HomeMy WebLinkAboutXR2023-3087 - PermitsSEW PART City of Newport Beach IIIIIIIIIIIIIIIIIIIIII IIIIIIII II COMB Permit XR2U23-3U87
'< @ Community Development Department- Building Division X R 2 0 2 3 3 0 8 7
„. 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-2656
Permit Counter Phone: (949) 718-1888 Issued Date : 1013112023
u S newportbeachca.gov/civic Final Date:
c7G/FORN�P Combination Type - MFP PLUM Permit Status: Issued
Work Class - Alteration 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: 430 ORION WAY Legal Desc : N TR 4692 BLK LOT 33 TR 4692 LOT 33 TOGETHER WITH
Description: MFR - SHOWER ENCLOSURE REMODEL 9 SF
Owner: LILIAN PIERSANTI
Contractor:
Architect:
Address : 430 ORION WAY
Address :
Address
NEWPORT BEACH, CA 92663
Phone : (949) 981-0197
Phone :
Phone
Con State Lie :
State Lie
Lie Expire
Applicant : LILIAN PIERSANTI
Bus Lie :
Engineer
Address : 430 ORION WAY
Bus Lie Expire :
Address
NEWPORT BEACH, CA 92663
Phone : (949) 981-0197
Workers' Compensation
Insurance
Phone
Carrier :
Owner/Builder : LILIAN PIERSANTI
Policy No :
Designer
Address: 430 ORION WAY
W. C. Expire :
Address
NEWPORT BEACH, CA 92663
Phone : (949) 981-0197
Phone
Code Edition : 2022
Fire Sprinklers :
NO
Construction Valuation :
$7,200.00
Type of Construction : V-B
Fire Hazard Zone
: NO
Added/New/Ti sq. ft. Bldg :
0
Occupancy Groups : U,R-2
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 : RM - Multiple Residential
f
PROCESSED BY
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty 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 structure, prior to its 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 teensure 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}.
1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U 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 or improvement 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).
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
apply to an owner of property who builds or Improvesthereon, and who contracts for the projects witha licensed Contractor pursuant to the Contractors' State License Law).
ID 1 am exempt from licensure under the Contractors' State License Law for the following reason.
By my signature below I. acknowledge that, except for my personal residence In which I must have resided forat least one year prior to completion of the improvements covered by this. permit, I cannot legal[)
sell a structure that I have builtas an owner -builder if it: has not boon constructed in its entirety by licensed Contractors. I understand that a copy of the applicable law, Section 7044 of the Businoss and
Professions Code,, is available upon request when this app lAt,1�_s,,suq III or at the following Web site;http:liwww.leginfo.ca.gov/calaw.html,
(Signature of Property Owner or Authorized Agent v�LW�WY.0 _ Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is to full force
and effect. License Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
IWARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS ($100,00M, 7N ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIOED FOR IN SECTION 3TOS OF THE LABOR CODE, INTEREST, AND ATTORNEY'$ FEE$.
11 hereby affirm under penalty of perjury one of the following declarations:
Ito I have and will maintam a certificate of consent to self -insure for workers' compensation, Issued by the Director of Industrial Relationsas provided for by Section 3700 of the Labor Code, forth,
!performance of the work for which this permit is issued. Policy No.
Of have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued, My workers` compensatoor
insurance carrier and policy number are:
Policy Number
of Agent
Date
certify that, in the performance of the work for which this permit is Issued.. I shall notemploy any person in any manner so as to become subject to the workers' compensation laws of California, and
t, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant__ _ Date_
GL.ARATION REGARDING CONSTRUCTION LENDING AGENCY
Ireby affirm under penalty of perjurythat there is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil Code).
Irises Name Lenders Address
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner's behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of this city or county Lac/e i ah ve-Identified property for inspection purposes. r
nature of Property Owner or Authorzed AGent K itr Print Property Owner's or Authorized Aoent's Name (.(l.f A*) F ?1I P,2$/W-)A Da SII
ACTION
REGULATIONS PART 61 OF TITLE AO AND AQN1D RULE
1403
El SUBMITTED ASBESTOS NOTI FICATIONTO
PfRrN1T fXTE.VOfL _ LJAOM D _
PERM?FINAi /z� _ �—� �AS9ESTOS NOI (FICA I' ION 15 NOT APPLICABLE TO
CERTIFICATE OF / PROPOSED DE, ION
SIGNATURE: OCCUPANCVYSSUEA _
FOR OFFICE USE ONLY