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Home My WebLink AboutXR2023-3035 - Permits,EwPoRT City of Newport Beach II IIIII I I I II I IIIIII IIIII II II III II COMB Permit : XR2023-3035 Community Development Department- Building Division X R 2 0 2 3 3 0 3 5 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-2631 n Permit Counter Phone: (949) 718-1888 Issued Date : 11/01/2023 u newportbeachca.gov/civic Final Date: Cq<IFn RN�P Combination Type - SFP ELEC MECH PLUM Permit Status: Issued Work Class - Alteration Inspection Area : B 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: 621 MICHAEL PL Legal Desc : Description: SFR REMODEL 100 SF Owner: ROBERT E ANDERSON Contractor : PRIME TIME COASTAL DEVELOPMENT Architect INC Address: 2812 BROAD ST Address: 5366 RURAL RIDGE CIR Address NEWPORT BEACH, CA 92663 ANAHEIM, CA 92807 Phone: Phone : (714) 313-6309 Phone Con State Lie : 1077067 State Lie: Lie Expire : 06/30/2025 Applicant : DANA SOMSEL Bus Lie : BT30077730 Engineer Address : 3003 GERALDO Bus Lie Expire : 01/31/2024 Address SAN CLAMENTE, CA 92673 Phone: (949) 280-2740 Workers' Compensation Insurance Phone: Carrier: STATE FUND Owner/Builder : Policy No: 9311976 Designer: DANA SOMSEL Address : W. C. Expire: 1/27/2024 Address : 3003 GERALDO SAN CLAMENTE, CA 92673 Phone: Phone: (949) 280-2740 Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $7,500.00 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 : Bldg Height : No of Stories : 2 Added/New sq. ft. Garage : 0 TOTAL sq. ft. 0 Building Setbacks Flood Zone : X Use Zone : R-1 - Single -Unit Residential PROCESSED BY: SPECIAL CONDITIONS:-+ a �A 4 a' S, OWNER -BUILDER DECLARATION € hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the cheokmark(s) I have placed next to the applicable iterl '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 10 permit to file a signed statement that no or she is licensed pursuant to the provisions Of the Contractor; State License Law (Chapter 9 (commencing With Section 7000)of Division 3 of the Business and �rofassions 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).. D 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or O portions of the work, and the structure is not intended or offered for sale (Section 7044, usiness 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, the building orimprovement is sold within one year of completion. the Owner -Builder will have the burden of proving that it was not built or nproved 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 poly 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), I I am exempt from licensure under the Contractors' State License Law for the following reason. ry my signature below I acknowiedge that. except for my personal residence in which I must have resided for at least one year prior to corn Diction of the Improvements covered by this permit, I cannot legally oil 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 Tofess ons Code„ is available upon request when this application is submitted or at the following INeb site:http•liwww.leginfo,c .goNJcalaw.iitml. signature of Property Owner or Authorized Agent _ Date ACENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) f Division 3 of the Business and Professio C I" ^erise is In full force nd effect. License Class i6 License No Date " J Contractor Signature VORKERS' COMPENSATION DECLARATION c rARNING: 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 ($100,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREBT• Me ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: ] 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 thr erformance 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' compensation ranee carrier and policy number are: ter Policy Number Expiration Date is of Agent Phone # certify that, in the performance of,wwork 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 Agra if l should become subject to t orkers nsahon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions, nature of Applicant _ _ ____ DataJ� Ile — 'I ARATICIM RF(;APr)uLr: (`ONSTRN('T1nN I. FNr711,111. ACFNCY I — ireby 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 Code). iders Name Lenders 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 ordinan s and state laws relating to building. construction. I authorize representatives of this city or county to entertillir Ide lifded property for inspection purposes. 7� naiurn of Proneriv Owner nr Aulhnmed Aaeni Print Prooertv Owner's or Authorized Anent'S Name !:� /Z, 6,P / a, "A - ACTION DATE BY DECLARATION OF COMPLIANCE WITI CODE OF FEDERAL FOR OFFICE USE ONLY I ' i RF.GUTATIONS PART 510F TITLE 40 AND AQMD RULE 1403 PERMIT EX IIhGD —� 'i ISUBNIITTED ASBESTOS NOTIFICATION TO PERMIT CAM ELLEG i I�IEPA PERiNiT EXrfNOEU l QAOMD _ ASBESTOS CERTIFICATE OF OCCUPANCY ISSUcO TO