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Home My WebLink AboutXR2023-3373 - Permits�EwP" City of Newport Beach II III I � I IIIIIIII IIII II IIIII II COMB Permit : XR2023-3373 o`< - � Community Development Department - Building Division X R 2 0 2 3 3 3 7 3 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No Permit Counter Phone: (949) 718-1888 Issued Date : 11/28/2023 newportbeachca.gov/civic .v, Final Date: C9�rF00.�`P Combination Type - SFP ELEC MECH PLUM _v - Permit Status: Issued Work Class - Alteration • ,-- -- = ° Inspection Area : 4 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 : 525 VISTA GRANDE Legal Desc : N TR 6230 BLK LOT 60 TR 6230 (L.L.84-214033) PAR 6 Description: ATT SFR REMODEL MASTER BATHROOM BO SF*CITY STANDARD PLAN*. T/O (E) WOOD SHINGLES. INSTALL LIGHTWEIGHT TILES CEDARLITE600 <6PSF / [CC ESR 2015P) WITH 30# FELT UNDERLAYMENT. 31 SQUARES. Owner: MARY BETH Contractor: GOLDEN STATE BUILDER INC Architect Address : 525 VISTA GRANDE Address : 1000 RIVERBEND CIR Address NEWPORT BEACH, CA 92660 CORONA, CA 92881 Phone: Phone: (714)814-9527 Phone: Con State Lic : 986172 State Lic Lic Expire : 08/31/2025 Applicant : GOLDEN STATE BUILDER INC Bus Lic: BT30083109 Engineer Address : 1000 RIVERBEND CIR Bus Lic Expire : 11/30/2024 Address CORONA, CA 92881 Phone: (714) 814-9527 Workers' Compensation Insurance Phone: Carrier: STATE COMPENSATION INSURANCE FUND Owner/Builder : Policy No : 9242187 Designer Address : W. C. Expire: 12/1/2024 Address Phone: Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $25,500.00 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 : 80 Bldg Height : No of Stories : 1 Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 0 Building Setbacks Flood Zone : X Use Zone: R-1 - Single -Unit Residential PROCESSED BY: R-5 SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION'. t hereby affirm under penally of perjury that E 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 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 700q) 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), 0 I, as owner of the property., or my employees with wages as their sole compensation, will do U 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' Stale Llceri 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 improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors State License Law). ❑ I am exempt from Ilcensure 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 for at least one year prior to completion of the improvements covered by this permit, I cannot legall) sell a structure that I have built as an owner-huilder 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 Professions Code, is available upon request when this application Is submitted or at the following Web site; httpalwww.leginfo.ca.gov)calaw.html, Signature of Property Owner or Authorized Agent _ Dote LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of penury that I am licensed under provisions of Chapter 9 (commending with Section 7000 of Division 3 of the Business and Prate s�9pns Cody( d my license is in full force and effect. License Class License No Date/� zN ' Contractor Signature (/1%-'/��^`-^ COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS (Bruit 801, IN ADDITION TO 1 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: IEl I haveand will maintain a certificate of consent to self -insure for workers' compensation, Ensued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for !performance 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 whichthis permit Is Issued. My workers' ratios carrier and poilcy number are: Policy Number Explratit of Agent Phone # Date certify that, in the performance of the w rk 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 if I should become s/u�p)ec�l to the wo r/s�'/,rompensation prowsians of Section 3700 of the Labor Code, I shall fodhwilh comply with those provisions. ./ lature of Applicant y IT __.. V ems'-�" � _.. _. -__ _. _._ _. _. Date... [ / - �'�' Z 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 Lentlers Address 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 nis anotration and the information I have provided is correct. I aqree to comply %Ath all applicable city and county ordinances and state laws relating to building construction. 1 aJthorize rpresE11at9ves of this city or county enter the aTiden property for inspection purposes. ^ nature of Prouerty Owner or Authorized Aaent Z Print Pronertir Owner's or Authorzed Anenl's Noma H Wit'^ fV Lf � nato A. TIO;l PERMIT EXTENDED F RMFFINAL CERTINCATE Ot ",7J1 ANCY 155UEO DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL + FOR OFFICE USE ONLY [ REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE NOiIF TO