HomeMy WebLinkAboutXR2022-2909 - Permits�EWPp�T City of Newport Beach
p� @� Community Development Department- Building Division X R 2 0 2 2 2 9 0 9 COMB Pernnit:XR2
F n 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No 2022-27 : PC
Permit Counter Phone: (949) 644-3288 Issued Date : 1110212022PC
Inspection Requests Phone: (949) 644-3255
CgGiFORN�P newportbeachca.gov/inspections Inspection Area : 6
Combination Type - SFP
Work Class - Alteration
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: 3901 SANDUNE LN
Legal Desc : N TR.6425 BLK LOT 73
o °
ae®aaa
Description: SFR INSTALL STONE VANEER ON CORNERS
OF GARAGE
Owner: KIELY BERNADETTE TR B
Contractor : TERRA PRIMA INC
- Architect
Address: 3901 SANDUNE LN
Address: 3800 TOPSIDE LANE
Address:
CORONA DEL MAR, CA 92625
CORONA DEL MAR,. CA 92625..
Phone: (503)970-5523
Phone:.: (714)679-2002
Phone:
Con State Lic :-982237
State Lic
Lic Expire : 03/31/2023
Applicant: TERRA PRIMA INC
Bus Lic.': BT30076800:.
Engineer:',
Address : 3800 TOPSIDE LANE
Bus Lic Expire : 10/31/2023 I
Address
CORONA DEL MAR, CA 92625
Phone: (714) 679-2002
Workers' Compensation: Insurance
Phone:
`
Carrier: SIRIUS AMERICAINSURANCE COMPANY
'
Owner/Builder :
Policy No: WC92023
Designer: TERRA PRIMA INC
Address :
W. C.'Expire: 3/1/2023
Address: 3800 TOPSIDE LANE
CORONA DEL MAR, CA 92625
Phone:
-
Phone: (714)679-2002
Code Edition : 2019
Fire Sprinklers : NO
Construction Valuation : $800.00
Type of Construction : V-B
Fire Hazard Zone NO
Added/New/Ti sq. ft. Bldg ;
Occupancy Groups : U
No of Units : 0
- Alteration sq. ft. Bldg
Bldg Height:
Noof'Stories : 1
Added/New sq. ft. Garage`. 0
TOTAL sq. ft. Bldg : 0
Building Setbacks : Front: 10, Side: 6, Side: 6, Rear: 6
Flood Zone : X
Use Zone : R-1-6000 - Single -Unit Residential (6000
indicates minimum lot area)
PROCESSED BY
SPECIAL CONDITIONS:
°
°
°
ozca♦
°
° .
I hereby eff;rm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasch(s)' indicated below by the checkmark(s) I have placed next to the applicable Item(s)
cfion 7031Z, Business and Professions Code: Any city: or county that requires a: permitto construct, alter, improve, demolish, or repair any structure, prior to tts`issuance, alsorequiresthe applicant for
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 an
1, as owner of the property, or employees with wages as their sole compensation will do`L) all of or L). portions of the work, and the structure is not intended or offered for sale (Section 7044,
;mess 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
rovements are not intended or offered for sale. If, however, the building or Improvement is sold withinone year of completion; the. Owner -Builder will have the burden of proving that it: was not built or
roved for the purpose of said)..
I, as owner of the property,am exclusively Contracting with. licensed Contractors to construct the project,(Seclion 7044,. Business and Professions Code: The. Contractors State License Law does net
lyto 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:
•1..
COMPEIKSATION DECLARATION
9 (commencing with Section
in full force
CT AN.EMPLOYER TO CRWHAL PENALTIES AND CIVIL UP TO ONE HUNDRED THOUSA14D DOLLARS (1100.000), IN ADDTTION TO
AND ATTDRNSS.FEES.
A h.v affirm undel`penaltyof perjury one of the following declarations:.
I hav4 and will'meinlein a certificate of consent to self»insure for workers' oompensation, Issued by the Director of Industrial Relations as provided for by Sectiorr3700 of the. Labor Code, for th,
1pGlnarce of the Oork For which this permit is issued. Policy No.
At—tYa and will,mahtst workers' compensation insurance as required by Section 3700:of the Labor Code, for the performance of the workfor which this permit is Issued. My workers` compensatior
rents carder -and Policy number are:
Tier _. Policy Number Expiration Date
no of Agent Phone ##
certify that, in the performance of the work: for which this permit is Issued, I shall not employ anyperson in any manner so as to become subject to. Me worker' compensation laws of California, and agree
I, if I should becoma i act to the workers' compensation provisions of Section 3700 of the Labor Code, I shalt forthwith comply with those provisions.
nature of Applicant Jl r>�r ate �1—-�z-
CLARATION REGAI CONSTR GTION LENDING AGENCY
n,eby affirm under penaltyof perjury that there is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil. Code).
Idera Name. - _ ___ __ Lender's Address
my signature below, I Certify to each of the following:
I am the property owneror authorized to act on the: property owner's behalf.
I have read this: application and the information f have provided is correct.
I agree to comply with all applicable city and un# ordinances and state lam r,
I authorize representatives of this city or county ntor the above-lAntifled pro
DATE ( ay
PERiIVIT FINAL
CERT1FIC11TtOF
OCCUPANCYISSUED
FEDERAL I FOR
RULE
NOT.APPLICAOLE T0.