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Home My WebLink AboutXR2022-3102 - Permits�EwaoRX City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XR2022-3102 04 Community Development Department- Building Division x R 2 0 2 2 3 1 0 2 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: Permit Counter Phone: (949) 644-3288 Issued Date : 11/29/2022 Inspection Requests Phone: (949) 644-3255 Inspection Area : 2 C,G/Fppd�P newportbeachca.gov/inspections Combination Type - SFP Work Class - Alteration 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 : 120 OPAL AVE Legal Desc : A TR BALBOA ISLAND RESUB SEC 1 BLK 11 LOT 29 Description: SFR CHANGE OUT (2) WINDOWS AND (1) DOOR *NO HEADER CHANGE` Owner: PROUD GAY MCNAUGHTON TR Address : 120 OPAL AVE NEWPORT BEACH, CA 92662 Phone: Applicant: AMERICAN VISION Address: 2125 N MADERA ROAD#A SIMI VALLEY CA 93065, CA 93065 Phone: (888)563-0008 Owner/Builder : Address : Contractor: AMERICAN VISION Address : 2125 N MADERA ROAD#A SIMI VALLEY CA 93065, CA 93065 Phone: (888)563-0008 Con State Lie : 778326 Lie Expire : 05/31/2024 Bus Lie: BT30020889 Bus Lie Expire : 10/31/2023 Workers' Compensation Insurance Carrier: INSURANCE COMPANY OF THE WEST Policy No: WSD505899301 W. C. Expire : 1/1/2023 Phone: 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 : 2 Building Setbacks : Front: 8, Side: 3, Side: 3, Rear: 5 Flood Zone: AO 1 Use Zone : R-BI -Two-Unit Resi ntial, Balboa Island PROCESSED BY: SPECIAL CONDITIONS: Architect Address 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. : $8,540.00 0 0 0 OWNER -BUILDER DECLARATION I hereby affirm under penalty 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, dernolish, 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 liconscd pursuant to the provisions of the Contractors' State License Law (Chapter g (commencing. with Section 7000) of Division 3 of the Business and 'rofessions 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 penult subjects the applicant to a civil penalty of iot more than five hundred dollars ($500).. 1 1, 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, 3usiness 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 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 built or reproved for the purpose of sale). 1, 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 Commulor pursuant to the Contractors' State License Law). a 1 am exempt from licensure under the Contractors' State License Law for the following reason: ly 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! ;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 ?rofessions Code., is available upon request when this application is submitted or at the following''Neb site:http:liwww.leginfo.ca.govlcalavahtml, >ignature. of Property Owner or Authorized Agent _ _ _ _ Date _ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of peq' that I am licensed under prevision; tgr mencing with Section 0) f IV, i 3 of the Business and Prof s on o!DOLLARS nd. y li use is In full force Ind effect. License Class 2 License No i / ,7 Date Contractor Signature VORKERS'COMPENSATION DECLARATION rARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE le UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINE$ UP TO ONE HUNG EO T USAND ($100,000), IN ADDITION TO THE �OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3.706 OF THE IASOR CODE, INTEREST, AND ATTORNEYS 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 Ih' er ormanco of the work for which this permit is issued. Policy No. �I havt a d 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` compensodo surancecarriar and Q11 n %bar are r / c� darrler /AL' r^0 U/� /'I�' ad6_ OL Policy Number LTi�b } !� D `� j Zi / Expiration Date 7/7/J_ 3 Vame of Agent Phone If :](Certify that, in the performance of the work for whi s permit is issued I shall not employ any person in any manner so as to become subject to the wore rs' compensation laws of California, and agre .hat, if I should becorrbject to the or ers' comp nsatlibn provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant �9'urT ��-�''-� ilvii /!/lZ� — )ECLARATIpN REG RD9 CONS CTION LEIVCNNG AGENCY hereby affirm under enalty of perju that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3 Code). _tinders Name Lender's Address 3y my signature below, I certify to each of ilia following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information 1 h ve provided is correct. I agree to comply with all applicable city an our y ordinances an late laws relating to building construction. I authorize representatives of this city or cou the abo a-i entitled property for inspection purposes. `- 3I nature of Prop" Owner cr Authorzed Aganl' ,- C a«-- Print Property Owner's or Authorized A ent's Name J4-ve-°S �`lf r// Data )f/Z/O� ACTION DATE BY If J Y CLARATION OF COMPLIANCE W17H CODE OF FEDERAL FOR OFFICE USE ONLY J/HEG114ATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS YOTI FICA. I ON 70 �_. _ PERMIT CANCELLED .' 'EPA �— PERM7T ,TIO1PERMiTFINAI twwAS ESTN IFIC5 NU/PLC—AEiLE 0 OCERTIfICATfOf PRO :f0 I N OCCUPANCOSSUED SIGNAURE