HomeMy WebLinkAboutX2022-1524 - Permitsp
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City of Newport Beach
Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
newportbeachca.gov/inspections
Combination Type - SFP ELEC MECH PLUM
Work Class - Alteration
COMB Permit : X2O22-1524
Plan Check No : 2884-2021
Issued Date : 08/1212022
Inspection Area : 3
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
Description
Owner:
Address
Phone:
Applicant:
Address :
Phone
: 1615 LINCOLN LN
Legal Desc
: N TR 3702 BLK LOT 1
DELTA 1- *ADDITIONAL SCOPE*
CONVERT (E) TO OFFICE
SPACE 134 SF
WALTER KOSICH
Contractor:
LEE B MARSTON CONSTRUCTION
1615 LINCOLN LN NEWPORT BEACH,
CA Address :
713 1/2 LARKSPUR AVE CORONA DEL
92660
MAR, CA 92625
Phone :
(949) 233-3280
Con State Lie
: 481631
LEE B MARSTON CONSTRUCTION
Lie Expire :
10/31/2023
7131/2 LARKSPUR AVE CORONA DEL MAR,
CA 92625
(949)233-3280
Owner/Builder :
Bus Lie:
Architect
Address
Phone:
State Lie
Engineer
Bus Lie Expire : Address
Workers' Compensation Insurance Phone
Carrier: STATE+COMPENSATION+INSURANCE+FUN
D
KHANSA EYASS
2252 JOSIE AV LONG BEACH, CA'908Y5
Address :
Policy No:
9138444
Designer: BRIAN SCOTT
Phone :
W. C. Expire :
7/25/2023
Address: 962 N HARWOOD ST ORANGE, CA 92P67
Phone: (562)865-7935
Code Edition : 2019
Fire Sprinklers
: YES
Construction Valuation : $10,720.00
Type of Construction : V-B
Fire Hazard Zone : No
Added/New/TI sq. ft. Bldg : 0
Occupancy Groups : R-3
No of Units :
1
Alteration sq. ft. Bldg : 134
Bldg Height:
No of Stories :
1
Added/New sq. ft. Garage : 0
Building Setbacks : Front: 20, Side: 6, Side: 6, Rear: 6
Flood Zone : X
Use Zone: R-1-6000 -Single-Unit Residential (6 0 indicates minimum lot area)
PROCESSED BY :
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION.
1 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 placednext to the applicable iterate)
;action 7031.5, BUS'IneSS and Professions Code: Any city or county ll'at requires a permit to construct. after, improve, demolish, or repair any structure, prior to Itsissuance, also requires the applicant for
re permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Slate 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 licensure and the basis for the alleged exemption, Any violation. of Section 703L5 by any applicant for A permit subjects the applicant to a civil penalty of
of more than five hundred dollars ($500),
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure Is not intended or offered for sale (Section 7044,
uUmess and Professions Coder The Contractors' State. License Low does not apply to an owner of property who, through employees' or personal effort, builds or Improves the property, provided that the
nprovereents arenot 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 builtor
n 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' 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
,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
ell 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
'rofessions Code, is available upon request when this application is submitted or at the following 'Nab sitePubipalwww. leginfo.ca.gov/ca law.hlml.
.ignature of Properly Owner or Authorized Agent Date
10ENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chaplerg (commencing with Section 7000) of Division 3 of the Business and Professions C „ andXmynse's In full force
rid effect. Licens^ Class License No Date Y-,;t_;L),ConImctor signature
VORKERS' CC irr-NSATION DECLARATION
A3t ll' IC: FAILURE T� S-1URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS [E100,6001, IN ADDITION TO THE
JST OF UOMPENSATIJN, D, MAGES AS PROVIDED FOR IN SECTION 370E OF THE LABOR CODE, INTEREST. AND ATTORNEY'S FEES.
,hereby affirm under penalty of perjury one of the following declarations:
have and will mairlunin 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
mmnce of the week for which this permit Is issued. Policy No.
ave and will mai:rt3in 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' compensa
3nci carrier -r ro policy number are:
Policy Number
of Agent
Date
JI Pnity that. in tire performance Of 51ork for chthis permitisissued, shall not employ any personin any manner so as to become subject to the workers' compensation taws of Callfomia, and ogre
Ial. if I ;,bould ba om.. quo' ct to es pensation provisions of Section 37D0 of the Labor Coda, shall forthwith comply with those provisions.gnature of Applicant Date�[J ECLARATION RE IR CON TION lE ING AGENCYV
hereby affirm under penalty of perjury thatthere is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
ender's 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 properly owner's behalf.
I have read this application and the information I have pi is correct..
I agree to comply with all applicable city and comity ordin ces and state relating to building construction.
I authorize representatives of this city or county a the above- Ed pro erty for inspection purposes.
sl nalure of Property Owner or Authorized A en Print Property Owner's or Authorized Agent's Name ` Date
ACTION DATE ill bEC0aATJON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY el
RFG(ILATIONS PART El OF TITLE 40 AND AQMD RULF
1403
PERMIT EXPIRED
1
1LJ I SURMITTFD ASRFSTOS NOTIFICATION TO
All required alarms., latches gates and fences which serve as part of a pool/spa barrier, Shall
be In place prior to approval to fill pool/spa & shall remain in place & be maintained for the
life of the pool.
PERMIT CANCELLED
LIPA
PERMiT EXTENDED
�AgNtD
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PEFM77 f1NAL
CERTIFICATE OF
OCCUPANCYiSSUED
7
i SRESTOS NOTIFICATION (QT APP LE 7U
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