HomeMy WebLinkAboutXR2022-3047 - PermitsCity of Newport Beach
D ' Comlaunity Development Department - Building Division
�". 100 Civic Center Drive, Newport Beach, CA 92660
G S Permit Counter Phone: (949) 644-3288
e.Inspection Requests Phone: (949) 644-3255
c'9<.IFp0.�\P newportbeachca.gov/inspections
Combination Type - SFP ELEC PLUM
Work Class - Alteration
iiiiiiipiiiiiiii II COMB Permit : XR2022-3047
Plan Check No
Issued Date : 11/17/2022
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 : 1120 DOLPHIN TER
Legal Desc : N TR 5130 BILK LOT 11
Description: SFR -DRYWALL REPAIR DUE TO WATER DAMAGE, INSULATION, ELECTRICAL AND PLUMBING
Owner: BRENNER HUGH MICHAEL TR
Contractor: BARTWOOD CONSTRUCTION INC Architect :
e
Address : 1120 DOLPHIN TER
Address : 10840 TALBERT AVENUE Address :
a
CORONA DEL MAR, CA 92625
FOUNTAIN VALLEY, CA 92708
Phone
Applicant: BARTWOOD CONSTRUCTION INC
Address : 10840 TALBERT AVENUE
FOUNTAIN VALLEY, CA 92708
Phone: (714)965-7900
Owner/Builder :
Address :
Phone
Phone: (714)965-7900
Con State Lie :
592681
Lie Expire :
04/30/2024
Bus Lie:
BT30080089
Bus Lie Expire :
11/30/2023
Workers' Compensation Insurance
Carrier: CYPRESS+INSURANCE+COMPANY
Policy No : BAWC329443
W. C. Expire: 1/1/2023
Code Edition : 2019
Fire Sprinklers :
NO
Type of Construction : V-B
Fire Hazard Zone :
NO
Occupancy Groups : R-3
No of Units :
1
Bldg Height :
No of Stories:
1
Building Setbacks : Front: 10, Side: 4, Side: 4, Rear: 10
Flood Zone : X
Use Zone : R-1 - Single -Unit Resident'
PROCESSED.BY:
SPECIAL CONDITIONS: FIELD VERIFY BY INSPECTOR
Phone:
State Lie
Engineer
Address
Phone:
Designer:
Address:
Phone:
Construction Valuation :
Added/New/TI sq. ft. Bldg:
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage:
TOTAL sq. ft. :
$100,000.00
0
0
0
I hereby affirm under penally Of perjury that I am exempt from the Contractors' Slate 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 toits issuance, also requires the applicant for
the 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
Professions 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
not more than five hundred dollars ($500).
13 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,
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
improvements are not intended or offered for sale. If, however, the building orlmprovement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
El I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does not
apply to an owner of property who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
El I am exempt from licensure under the Contractors' State License Law for the following reason ---------
By my signature below Iacknowledge 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 legally
sell a structure that I have built as an owner -builder if it has not been constructed in its entirely by licensed contractors. I understand that a copy of the applicable law. Section 7044 of the Business and
Professions Code, is available upon request when this application is submitted or at the following Web site:http:iiwwvr,leginto.ca.govlcalaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9' (commencing with Section 700 =f Division 3 of the Business and urofessio Co d m IiOense is In full force
and effect. Llccc3c :css License No Data Contractor Signature
�N!ORKERS' COMPENSATION DECLARATION
1014RNING: -AILURE TJ e_LLRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUS O DOLLARS (6100,000), IN ADDITION TO THE
'.. COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
II Iier_>by ,affirm under penalty of perjury one of the following declarations:
I❑ 1 halo and vi 'ra'.r,%m a certificate of consent to sell-inslrra for workers' compensation, Issued by the Director Of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
au maNce of the work for which this permit is issued. Policy No.
--zv 1 and wil: 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' compensatia
mgnranre carrier and policy number are:
is of ^.gent
oei tuy that, in the performance
...:should become subject t5y
of
Policy Number
Date
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
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
:h A Cate_., a.?
,reby affirm under 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 Coda).
,der s Name Lender'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 provided Is correct.
I agree to comply with all applicable city and county ord5pTces and state laws relating to building. eonstructlon.
I authorize representatives of this city or county to ent r t above-Iidentified property for inspection purposes.
nature of Prooar[v Owner or Authorized Aoenl / 1 ' _Print Property Owner's Or Authorized Agent's Name �/` (A�
ACTION DATE BY ( 6ECLARATIll COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
I REGULATIONS PART 61 OF TITLE 40 ANt?AONID RULE
PERMiTEXPINED 1� Li I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED [ CPA
PERMIT -FINAL Dv` JlPli A BE OOEMO LITCAII ION 15 NOT APPCICAeLE TO
CERTIFICATE OF l2 S 2 �. y ('�
DCCIlPANCViSSUED Y(=iJC SIGNATURE:: Y V`J'Ca-r-Y�T—