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Home My WebLink AboutXR2023-1418 - PermitseWv City of Newport Beach II��I�IIII��I�I�I1 II COMB Permit:XR2023-1418 Community Development Department- Building Division X R 2 0 2 3 1 4 1 g �,J t•.., y 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-1294 y�. Permit Counter Phone: (949) 718-1888 Issued Date: 1/2023 newportbeachca.gov/civic Inspection Areaa: 1 Combination Type - SFP Work Class - Other 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 : 328 LUGONIA ST Description: SFR - ROOF TRELLIS 300 SF Owner: GREG & SANDRA FISHER Address : PO BOX 3989 PARK CITY, UT 84060 Phone: (949)230-5103 Applicant: GREG & SANDRA FISHER Address: PO BOX 3989 PARK CITY, UT 84060 Phone : (949) 230-5103 Owner/Builder : GREG & SANDRA FISHER Address : PO BOX 3989 PARK CITY, UT 84060 Phone: (949)230-5103 Legal Desc : N TR 772 BLK 15 LOT 28 TR 772 LOT 28 BLK 15 ALL (EX NELY 7 F T) THEREOF Contractor Address : Phone: Con State Lie Lie Expire Bus Lie : Bus Lie Expire Workers' Compensation Insurance Carrier : Policy No: W. C. Expire: Code Edition : 2022 Fire Sprinklers : NO Type of Construction : V-B Fire Hazard Zone : NO Occupancy Groups : U No of Units : 1 Bldg Height : No of Stories : 2 Building Setbacks : Front: 5, Side: 3, Side: 3, Rear: 5 Flood Zone : X Use Zone : R-1 - Single -Unit Residential PROCESSED BY:/ SPECIAL CONDITIONS: Architect: Address : Phone: State Lie Engineer: BURKETHOMAS Address : 151 KALMUS DR #140 COSTA MESA, CA 92626 Phone : (949) 494-0776 Designer: BRAD GRAFF Address : 15333 CULVER ST, STE 340 IRVINE, CA 92604 Phone: (714)323-7830 Construction Valuation : $3,500.00 Added/New/Ti sq. ft. Bldg : 0 Alteration sq. ft. Bldg : Added/New sq. ft. Garage: 0 TOTAL sq. ft. 0 I hereby affirm under penalty of perjury that I am exempt from the Contractors' State license Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicableiterm(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 is permit to rile 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 of the Business and rofessions Code) or that he or she is exempt from licensors and the basis forthe alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of of more than five hundred dollars ($500). 11, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work; and the structure is not Intended or offered for sale (Section 7044, usiness 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 nprovemenls 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 roved for the purpose of sale). as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Slate License Law does not ty 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 ficensureunder the Contractors' State License Law for the following reason:— y 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 all a structure that I have built as an owner -builder if it has not boon constructed in its ontirety by licensed contractors. I understand that copy Of the applicable law, Section 7044 of the Business and 'rofassions Cods, is available Owner or Authorized request when i� appll`T��{� is s��nktted a� f�o)vlrfg Web site:http://www.taginto.aa.gov/calaw.html./� � ,? iignatum of Property Owneror Authorized Agent 7—7i1/1'1/.YJy �( f'.�� DateY�L—or3 .ICENSED CONTRACTOR'S DECLARATION /� hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3of the Business and Professions Code, and my license is In full force nd effect. License Class License No Date Contractor Signature yORKERS' COMPENSATION DECLARATION 'ARNING: 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 OST OF COMPENSATION: DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODF, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: I 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 erformance of the work for which this permit is issued. Policy No. ]I 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' compensator Isurance Carrier and policy number are: :arrler Policy Number Expiration Date to of Agent certify that. in the performance of the 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 I, if I should become Jyt bject to the WOrKera con en anonp�ro,v,is,i,ons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant ` �if �EG CLARATION RF43 i) NSTRUC nON NDI 0 AGENCY Imby 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). rder's Name Lenders 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 ordinances and state laws relating to building construction. I authorize representatives of this city or cou,,ra/�o a er the -ldff nt led plOperty for inspection purposes. nature of ProDenv Owner or Authorized Apom 0,4a ove Pont Property Owner's or Authorized Agent's Name �%��u' 1__�.J/_1.LIL_. Data ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMIT TSU ASREM CIS NOPFICATION TO PERMITCANCEL ED '_EP1_ ;FyviD PERMITEXTENDED _ PERMITFINAL bw v3 JR B£5Tp5 OTINCAI'ION I$ NOT APPLICABLE TO CERTIFICATE OF OCCUPANCY ISSUED PROPOSEDt�0La QN FIGNATUP'--: