HomeMy WebLinkAboutXR2023-1626 - Permits0EWPORT City of Newport Beach 111���pI��111111111111111111111111111111111111111111111111COMB Permit : XR2O23-1626
�`�• Community Development Department - Building Division
F, ;: t 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2023-1450
u ! T Permit Counter Phone: (949) 718-1888 Issued Date :
newportbeachca.gov/civic Inspection Area : 5
`" "u,,� Combination Type - SFP
Work Class - Other
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: 2209 PACIFIC DR Legal Desc : A TR CORONA DEL MAR BILK D CORONA DEL MAR BILK D PER OF BILK AN D FOR ABAND
Description: SFR DECK AND RAILING REPAIR ON BASEMENT LEVEL 586 SF
Owner: MICHAEL FILLMAN
Address : 800 NEWPORT CENTER DR STE450
NEWPORT BEACH, CA 92660
Phone
Applicant: GAYOSSOS CONSTRUCTION INC
Address: 1001 W 17TH ST #G
COSTA MESA, CA 92626
Phone : (949) 295-2782
Owner/Builder:
Address :
Phone
Code Edition :
Type of Construction
Occupancy Groups:
Bldg Height:
Building Setbacks
Flood Zone:
Use Zone :
PROCESSED BY:
2022
V-B
U,R-3
Front: 24, Side: 4, Side: 4, Rear: 10
X
R-1 - Single -Unit Residential
SPECIAL CONDITIONS:
Contractor: GAYOSSOS CONSTRUCTION INC
Address: 1001 W 17TH ST #G
COSTA MESA, CA 92626
Phone :
(949) 295-2782
Con State Lie
: 1068871
Lie Expire:
09/30/2024
Bus Lie:
BT30076249
Bus Lie Expire : 08/31/2023
Workers' Compensation Insurance
Carrier: GUARD PIB
Policy No: GAWC424570
W. C. Expire : 1/28/2024
Fire Sprinklers :
NO
Fire Hazard Zone :
NO
No of Units :
1
No of Stories :
4
Architect :
JERRY ROZYCKI
Address :
100 BAYVIEW CIR NEWPORT
92660
Phone:
(949)715-0775
State Lie :
CO24473
Engineer: GRGURICNENO
Address: 2880 S COAST HWY
LAGUNA BEACH, CA 92651
Phone: (949)715-0775
Designer
Address
Phone:
Construction Valuation : $30,000.00
Added/New/Ti sq. ft. Bldg : 0
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage : 0
TOTAL sq. ft. : 0
I �v
CA
f hereby affirm under penalty of perjury that f am exempt from the Contractors' State. License Law for the resson(s) indicated below by the checkmark(s) I have placed next to the applicableitem(s)
3ecion 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
Ie 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 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 permit subjects the applicant to a civil penalty of
of more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) 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
nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-Buider will have the burden of proving that it was not built or
nproved for the purpose of sale).
11, 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
only to an owner of property who builds or improvesthereon, 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 legal
all a structure that I have built as an owner -builder if it has not: been constructed in its entirety by licensed Contractors. t 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 Web site:httpalwww.leginfo.ca.govlcalaw.html.
signature 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 Sectio & 00 o v' ' 13Of the Business and P si e, m I nets In full force
nd effect. License Class License. No Dat Contractor Signal IS 99
COMPENSATION DECLARATION
ARMING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUt.. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FNIES UP
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3TO6 OF THE LABOR COOK INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
($108.8081, IN ADDmON TO
have and will maintain a certificate of consent to self -insure for workars' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
rmance of the work for which this permit Is issued. Policy No.
gave 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' compensa
lnce, carder and policy number are:
Policy Number
Date
lame of Agent Phone If
3 certify that, in die rf me ce 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 work Impensation laws of California, and Agra
let, if I should become fact pensatlon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. q/
Ignature of Applicant Da e �6 9 5
IECL.ARAT10 REGARp1h ENDING AGENCY d
hereby affirm under pena of rjury that there is a construction lending agency for the performance of the work for which this permit Is issued(Section3097, A Code).
enders Name Lender's Address
7r 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 fAave, provided is correct. ,t
I agree to comply with all applicable city and cou tat laws relating to building construction. I\ ^ s� j��I//
I authorize representatives of this city or county to� r the led property for Inspection purposes. VA 4 \, 5 0 d " _ ,1 do✓ ��t i.r $+a
ACTION
I PERMITEXTENDED I I
PERMIT FINAL
CERTIFrCATEOF
OCCUPANCYI53UED
OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
PART 91 OF TITLE 40 AND AQMD RULE
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