {�t� Dale�rJ
CLARATlGN REGA IN
CGNSTR N LCNDING AGENGY_7_
!reby affirm unuer penaltyof perjury a here is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Ides s Name Lenders Address
my signature belov., I certify In ^^ch of the following:
I am the property owner or eaihorized to act on the property owner's behalf.
I have mad this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinances and slate laws relating to building construction.
I authorize mpmsentatives of this city or county to on b�e-i n' Jed prope f inspection purposes. / _
nature of ProDenV Owner or Authorized Agent :e%%11 Print Property Owner's or Authcrize8 AyenC5 NamgY///��.r�z%z2� �i Date.
ACTION
1403
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXEENDEO
SfrdPUANCE WITH CODE OF FEDERAL ( FOR OFFICE USE ONLY
61 OF TITLE 40 AND AQM D RULE
CERTIFICATE OF (1 PROPOSEDDEAL NCJfiF1�INOTAKAHLE TO
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