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HomeMy WebLinkAboutXR2022-3126 - Permits�aEWPORT City of Newport Beach Community Development Department- Building Division H 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 U Inspection Requests Phone: (949) 644-3255 ogsiFonN`P newportbeachca.gov/inspections Combination Type - SFP Work Class - Other 11IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII111111111111111111111111 jj COMB Permit : XR2022-3126 Plan Check No : PC2022-2988 Issued Date: 03/06/2023 Inspection Area : 4 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 : 3 INVERNESS LN Legal Desc : N TR 7638 BLK LOT 62 Description: SFR - NEW DORMER OVER GARAGE Owner: WALKER BRIAN J TR THE WALKER FAMILY Contractor: JAMISON HOME SERVICES CORP Architect REVOC LIVING T Address : 3 INVERNESS LN Address : 19046 SINGINGWOOD Cl Address : c NEWPORT BEACH, CA 92660 TRABUCO CANYON, CA 92679 rx'� Phone : Phone : (949) 750-7477 Phone Con State Lie : 1074004 State Lie : �^ t Lie Expire.: 03/31/2023 i = 1 Applicant: DAWN VAUGHT Bus Lie : BT30079601 Engineer : GHAZLANI ANDY Address : 1041 W 18TH ST, A106 Bus Lie Expire : 08/31/2023 Address : 4202 ATLANTIC AVE #204 COSTA MESA, CA 92627 LONG BEACH, CA 90807 Phone: (714) 488-8003 Workers' Compensation Insurance Phone: (562) 253-2385� Carrier: HARTFORD Owner/Builder : Policy No : 76WEGAVOM9Z Designer : JASON RICHARTJ Address : W. C. Expire: 11117/2023 Address : 1041 18TH W, A106 COSTA MESA, CA 92627 Phone: Phone: (949) 422-9191 Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $13,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/Ti sq. ft. Bldg : 0 Occupancy Groups : U,R-3 No of Units : 1 Alteration sq. ft. Bldg : Bldg Height : No of Stories : 2 Added/New sq. ft. Garage: 0 TOTAL sq. ft. 0 Building Setbacks : Front: 10, Side: 5, Side: 5, Rear: 15 Flood Zone : X Use Zone : PC - Big Canyon PROCESSED BY: SPECIAL CONDITIONS: 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 ftem(s) (Section 7031-5, Business and Professions Code; Any city or county that requires a permit to construct, after, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State. License Low (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that its or she is exempt from liaansure 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 not more than five hundred dollars ($500). 0 I, as owner of the property, or my employees with wages as theirsole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors Stale License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If,. however, the building or improvement is sold within one year of completion., the Owner-Bulider will have the burden of proving that it was not built or improved for the purpose of sale), rl I, 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 riot apply 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). © 1 am exempt treat licensure under the Contractors' State License Law for the following reason: By 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 legall, sell a structure that I have built as an owner-buildor if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable taw, Suction 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site:tittp:/dWww toginfo.ca:govlcalaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0) of D' RBia of the Business and Protess F;Od - u tGanse is in full force and effect. License Class License No Date otractor Signature WORKERS' COMPENSATION DECLARATION NAPPING: 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 (3100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION Jets OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEE& hereby affirm under ppanalty of perjury one of the following declarations: -1 1 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 Zeyormance of the work for which this permit is issued. 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' carder and policy number are: Policy Number Date me of Agent Phone # certify that, in the 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 this workers' compensation laws of California, and agre t, if I should become so act to the work IS' u .Lion provaBons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. !,IV 7 nature of Applicant CLARATION REOA ! 4 UC L G AOENGY areby affirm under pe aIty 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), Wer's Name Lender's Address my signature below, I certify to each of the following: I am the property owner or authortzed 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 will) all applicable city and co ordinances and state laws relating to building construction. /Oate I authorize representatives of this city or ::only afarthe above -identified property for inspection purposes. roDarkv nature of POwner or Authonzed Aaen[ / �� Print Prooertv Owner's or Authorized Agent's Name c—�s.� ) _ --___ ✓'`� a / (ACTION j DATE j 6Y r 'DECk.ARATTOONEP�OMPOANCE VVlrk CODE OF FEDERAL FOR OFFICE USE ONLY i I REGULATIONS PART 61 OF TITLE 40 AND AONtb RULE �-71441n3 PERMITEXP1RED 41I SUHMrTEDMBSIOS N0TIRC4T10N TO _— PERMIT CANCELLED PERIYTYT FXTENDElJ PERMI F HNAL ����� CERTlFrCATE OF OCCUPANCY ISSUED S iSNOTAPPLICABLE TO