HomeMy WebLinkAboutXR2023-2080 - Permits4�� PD� e Co[mmuOnity Development BeachDepartment -Building Division II III I I I III IIII IIII II III IIII III III II COMB Permit : XR2023-2080
pX R 2 0 2 3 2 0 8 0
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-1819
ther+�^:? Permit Counter Phone: (949) 718-1888 Issued Date : 08/25/2023
<.. newportbeachca.gov/civic Final Date:
C�4FoaN�' Combination Type - Permit Status: Issued
Work Class -Alteration Inspection Area : 1
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 : 1101 BALBOA BLVD W Legal Desc : N TR 234 BLK 11 LOT 24
Description: MFR REMOVE AND REPLACE DECK FLOOR AND RAILING, YARD DRAINAGE 317 SF
Owner:
JEFFREY MONAHAN
Address :
1101 BALBOA BLVD W
NEWPORT BEACH, CA 92661
Phone :
(310) 567-8786
Applicant :
SAM PARS[
Address :
24257 SANTA CLARA AVE
DANA POINT, CA 92629
Phone :
(949) 878-8953
Owner/Builder : JEFFREY MONAHAN
Address : 1101 BALBOA BLVD W
NEWPORT BEACH, CA 92661
Phone: (310)567-8786
Contractor
Address :
Phone :
Con State Lic
Lic Expire
Bus Lic:
Bus Lic Expire
Workers' Compensation Insurance
Carrier :
Policy No:
W. C. Expire:
Architect
Address
Phone :
V
State Lic
Engineer :
MOAYEDI KAMRAN
Address :
26180 ENTERPRISE WAY #300
LAKE FOREST, CA 92630
Phone :
(949) 636-6725
Designer
Address
Phone:
Code Edition:
2022
Fire Sprinklers : NO
Construction Valuation :
$4,000.00
Type of Construction :
V-B
Fire Hazard Zone : NO
Added/New/TI sq. ft. Bldg :
0
Occupancy Groups :
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 :
Front: 10, Side: 3, Side: 3, Rear: 0
= ,
Flood Zone :
X
Use Zone :
R-2 - Two -Unit Residential
PROCESSED BY:
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I Are exempt from the Contractors' State License Law tot 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 penit 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 licensure and the basis for the alleged exemption. Any vioiation 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 (_,) ail 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 properly, provided that the
IT ra 0monts 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
im roved for the purpose of sale).
kp
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
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).
am exempt from licensors 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 resfded forat least one year prior to completion of the Improvements covered by this permit, I cannot legally
sell a structure that I have built as an owner-buildor ilift has not been constructed in is entirety by licensed contractors. I understand that a copy of the applicable law, Sectlo 7044 of the Business and
Professions Code, is available upon request whe411i,,n
s appllca or at the following Web site:http:Jiwww.leginfo.ca.govlcalaw.html. /
Signature of Property Owner or Authorized Agen,_ __�_,_.______...._._._.__�._�___��_________ D
LICENSED CONTRACTOR'S DECLARATI
I hereby affirm under penally of perjury that I am 5 r provisions of Chapter 9 (commercing with Section 7000)of Division 3 of the Business and Professions Code and my license is In full force
and effect. License Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATIrORNEY's FEES-
hereby affirm under penalty of perjury one of the following declarations:
❑ I have anti will maintain a certificate of consentto self -insure for workers' compensation, Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th,
performance of the work for which this permit is issued. Policy No -
Ell 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' compensatior
Insurance carrier and policy number are:
arrler Policy Number Expiration Date
area of Agent _ Phone ft
]I certify that, in the performance of the work 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 agre
let, if I should becon s (act to �eNaaHerrpw,usirZas of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant at D
.___ _L- _.__ ___. ..._._._.,.�._,.__------._.._
ECiARATtON R6GA NSTRUCTItlN LENDING AGENCY
hereby 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 309 C vii Cade).
enders Name _ _ Lender's Address
y my signature below. 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 an c my ordinances and state laws relating to building. construction.
I authorize representatives o, in,6 city or cut to enter In roperty for inspection purposes.
ignature of Property Owner or At,;horizad Ager�� _ Print Property Owner's or Authorized Agent's Nan ® ���`'T'u't M Oste���
tCTIoiN DATE j 0Y JCOMPLIANCE WIT 1-1 CODE OF FEDERAL FOR OFFICE USE ONLY
RFGIJLATIONS PART Fit OF TITLE 40 AND AgMD RULE.
1403
'ERM1T EXPIREDLJ I SOrTAITTI'L., ASBESTOS NOTIFICATION TO
PERMIT EXTENDED
CERTIFICATE
ATE i ,1�TO TIFICATftTN ISN L7[�+aOE to
CERTIFICATE OF L 2s. �� I PR OSEO i%1E\t`,f�iOL17lO
OCCUPANCY ISSUED f SIGN RE
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