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HomeMy WebLinkAboutXR2023-2721 - Permitsw <, City of Newport Beach IIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XR2O23-2721 Community Development Department- Building Division X R 2 9 2 3 2 7 2 1 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-2381 :} Permit Counter Phone: (949) 718-1888 Issued Date : 0912812023 U 3 newportbeachca.gov/civic Final Date: .....,>N" Combination Type - MFP ELEC PLUM Permit Status: Issued Work Class - Other Inspection Area : 4 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 : 21 BRITTANY Legal Desc : N TR 12164 BILK LOT 1 UN 1 TR 12164 LOT 1 UNIT 1 OF Description : MFR SUB SLAB DEPRESSURIZATION SYSTEM Owner: BAYRIDGE PARK HOMEOWNERS Contractor: ENGINEERING AND ENVIRONMENTAL Architect:0..J > > ASSOCIATION CONSTRUCTION INC Address : 1 HARTFORD DR Address : 7171 WARNER AVE STE B404 Address NEWPORT BEACH, CA 92660 HUNTINGTON BEACH, CA 92647 Phone : (949) 706-4544 Phone : (760) 803-9389 Phone : .. Con State Lie : 883727 State Lie Applicant: ENGINEERING AND ENVIRONMENTAL Lie Expire : 09/30/2024 Bus Lie : BT30082135 Engineer : CHARLES BLANCHARD > ,; CONSTRUCTION INC Address : 7171 WARNER AVE STE B404 Bus Lie Expire : 07/31/2024 STE „ Address 555 12T DST 94607 , - HUNTINGTON BEACH, CA 92647 Workers' Compensation Insurance Phone: (925) 580-2754 - Phone: (760) 803-9389 Carrier: ACE AMERICAN Owner/Builder: Policy No : C51450152 Designer Address : W. C. Expire : 10/1/2023 Address Phone: Phone: 2022 Fire Sprinklers : NO Construction Valuation : $40,000.00 Code Edition : V-B Fire Hazard Zone : NO Added/New/Ti sq. ft. Bldg : 0 Type of Construction : No of Units : 0 Alteration sq. ft. Bldg : Occupancy Groups : U No of Stories : 0 Added/New sq. ft. Garage: 0 Bldg Height : TOTAL sq. ft. 0 Building Setbacks Flood Zone : X Use Zone : PC - Aeronutronic Ford PROCESSED BY: SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION - I hereby affirm under penally 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 Si 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 permit subjects the applicant to a civil penalty of lot 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 portions of the work, and the structure is not intended or offered for sale (Section 7044, iusiness and Professions Code: The Contractors' State License. Law does not apply to an owner of property who, through employees' ar personal affnrt, builds or improves the properly, provided that the Tprovements 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 reproved 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' State License Law does not Ipply 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 ficensure under the Contractors' State License Law for the following reason: ry 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 Iegall ell 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, Section 7044 of the Business and 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:/iwww.leginfo.ca.gov/calaw.html. lignature of Property Owner or Authorized Agent _._,_,_,___ _ _ _ Date .ICENSED CONTRACTOR'S DECLARATION hereoy adirm under penalty of perjury at I am licensed under provisions of Cha e 9 om 10 g with Sectio 00 f vlsF n 3 of the Business a Prof on Vi)RKFkS' COMPENSATION DECLARATION an my license is in full force nd effect. License ass License No S D `' Contractor attire' 'ARNING: FAILURE TO SECUR4 WORXERT COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FIRES UP TO ONE HUNDRED THOUSAND DOLLARS tS104000), IN ADOmON TO THE OST ^F CC7VPENSATIT', DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNETS FEES_ hereby affirm under penalty of perjury one of the following declarations: I have red will m�,i„lain a Certificate of corn9onl to self- insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for orri wark for which this permit is issued. Policy No. end 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' carrier and policy number are: Policy Number of Agent Date JI certify that, in the p rformance 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 woel555aaers' compensation laws of California, and ogre Tat, if I shout beep sub to tf workers co pep€a0on-provisions of Section 3700 of the Labor Code. I shall for(hwilh comply with those provsions. 'ignalure of APP ant /Yp�i\ C.Cb IC;CLARATI R CARDING CONSTRUCTION LENE)ING AGENCY her affirm unit penalty 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). ender's Name Lender's Address �y my signature below. I certify to aac[r of the followiny: 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 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 coualy t retie ab emYled property for inspectlon purposes. / S �1.�`�+� ignature of Property Owner or Authorized Agert) ge _ Print Property Owner's or Authorized Ant' amR ACTION DATE 137 DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE 40 ANT) AOMD RULE 1403 FOR OFF I CE USE ONLY PERMIT EXPIRED 1. I SUBMITTED ASBESTOS NOTIFICATION TO PERM IT C.4NCEICED IICPA P€RrL17T EXTENDED _ _ �AQMD ASBESTOS11']CAI ION IS NOT APPLICABLE IU f,</f �� CERTIFICATE OF !� OSF.O OCCUPANCY ISSUED :SIGNATURE: