HomeMy WebLinkAboutXR2023-2774 - Permits�EWPORT City of Newport Beak, i.�� IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 1111111
o� @e Community Development Department - Guilding Di% isiun X R 2 0 2 3 2 7 7 4
> 100 Civic Center Drive, Newport teach., C8, P26SO
Permit Counter Phone: (949) 718-1888 - -
tea.. S newportbeachca.gov/civic
Cql/F00.��P Combination Type - SFP FLEC PLUM
Work Class - Alteration
COMB Permit : XR2O23-2774
Plan Check No:
Issued Date
Final Date:
Permit Status: Applied
Inspection Area : 8
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: 29 CAPE ANDOVER
Legal Desc : N TR 15012 BLK LOT 21
Description : SFR BATHROOM AND KITCHEN 300 SF *CITY STANDARD'
Owner: ADAMS MARK S/THORNTON JULIE
Contractor : FLOOR GALLERY OC INC
DBA Architect
HAMILTON CONSTRUCTION
Address : 29 CAPE ANDOVER
Address : 24001 VIA FABRICANTE, 1005
Address
NEWPORT BEACH, CA 92660
MISSION VIEJO, CA 92691
Phone: (949) 232-3363
Phone: (949) 206-1000
Phone:
Con State Lic : 544990
State Lic
Lic Expire: 04/30/2024
Applicant : FLOOR GALLERY OC INC DBA HAMILTON
Bus Lic: BT30082735
Engineer
CONSTRUCTION
Address : 24001 VIA FABRICANTE, 1005
Bus Lic Expire : 10/31/2024
Address
MISSION VIEJO, CA 92691
Phone: (949) 206-1000
Workers' Compensation Insurance
Phone:
Carrier :
Owner/Builder :
Policy No : 57WE&ftWG
Designer : FLOOR GALLERY OC INC DBA HAMII
CONSTRUCTION
Address :
W. C. Expire: 5/15/2024
Address : 24001 VIA FABRICANTE, 1005
MISSION VIEJO, CA 92691
Phone:
Phone: (949) 206-1000
Code Edition : 2022
Fire Sprinklers : NO
Construction Valuation : $46,000.00
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 : 300
Bldg Height:
No of Stories : 2
Added/New sq. ft. Garage: 0
TOTAL sq. ft.: 0
Building Setbacks : Front: 10, Side: 5, Side: 5, Rear: 10
Flood Zone : X
Use Zone : PC - Upper Castaways
PROCESSED BY:
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
t hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) inoica'ed be'DY'bi the ;heckatark(.;) 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, demodsh, o. race-, any ^trPClcre, prior to its issuance, also requires the applicant for
the permit to file a signed statement that lie or she is licensed pursuant to the provisions of the Contractors' State License Len (Chapte, 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 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).
❑ [,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 stucture iL nd IntoI ded or offered for sale (Section 7044,
BLISo PPS and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees or personal atfor'. !rondo 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 cc,neation, the Owner-£Iuilder w61 have mn burden of proving that it was not built or
improved for the purpose of sale).
❑ 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
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 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 for at 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 owmor-builder 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 sine:http:llwww.legfnfo.ca.govlcatavahtml.
Signature of Property Owner or Authorized Agent - Date
LICENSED CONTRACTOR'S DECLARATION /)
I hereby affirm under penally of perjury that I am licensed under provisions o yh�fit r ( Irpgnplp9 with Section 7000) of ivisfo 3 f the Business and Professi s de, and Ry li bn �is In full ce
and effect. License Class License No t ] 1`'l "1 l� 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 (SIOD,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYa FEES.
I hereby affirm under penalty of perjury one of the following declarations:
have and will maintain a certificate of Consent to self -insure for workers' compensation, Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
Irmance 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 which this permit is issued. My workers' compensa
ranee carrier and policy number are:
ter Policy Number Expiration Dale
Te of Agent _
certify that, in the porforman of the work for w 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 agree
t, if I should became sub (o he workers' c pe ationnnprovisions offSSlion 3700 of the Labor Code, I shall forthwith comply with those provisions-
nature
��// ''77 11 �j
nature of Applicant _ �' �// �Daten (/.J//�i�J
CI.ARATION REGARD CONSTRUCTIO LENDING AGE:N
baby affirm under penalty of perjury that t re is a construction ending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
ider's Name _ Lender's 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 ordipiartfas and stat
I authprize representatives of this city' or county toe rt above-i nlifie property for inspection purposes.
ACTION DATE I " REREGULATIONSaY ONS P� 61 OF TITCLRO AND AQMD RU LE
I FOR OFFICE USE ONLY
PERMIT EXPIRED I i I U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT EXTENDED _ QMD
PERMIT FMlAL ASBESTOS NOTIFICA7"ION 15 NOT APPLICABLE TO
CERTIFICATE OF r��vry-P ROPOSEB DEMOLITION
OCCUPANCYISSUED ^' , SiGNATUREM