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HomeMy WebLinkAboutXR2023-1152 - Permits�EWPO/tT City of Newport Beach IIIIIIIII IIIIIIIIII IIIII IIIIIIIIIIIIIIIII III II COMB Permit : XR2O23-1152 Community Development Department - Building Division X R 2 0 2 3 1 1 5 2 F „ 100 Civic Center Ddve, Newport Beach, CA 92660 Plan Check No : 1078-2021 T�7 S Permit Counter Phone: (949) 718-1888 Issued Date : 05/04/2023 newportbeachca.gov/civic Inspection Area : 1 C94Gp AN�P Combination Type - Work Class - Other 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: 127E BAY AVE Legal Desc : A TR EAST NEWPORT BILK 1 LOT 2 EAST NEWPORT BLK 1 LOT 2 AND W 3FT OF LOT 1 AND E Description: SFR BLOCK WALL 13 LF X 42" HIGH INSIDE P/L *MARKERS ON SITE* Owner: MICHAEL BASSO Address : 7 SHELL BCH NEWPORT COAST. CA 92657 Phone: Applicant: SEPULVEDA BUILDERS INC Address: 790 NEWTON WY COSTA MESA, CA 92627 Phone: (714)222-1150 Owner/Builder: Address : Phone Contractor: SEPULVEDA BUILDERS INC Address : 790 NEWTON WY COSTA MESA, CA 92627 Phone: (714)222-1150 Con State Lie : 695401 Lie Expire : 10/31/2024 Bus Lie: BT30058100 Bus Lie Expire : 02/28/2024 Workers' Compensation Insurance Carrier : Policy No: EXEMPT W. C. Expire: Architect Address Phone: State Lie Engineer: ROHRER PAUL DUANE Address : 1527 E. AUTUMRIDGE CT ORANGE, CA 92866 Phone : (714) 272-9579 Designer Address: Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $800.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 Occupancy Groups : U No of Units : 0 Alteration sq. ft. Bldg: Bldg Height: No of Stories : 0 Added/New sq. ft. Garage : 0 TOTAL sq. ft. 0 Building Setbacks : Front: 10, Side: 3, Side: 3, Rear: 5 7 Flood Zone : X - Use Zone : R-1 - Single -Unit Residential I PROCESSED BY: SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION f hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the resson(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, demolishr or repair any structure, poor to its issuance, also requires the applicant for he permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Statc License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 'rofossions Code) or that he or she is exempt from Iicensure 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 rot more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portionsofthe work, and the structure is not intended or offered for sale (Section 7044, 3usiness and Professions Code: The Contractors' State License Law does not apply to an owner of properly who, through employees' or personal effort, builds or improves the property, provided that the mprovements 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 bull( or mproved. 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 Ippty 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 1 am exempt from Iicensure under the Contractors' State License Law for the following reason: 3y 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} sell a structure that I have built as an owner -builder if it has not boon constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and 'Tofessions Code, isavailable upon request when this application is Submitted or at the following Web siteihttp:liwww.leginio.mgov/calaw.html. >ignature of Property Owner or Authorized Agent Date _ _ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of per}'ury that I am Ilcensed under provisions of Chapter 9 (commencing with Section the Business and Prof le -- i1 my license is In full force and effect. License Class License No Date Contractor Signature VORKERS' COMPENSATION DECLARATION EARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUaJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE :DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY's 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 erformanco 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' rance carrier and policy number are: Policy Number of Agent Date loertify that, to the orforma of the work for which fhls permit is issued. shall not. emptoy any person in any manner so as to become subject to the workers' compensation laws of CBlifomia, and ogre '0' I should bec0 the workers' Compensation provisions of Section 3700 of the Labor Code, I Shall'04 Vath comply with those prov'�sions. nature Of Applean Date ---I� � CLARATfON RE O CONSTRUCTION I.F-IJDINO AOCNCY^ areby affirm undo pens of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Ivll ode). tdar's Name Lentler'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 rovided is correct. I agree to comply with all applicable city and coup o trances and state laws relating to building construction. I authorize representatives of this city or county to e er ldentifled property for inspection purposes.\/� �JL nature of PrODertv Owner or Authorized ADenl Print Property Owner's or Authorized Anent's Name J� ACTION ( DATE BY ; VRECLAMKTONS PARTPLIAOF NCEWITHC DE OFQMD FEDERAL FOR OFFICE USE ONLY I SURMITTLD,.SR ST0S NOTIFICATION TO PERMITG4NCELLE0 PERMITFINAL /1� ( LJ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF L/L L63 V II PROPOSED DEMOLITION OCCUPANCYISSUED I .SIGNATURE: _