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XR2022-2130 - Permits
��EWPoRT City of Newport Beach O - @ Community Development Department- Building Division y y 1.00 Civic Center Drive, Newport Beach, CA 92660 ~ ° D Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 �`4C/pppH�¢ newponbeachca.gov/inspections Combination Type - SF__- ---- Wor - er DLO^ ?,3 NO Job Address Description : Owner: LI Address : 1: Phone Applicant: CHI Address: 273 CA Phone : (94, Owner/Builder : Address Phone: Code Edition : Type of Construction Occupancy Groups Bldg Height: COMB Permit : XR2022-2130 Plan Check No: 2538-2019 Issued Date : 08/22/2022 Inspection Area: 6 EX '�e DAYS AFTER ISSUANCE ^^ ' "^T""' '^ TION, S'UYNO LATER THAN 3 YEARS FRI ICTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSIn nk,.S AON[TfdO`t3tl�il iMl E AVER`' HCALLEtL7GAR BEK 63 OT 9 7-" - ' AL SCOPE' (4) 42" HIGH PILASTER & BLOCK WALL 16 LF X 30' HIGH INSIDE P/L'CITY STA .LER or,'�q}��sa t B OTHERS CONSTR Architect : J1 ^ KIT r .offn. .BYe 1 AIR C FS NEWPORT BEACH Address: vim'' Pho IN=W Phone : Con State Lic : 905510 State Lie ITHIA Lie Expire: 10/31/2023 ST HWY #B CORONA DEL MAR Bus Lie a "�E2�ri c.Expire:006 2 / ' wrTdre. ss Workers Com ensation Inl Mork started., Phone (, ©r K started) P Carrier: SECURITY+NATIONAL+INSURANCE+COMPA NY Not �: _ Pol' Designer: W. C. Expire: 2/112023 Insp. t Address IfeetEciseaP o7t ne ISSUANCE DATE [DAYS IN ALL AREAS I IA HWY #B CORONA DEL STEVEN THOMAS Fire Sprinklers : YES Construction Valuation V-B Fire Hazard Zone: No 'Added/New/TI sq. ft. Bldg U No of Units : 1 Alteration sq. ft. Bldg : No of Stories : Added]New sq. ft. Garage: Building Setbacks : Front: 20, Side: 3, Side: 3, Rear: 5 Flood Zone : X Use Zone : R-2 - Two -Unit Residential PROCESSED BY: SPECIAL CONDITIONS: w-- LANE MISSION VIEJO, CA $5,500.00 0 » 0 » . ° ° > o' ° o » » » > OWNER -BUILDER DECLARATION I hereby affirm urLdar Briefly of perjury that I am exempt from the Cortuactors' State, License Law for#he reason(s) indicated below by the checkmark{s) I have placed next #o the appt'rcahleiI m(s) (Section 7031,5, Buyfne an n that requires a permit to au struot after, Improve, demolish, or repair any structure, Prior to its issuance; also requires the applicant for the permit to rife a signe statement that hdorsht is licensed pursuan `$rota Liconsd taw {Chapter 9 (commencing with Section ?000) afBivision 3 of the Business and Professions CodepE}r m he: o r•empt from lieensure and the basis fartheatteged exemption. Any o a i 'C emrftsubjacts the a besot to a civil not more than five h"undr d dot } �/ O _ --�, PP penalty of T Bu i, e s owner of , pr pally„ or my employees with wages as the r s e all Qf or {_)f ofq+pq aq ,and Ute structure is oat in ntl proffered: far sale {Seehon 7044, Business and Prefwbl 1 roc#ors' to Lipenst Law does not a 1 to an owner of ro art wha, t r `d e PP Y P P y g �es'. or personal effort, build or roves ttie property. provided that dt@ Improvements are trot i ode ff orsa v e Ing -i a Id withinone r,Qf completion, the Owner-8liiitler will have a en of proving that itwas not built of Improved for the p{#ypos of e). u tS�% Oi ❑ 1 ��°/ )-p ��� ��nnrr�� © 1; as owner of.t�e P por! vely n - a m to ca roject {Section 7044, Business and ProessionsY:B#'ltt. e Grltractors' State license Law doesnot apply to an owner , p rly+A. rimpro a n, a Do ❑ s wi a Iicens@dOC tractor pursuantt0 the Contractors State aensa taw), i am exempt ftoitr li ens under the Confractors' Stale License Law for the following reason: TT 99��Oi'Yj: By my signature ti' low ack we t, ex er residence in which I must have resided for at least one year prior to completion o e p vernkirts covered by this permit, I cannot legatl sell structure the Ih abu as ono eats aril ith t a ,. d contractors. I understand that a aoPy of the applic Is [air, Section 7044 of the Business and Professions Code,�ds flab upon re at ap. do d t. owing:http:llwww.leginfo.ca.gov/aalaw:htm1. Signature of Prop, rty er LIA9 _-I—, _ .Date LICENSED CONiTR CTOR AT. 1 hereby affirm under ally of perjury that I am licensed under provisions of Chapter 9 jcommencm in SeGlion70D Divisi n 3: of the Business and P fes'q le�aae yii rise in f I force and eifact LlceI as tieense Nc Date `LZ �'ZContractor signora Y`' WORKERS' CqMP NS RATION AST OF OMPENFAILURE'rb 3 VHE "Q AG #�I a SHALL SV&3 PL Tfr3 CRlrnt@µAL PENALTlE5 AND CINL FINES UP TQONE NVND TH66SAND DOLLARS IS100.0001: IN ADDt7tON TO THE COST OF COMAENSgTION AMA O a7A O gRjjODE, INTEREST ANDA O I hereby affirm under amity of perjury oOfIC CFairlg I h and %WI intain a ccrtificaf a consaJlT 4tr re for workers' Dompensatian, IssyGyj y he Dgector-of Industri t Re a ron a pmvid for tsy Saciion:3700 of the Labor Code, for tti perf once of RSe w f rw iich this permit is issued. Policy No. t 1 1� iNOrfC $ j'7'�d! have and void m nt I `W ' nsation insurance, as required by Section 3700:of the Labor Code, for the performance of the work for whit his permit is issued. My workers' compensatio insurance carrieran policynumberare: Carrier - Policy Number Iration Date Name of Agent: Rhone # I certify that, In the performance the work for whlc I - ° an erson-in any ma nersae# Cpfpesu6 a rkers'compeasationlawsofCalifornia;andafire that. If I should become subject 4 work ' compe satin provisions of Sec!son:3700 of the a or rovisions. Signature of Applicant —t—L DECLARATION REGARDING 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).. Lender's Name Lenders Address By my signature%pic g, } certify to each of the following: • J;1pCIthe propgity,{lwner or authorized to act on the: Property owner's behalf. • I haft read %rtaQjJ lcatfanand the information; have provided is correct • • at ree to comply with all epPlicable cl y and county Ord' os an state la :relating to building construction. • I eethorize re resematives of this city of county t e e-lien lied ropeny far inspection purposes. (+� i naiere of Pr ertOwner or Authorized Agent Print PropertyOwner's or Authorized Agent's Name i(�.. Date b Z� AcT3GR DATE BY DEC ARATIONOF COMPUAWE WITH, CODE OF FEDERAL FOR OFFICE USE ONLY •••s• • • REGUtAhON5 PART 61 Of 7171.E 40 AN0 ACtMl3 RULE • ••• .. • • . 1-0p3.. fF1MAli�Xp1RE� i SUBMITTEOASBESTOS N071 FICAT[ON. TC3 1PERMITCANCEWD - • -J6 *17 1 EPA. All required alarms, latches gates and £ences.which serve as part of a poollspa barrier,. shall p�Rrv'ifiFxrEroDt7j .. QMD be in place prior to approval to fill pool/spa & shall remain in place & be. maintained for the PE/FnRR FINAL •••• ASBESTOS NOTIFICATION (SNOT BLfTO life of the pool CferwrCAT£Qr pa,1011 rl ricnnrnr itinnr �. _API Fee Name Transaction Date Payment Method Building Building Permit Fee - Valuation Building Plan Check Fee Drawing Fee Green Building Fee OTC Plan Check Fee - Planning GRAND TOTAL: PERMIT FEE DETAILS FOR PERMIT XR2022-2130 Fee Amount Fee Paid Amount Trans. Paid Amount Paid By ,.. $174.50 $0.00 $151.82 f $0.00 $8.00 ` $0.00 $1.00: - $0.00.-. $53.00 $0.00 ••e• •••se • • • e e •s • • • •• •• • • • • e e • •s • ••• • •• J 6Pf! i E i R• ♦•Bi• 2 •YOfe6 f • •• E • i •• J ••l1. 1_! •• •E1i i•