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HomeMy WebLinkAboutXR2024-0774 - Permits4EWPORT City of Newport Beach II IIIIIIII IIIII IIII IIIIIIIIIIII IIIIIIII III II COMB Permit: XR2024-0774 Community Development Department- Building Division X R 2 0 2 4 0 7 7 4 a 11, £ " n., 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No :-PC2023-3005 Permit Counter Phone: (949) 718-1888 Issued Date : 03/27/2024 U - newportbeachca.gov/civic Final Date: ,FoCombination Type - SFP ELEC Permit Status: Issued Work Class -Alteration Inspection Area : 6 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 : 19 VIA AMANTI Legal Desc : N TR 16266 BLK LOT 1 UN HOLD Description: DELTA 2 REPLACE (E) FIREPLACE WITH (N) ELECTRIC FIREPLACE AT LIVING ROOM (REV2024-0581) Owner: GAYLE AND ANDREW POLSKY Address : 19 VIA AMANTI NEWPORT BEACH, CA 92657 Phone : (310) 402-4960 Applicant: WALZ JOHN ROBERT Address : 510 LARKSPUR AVE NEWPORT BEACH, CA 92625 Phone : (949) 836-5977 Owner/Builder : Address : Phone: Contractor: ESOTERIC HOMES INC Address : 1300 QUAIL ST #108 NEWPORT BEACH, CA 92660 Phone : (714) 742-5080 Con State Lic : 993095 Lic Expire : 05/31/2024 Bus Lic : BT30050308 Bus Lic Expire : 03/31/2024 Workers' Compensation Insurance Carrier: STATE COMPENSATION INSURANCE FUND Policy No: 9337214 W. C. Expire: 4/20/2024 Code Edition : 2022 Fire Sprinklers : Type of Construction : V-B Fire Hazard Zone Occupancy Groups : U,R-3 No of Units : Bldg Height: No of Stories Building Setbacks Flood Zone : X Use Zone : PC - Newport Ridge, \J PROCESSED BY: SPECIAL CONDITIONS. REJ2024-0501 Architect : WALZ JOHN ROBERT Address : 510 LARKSPUR AVE NEWPORT BEACH, CA 92625 Phone : (949) 836-5977 State Lic : C031388 Engineer: Address Phone: Designer: Address Phone: NO Construction Valuation : $2,000.00 NO Added/New/TI sq. ft. Bldg : 0 1 Alteration sq. ft. Bldg : 2 Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 0 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed 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 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 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). ❑ 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' 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 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). ❑ 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), ❑ 1 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 legalll 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:httpJlwww.leginfo.ca.govlcalaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION to I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 of Division 3 of the Business and Professio ^ode, an 'Cense is in full force and effect. License Class License No Date-2G'Q�ontractor Signatur� WORKERS' COMPENSATION DECLARATION cl (/�4 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED HOUSYDDOLLARS ($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: ❑ I 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 th- nce of the work for which this permit is issued. Policy No. eve 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 ins ance carrier and policy number are: Gamer Policy Number Expiration Date Name of Agent Phone # ❑I certify that, in the performance oft ork 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 of kers' corn psa ' n provi " ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant DECLARATION RE G D G U TION LENDING AGENCY I hereby affirm under penalty o ped at there is a Construction lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil Cade). 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 owners 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 toenter the above -identified property for inspection purposes. Signature of Pro a Owner or Authorized Agent Print PropertOwner's or Authorized Agent's Name Date 'a! ACTION DATE BY Ll DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY EGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF A OCCUPANCY ISSUED Il ��- FICATION TO U ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO PROPOSED DEMOLITION SIGNATURE: