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Home My WebLink AboutXR2022-2222 - Permitso "�Wp ar City of Newport Beach A Community Development Department- Building Division �y 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 u Inspection Requests Phone: (949) 644-3255 CSG/FpftN�r newportbeachca.gov/inspections Combination Type - SFP Work Class - Alteration II III I I I II I II I III it II II I II COMB Permit : XR2O22-2222 Plan Issued e Check C 08/2 : PC2022-2069 022 Inspection Area : 2 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: 512 HARBOR ISLAND DR Legal Desc : N TR 3867 BLK LOT 39 Description: SFR ADD 21 SF, RELOCATE FRONT DOOR AND INTERIOR DOOR 60 SF Owner: NORMAN PERLMUTTER Contractor: ROUNDHOUSE CONSTRUCTION Architect Address : 512 HARBOR ISLAND DR NEWPORT BEACH, Address: 653 SEAL ST COSTA MESA, CA 92627 Address CA Phone: Applicant: WALKER BARRY Address: P.O. BOX 11658 NEWPORT BEACH, CA 92658 Phone: (949) 246-4085 Owner/Builder: Address: Phone: Phone: (949)642-9714 Con State Lie 829781 - Lic Expire : 12/31/2023 Bus Lie: BT30079555 Bus Lie Expire : 08/31/2023 Workers' Compensation Insurance Carrier: NORGUARD+INSURANCE+COMPANY Policy No: MAWC216909 W, C. Expire : 12/30/2022 Phone: State Lie WALKER BARRY P.O. BOX 11658 NEWPORT BEACH, CA 92658 (949)246-4085 Engineer: GROVERMAN DAVID RICHARD Address: 541 BUCKHORN HAILEY ID 83333, CA Phone: (949)500-0653 Designer: Address Phone: Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : Type of Construction : V-B Fire Hazard Zone : No Added/New/TI sq. ft. Bldg : Occupancy Groups : R-3 No of Units : 1 Alteration sq. ft. Bldg : Bldg Height: No of Stories: 2 Added/New sq. ft. Garage : Building Setbacks: Front: 10, Front: 18, Side: 4, Side: 4 Flood Zone : X Use Zone: R-1 - Single -Unit Residential PROCESSED BY: K SPECIAL CONDITIONS: ��CTOR $20,009,OQ 21 60 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 Items) 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 he 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 'rofessions Code) or that he or she is exempt from licensors 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 lot more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure Is not intended or offered for sale (Section 7044, lusiness 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 [hat the mprovements 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 mproved for the purpose of sale). I, as owner of the property, am exclusively contractingwith licensed Contractors to construct the project (Section 7044, Business and Professions Code; The Contractors' State License Law does not ply 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 licensors under the Contractors' Slate License Law for the following reason: ly 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 Deli a structure that I have built as an owner -builder it it has not been constructed in its anlirety, by licensed contractors. I understand that a copy of the applicable law. Section 7044 of the Business and 'rofessions Code, Is available upon request when this application is submitted or at the following Web site:http:llwww'.leginto.ca.gov/calaw.html. 39nnture of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section TOO of lvisiQn of the Business and Proms to d lioennse Is in full force Ind effect. License Class License No Date -LE G Contractor Signature .i VORKERS' COMPENSATION DECLARATION 1ARNING: 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 16100,00ei, IN ADDITION TO THE !DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, 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 prfa(mance of the work for which this permit is issued. Policy No. 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' carrier and policy number are: r Policy Number Expiratic of Agent Phone ff Date certify that, io Li, 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 .. if I should be LJ:r-s subject to a Orker ' c mpens- provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. :ignatuw of Aptlhc,iril, K__ _du L_+ Dale VglZ�'ZL IRCLARATION kEUARDING CONSTRUCTION LENDING AGENCY 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), Roper's Name Lenders Address ly my s�gnaturo hPlow, I certify to each of the following: i am the prr,pe•b' owner or authorized to act on the property owner's behalf. I ha,,e 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 au.horize representatives of this city or county to t ih bo -identified property for Inspection purposes. ^ Olr-� fjZ �_2L lanaWle of ProDerth' Owner or Authorized Auent Print Property Owner's or Authorized Anent's Name X m4Q�'" g �" Dale DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED I U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED 0 EPA PERMIT EXTENDED AQMD PERMIT FINAL CERTIFICATE OF OCCUPANCY USUEO �/(f� 1n UILD' SBESTOSNOTIFICATION 15 NOT APPLICABLE TO tOPOSED DEMOUTIO',],A�p� SIGNATURE: / 1 VVI(7 FOR OFFICE USE ONLY All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shall be in place priorto approval to fill pool/spa & shall remain In place & be maintained for the life of the pool.