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HomeMy WebLinkAboutXR2023-2953 - Permits�EWPpRr City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XR2O23-2953 Community Development Department- Building Division X R 2 0 2 3 2 9 5 3 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-2568 J+L^ 2 Permit Counter Phone: (949) 718-1888 Issued Date : 10/23/2023 newportbeachca.gov/civic Final Date: °94coaa`" Combination Type - Permit Status: Issued Work Class - Other Inspection Area : 5 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: 4601 DORCHESTER RD Legal Desc : N TR 3519 BILK LOT 90 Description: SFR NEW 42" H CMU WALL W/ 5'H GLASS ATTACHED TO THE SIDE (5' H MAX X 364" LF) *INSIDE THE P/L* Owner: NPNB LLC Address : 1 CORPORATE PLAZA DR STE110 NEWPORT BEACH, CA 92660 Phone : (949) 756-B393 Applicant: NANCI GLASS Address: 1 CORPORATE PLZ #110 NEWPORT BEACH, CA 92660 Phone: (949)756-8393 Owner/Builder : Address : Phone Code Edition : Type of Construction Occupancy Groups: Bldg Height : Contractor: NICHOLSON CONSTRUCTION Architect: COMPANY Address : 1 CORPORATE PLZ #110 Address NEWPORT BEACH, CA 92660 Phone: (949) 872-6637 Phone Con State Lie : 660295 State Lie Lie Expire: 12/31/2024 Bus Lie: BT98032850 Engineer: Bus Lie Expire : 04/30/2024 Address Workers' Compensation Insurance Phone Carrier: STATE FUND Policy No: 9074255 Designer: W. C. Expire: 10/1/2024 Address 2022 Fire Sprinklers : V-B Fire Hazard Zone U No of Units : No of Stories Phone NO Construction Valuation : NO Added/New/Ti sq. ft. Bldg 0 Alteration sq. ft. Bldg : 0 Added/New sq. ft. Garage TOTAL sq. ft. : Building Setbacks : Front: 6, Side: 6, Side: 6, Rear: 6 Flood Zone : X Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area) PROCESSED BY: SPECIAL CONDITIONS: iti.m a.'vs d'<Js $25,000.00 0 I OWNER -BUILDER DECLARATION i hereby affirm under penalty of perjury that I ant exempt from the Contractors' Stale License Law for the reason(s) indicated below by the checkmark(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 )a permit to file a signed statement that lie 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 fora permit subjects the applicant le a civil penalty of of more than five hundred dollars ($500). 1 I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) 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 aprovements 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 nproved for the purpose of sale)_ 1 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 poly 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 I am exempt from licensure under the Contractors' State License Law for the following reason: ,y 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 legaly oil a structure that I have built as an owner -builder it it has not been constructed in its entirety by licensed contractors. I understand that a copy of this 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:ii ww. eginfo.ca,gov)calaw.html. ignahare 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 7 00) of 'vision 3 of the Business an sc' � s Code, no my license is in full tome nd effect. License Class License No Date i' Contractor Signature PORKERS' COMPENSATION DECLARATION ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T}J0 AND DOLLARS ($1 D0,000), IN AOORION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: —1 1 have and will maintain a certificate of consent to sell -insure for workers compensation, Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for to )urformance of the work for which this permit is issued. Policy No. _ Sk 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' compensatio nsurnnce carrier and policy number are: .antler Policy Number Expiration Date Jame of Agent Phone IN :11 Certify that, in the performance of the work for which this permit is Issued, I shall notemploy any person in any manner so as to become subject to the workers' compensation laws of California, and agm hat, If I should bee ct to the',vorkei compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions n itignatureofApplic _ _ r Date ?ECLARATION REGARDING CJ OC�STFt iJ LEtyiyiNG AGENCY hereby affirm under penalty of perjury that Ihere is a construction lending agency for the performance of the work for which Ibis perm It is issued (Section 3097, Civil Code). _ender's Name Lender's Address 3y my signature below, I Certify to each of the following:" I am the properly 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 D0u er -I en r le edv for inspection purposes. signature of Pro sIt Owner or Authorized Agen } Print Property Owner's or Authorized Agent's Name �' Date ACTION j DATE BY '% DECLARATPON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY 4 ! RFGUTATIONS PART 61 OFTITLE 40 AND ACINID RUI.E 1403 PERMIT EXPIRED I SUREAITTED ASBESTOS NOTI F ICATION TO PEA'M7T CAMCFLl E1 I r1-11� A PE.gt,IT EXTENDED 1 LJAClMD .___ _ _ .._ ._ 1. _.___ PCA'NItT ipWAL I �ASBE$TO5 NOtIFICA(10'N IS N01"APPLICABLE 'TO CE,3TIFlCATE Of IL '� `� ��- PROPOSED DEMOLITION OCCUPANCYISSUED I YYY SIGNATURE: