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Home My WebLink AboutXR2023-0303 - PermitsaE Per City of Newport Beach Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 i+►- = Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 `694FonNa" newportbeachca.gov/inspections Combination Type - SFP Work Class - Other 11�111111111 1111111111111111111111111111111111111111111 11111 COMB Permit : XR2023-0303 Plan Check No : 2295-2019 Issued Date : 0210212023 Inspection Area : 3 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 : 1113 KINGS RD Legal Desc : N TR 1219 BLK. E LOT 31 Description: RENEW EXPIRED -DELTA 4 -ADD MECHANICAL VAULT (NON-HABITABLE)210 SF (REV21-0754) (X2021-1231) Owner: REED GREGORY IRA TR CMGI TR Address: PO Box 1245 NEWPORT BEACH, CA 92659 Phone: Applicant: LEGACY C D M INC Address: 2618 SAN MIGUEL DR #204 NEWPORT BEACH, CA 92660 Phone: (949) 677-3650 Owner/Builder: Address : Phone: Contractor: LEGACY C D M INC Address : 2618 SAN MIGUEL DR #204 NEWPORT BEACH, CA 92660 Phone: (949)677-3650 Con State Lie : 962720 Lie Expire : 04/30/2023 Bus Lie: BT30043218 Bus Lie Expire : 05/31/2023 Workers' Compensation Insurance Carrier: STATE FUND Policy No: 9147240 W. C. Expire: 11/24/2023 Code Edition: 2019 Fire Sprinklers : NO Type of Construction : V-B Fire Hazard Zone: NO Occupancy Groups : U No of Units : 1 Bldg Height : No of Stories : 2 Building Setbacks : Front: 10, Side: 4, Side: 4, Rear: 10 Flood Zone : X Use Zone : R-1 - Single -Unit Residential PROCESSED BY: Architect Address Phone: State Lie Engineer : FORBES DALE L Address : 1800 E 16TH ST #B SANTA ANA, CA 92701 Phone: (714)835-2800 Designer Address Phone Construction Valuation : $343�kk Added/New/TI sq. ft. Bldg : 0 Alteration sq. ft. Bldg : Added/New sq. ft. Garage : 0 TOTAL sq. ft. : 0 SPECIAL CONDITIONS: ! r �^rf' , ft J 10MMURMNREff I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale License Law for the reasons) indicated below by the checkrnark(s) I have placed next to the applicable item(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 he permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State 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 licensors and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a parent subjects the applicant to a civil penalty of iot more than five hundred dollars ($500). 1, 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, fuSIn P,Ss 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 [hat the nprovements are not Intended or offered for safe. 11, 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 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 Ipply to an owner of property who builds or Improves: thereon, and who contracts for the projectswitha licensed Contractor pursuant to the Contractors' State License Law). I am exempt from licensure under the Contractors' State License Law for the following reason' iy my signature below I acknowledge that, except for my personal residence in which I most have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal poll a structure that I have built as an ownar-buildor if it has not boon constructed in its entirely by licensed Contractors. I understand that a copy of the applicable law, Section 7044 of the Business and 'rofessions Code, isavailable upon request when this application is submitted or at the following Web site:http:/lwww.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 under provisions of Chapter 9 (commencing with Section 7000) f i side 3 of the Business and Professions ads, my license is In full iorr,+r and effect. License Class License No Date �. Contractor Signature VORKERS' COMPENSATION DECLARATION 1ARNING: FAILURE TO SSIVRE WORXIMS' COMPENSATION COVERAGE IS UNLAWFUL, AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN AODrTION TO TH :OST OF COMPENSA-ION, DA(.IAGES AS PROVIDED FOR IN SECTION 3706 OF THE LAaOR CODE, INTEREST, AND ATTORNEYS FEES. h 3reby affirm under penalty of perjury one of the following declarations: .,a 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 tl orfl�iance of the work for which this permit is Issued. Policy No. have and will mrinhiin 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' irance carrier and policy number are: r Policy Number Expiration Dale of Agent Phone N_ certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, And ogre , i' 1 should bect me ..object to the workers' compensat provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ,e'vrnf:Applicant Y//�%/7' / Date_,_,_ 04 prttT//pG3 v AanrerTu n..r_Arnrur- rTrieol'I�rfnu r. c�ir_Gry areby affirm unLLr panaly of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). lders Name Lendar'sAddress my signature below, I certify to each of the following: I am the property owner or authorized to act on the property ov:ner's behalf, I have read 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 representatives of this city or county to enter theabove-identified property for inspection purposes. �^ nature of Prooenv Owner or Authorized Adept Print Property owners or Authorized ADent's Name A11 Q�r'n ACTION ( DATE BY DECLARATION OF I REGULATIONS PART 61 OF TNCE WJrH CODE OF FEDERAL FOR OFFICE USE ONLY TITLE AO AND AONID RULE PERMIT EXPIRED I I I LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT WENDED IJAQMD PEReLHT FINAL ASBESTp5 NG11HCAHONISNOTAPPUCAKE 10 CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCYISSUEA 1 SIGNATURE: ft-&A /�/ 1