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Home My WebLink AboutXR2024-0483 - Permits�EWPORr City of Newpc rt Beacb 111111p11111111111p111111111111111111p11111p1111p1ll 111 COMB Permit : XR2024-0483 C� it 4r1i d Community Development Dnpanment B,tildmg DiAsim X R 2 0 2 4 0 4 8 3 Permit O Counter 949) 718-1888 100 Civic Center Drive, Newport Beach, CA d2G6C IsIssued a ec olan Chek N081202a2024-0398 u, x _ newportbeachca nov,c,cic Final Date: cy</Fo_aN�" Combination Typ e - MFO FLHC Permit Status: Issued Work Class - Ade.at:on 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 : 35 CORSICA DR Legal Desc : N TR 12306 BLK LOT 2 UN 1 TR 12306 LOT 2 UNIT 1 OF Description: MFR/ALT - 2ND FLR INFILL TO EXTEND (E) LOFT. 144 SF Owner: LORI CARDOZA Contractor: LOFTCRAFTERS INC THE Architect Address : 35 CORSICA DR Address : 8 HAMMOND #102 Address NEWPORT BEACH, CA 92660 IRVINE, CA 92618 Phone: (098) 445-2009 Phone: (949) 456-1234 Phone: Con State Lic : 463944 State Lic Lic Expire : 08/31/2024 Applicant: BEN LOEWEN Bus Lic: ST30020595 Engineer: MICHAEL KOO Address : 8 HAMMOND, 102 Bus Lic Expire : 09/30/2024 Address : 8 HAMMOND IRVINE, CA 92618 IRVINE, CA 92618 Phone: (949) 456-1234 Workers' Compensation Insurance Phone : (949) 456-1234 Carrier: ACE AMERICAN INSURANCE COMPANY Owner/Builder : Policy No : C55561540 Designer Address : W. C. Expire: 11/1/2024 Address Phone: Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $27,000.00 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: PC - North Ford — PROCESSED BY: SPECIAL CONDITIONS: ON OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the rhe-kf.ialx(s) I have p'roCad next to the applicable item(s) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or reGEir sn/ 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 violation of Section 7031.5 by any applicant for a permit sdUjec;s "he applicant to a civil penalty of not more than five hundred dollars ($500). 7 ❑ 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 lht structure is nor imended o,, obeTW 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 eheri, 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). 111, 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 fallowing 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 legal) sell a structure that I have built as an owner -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 site:http:llwww.leginfo.ca.govlcalaw.html. Signature of Property Owner or Authorized Agent Date _ LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700D) of Di Sion 3 of the Business and Pro/essio Coda-, anr) m license is in full forge and effect. License Class License No Date 10,9Contractor SignaturEyO AAA 'L•P Z ICl WORKERS' COMPENSATION DECLARATION II WARNING: 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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: 111 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 IN p ce of the work for which this permit is issued. Policy No. a 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' compensatio ins nce rrler and policy number are: Carrier�Q� �L 1� Policy Number ` '�5�ti�� l Expiration Date * q Name of Agent Phone 4 ❑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 that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant ^tkftQ1A. I U Dale DECLARATION REG DING CONSTRUCTION LENDING AGENCY I 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 3097, Civil Code). Lenders Name Lender's Address By 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 to enter bove-ide tined property fQr inspection purposes. Si nature of Pro ertOwner or Authorized Agent 19�Print Property Owner's or Authorized Agents Natle if Datie ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 of TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED 0 1 SUBMITFEDA50ESTOS NOTIFICATION TO PERMITCANCELLED UEPA PERMITEXTENDED QMD PERMITFINAL TO5 NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATEOF PR DDEMO N OCCUPANCY155UED SIGNATURE: