HomeMy WebLinkAboutXR2023-0325 - Permits�_Wpo� City of Newport Beach IIIII II I I II II IIIIII II IIIII I II I II COMB Permit : XR2023-0325
of p+ Community Development Department -Building Division X R 2 0 2 3 0 3 2 5
r}- 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No:
u Permit Counter Phone: (949) 718-1888 Issued Date : 02/06/2023
newportbeachca.gov/civic Final Date: 0811512023
"<„,cnN�P Combination Type - MFP Permit Status: Final
Work Class - Other Inspection Area : 1
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 : 510 BAY AVE W
Legal Desc : A TR EAST NEWPORT BLK A BLK LOT 123
Description:
MFR - T/O COMP. INSTALL 30# FELT.
INSTALL 12 SQ COMP SHINGLE
Owner :
JONES PATRICIA L TR
Contractor
Address :
431 CATALINA DR
Address
NEWPORT BEACH, CA 92663
Phone
Applicant: JUAN BECERRIL
Address: 820 CENTER DR, #2
COSTA MESA, CA 92627
Phone: (949)274-3739
Owner/Builder : JONES PATRICIA L TR
Address: 431 CATALINA DR
NEWPORT BEACH, CA 92663
Phone:
Con State Lie
Lie Expire:
Bus Lie :
Bus Lie Expire
Workers' Compensation Insurance
Carrier :
Policy No:
W. C. Expire:
Architect:, �V_
Address; \
Phone
State Lie
Phone:
Designer:
Address :
Phone: Phone
Code Edition :
2022
Fire Sprinklers :
NO
Construction Valuation : $12,000.00
Type of Construction :
V-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg : 0
Occupancy Groups :
U,R-3
No of Units :
2
Alteration sq. ft. Bldg :
Bldg Height:
No of Stories :
2
Added/New sq. ft. Garage: 0
TOTAL sq. ft. 0
Building Setbacks :
Front: 9, Side: 3, Side: 3, Rear: 5
Flood Zone:
X
Use Zone :
R-1 - Single -Unit Residential
PROCESSED BY:
SPECIAL CONDITIONS:
OWN❑ BUILGIER DECLARATION
I hereby affirm under penally of perjury that I am exempt from the Contractors' Slate License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(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
1e 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 licensure 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
of more than five hundred dollars ($500).
1, as owner of the property, or my employees with wages as their sole compensation, will do J 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' Slate License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the properly, provided that the
nprovements are not intended or offered for sale. If, however, the budding or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
nproved for the purpose of sale).
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 not
pply 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 licensure under the Contractors' Stale 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
ell a structure that 1 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 Web site:http:(/www.leginfo.ca.govYcalaw.htmi.
lignalure 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 7000) of Division 3 of the Business and Professions Code, and my license is in full force
nd effect. License Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
IARNING: 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 4100,0001, IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37H OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
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 the
erformance of the work for which this permit is issued. Policy No.
11 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' compensatior
lsurance carrier and policy number are:
Policy Number
Date
1e of Agent """
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 the workers' compensation laws of California, and
. if I should become subject to the workers' compensation previsions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant __ _ __ _ ___ __ Date
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
Reby 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).
lder s Name Lender's 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 county to enter the above -identified property for inspection purposes.
nature Of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name
ACTION
DATE
BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
1403
PERMIT EXPIRED
0 1 SUBMITTED ASBESTOS NOTIFICATION TO
P£RMITCANCELIED
j
EPA
PERMIT EXTENDED
�. OMD
PERMITFINAL
2
,,.)� LJ ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
CERTIFICATE OF
V•'
PROPOSED DEMOLITION
OCCUPANCY ISSUED
SIGNATURE:
Date
�EWPO?
City of Newport Beach
Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
u
Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
cql./rp0.N�P
newportbeachca.gov/inspections
Combination Type - MFP
Work Class - Other
111111111111111111111111111111111111111111111111111111111jj COMB Permit : XR2023-0325
Plan Check No
Issued Date : 02/06/2023
Inspection Area: 1
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
e
Job Address: 510 BA ®ate,
AVE W
Description: MFR - T CQIw
Owner: JONES
Address: 431 CA
NEWP(
Phone:
Applicant: JUAN'B
Address : 820 CEI
COSTA
Phone: (949)21
Owner/Builder : JON
Address: 431 CAT
NEWPOI
Phone:
Code Edition:
Type of Construction
Occupancy Groups:
Bldg Height :
Building Setbacks
Flood Zone:
Use Zone :
AfJ,12 SO COMP SHINGLE
Ri
Contractor r :.d
Address : z ,�: Eliam
ElPhoneCon State Lic,. '`-f f'? Lie Expire
_` Bus Lie tv,A Daw
Bus Lie Expire :
applicable:
BL A BLK LOT 123
❑ 80% or ❑ 100% refund
Architect
to whom: Address
Phone:
State Lic
Engineer:
Address
'39 11j, Workers' Compensation Insurance Phone
t C ZZ D oPA LE n- rr : 3s.c rr
, ANA xpire :
3EACH, CA92TAirork Started) (no Work started)
GYP Phone:i
V-B Fire Hazard Zone : NO
U R-3 No of Units : _. 2
No of Stories : 2
X
R-1 - Single -Unit Residential
PROCESSED BY: QI
SPECIAL CONDITIONS:
ation : $12,000.00
ft. B:ldq : 0
itgiti?IF. plteratlonsq.ft-pidg;:
Added/New Is fn Garage : 0
TOTAL sq. ft. : 0
�ti A
t 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)
ction 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
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing with Section 7000)of Division 3 of the Business and
fessions Code) or that he or she is exempt from licensure 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
more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
:iness 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
Movements 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 huff. or
(roved for the purpose of sale). _
1, as owner of the property, am exclusive[ cone ..,;, L e prolect Section 7044, Business and Professions Code: The Contr tors' Stale License Law does not
>ly to an owner of property wh w s or improves they , a d A ia o cl he projects with a licensed Contractor purau t to h Contractors' State License w) ;
m exempt from licensure u der it ClanF�iirna��c'tors' Sta Li ensa dw f r L' owinn reason: If. a�Ji� ruble'
y m, signature below I acknowI get ,� µ form _-- --
structure that I have built a an owner -builder if it has
rofessions Code, is available up n request when this appl
ignature of Property Owneror A horf
.ICENSED CONTRACTOR'S EC RATI
hereby affirm under penalty of p 'ury t at I am I ns -
nd effect. license Class
`ARNING: FAILURE TO SECURE WORI(E ' CO OVER k
oeT OP COMPENSATION. nAMAGEa Aa OVI. F IN ION
hereby F
hereby affirm under penalty of pe ry o f a wir
I I have and will maintain a der Elder I s W
erformance of the work for which is.re d. Policy No.
htchi-nTC1sTTiave resided for at least one year
in its entirety by licensed contractors. "Ell
Date
&ts18 91f a ushess and Pryfeasio
CIVIL FINES UP TO ONE HUNDRED
of Industrial Relations as provided for by
11 have and will maintain worker,. compensation insurance, as required by Section 3700 of the Labor ' de. for the performance of the or% for vhich this permit
Isurance carrier and policy nuYnbe are: `y..'yg P Y {can. a n
:artier I` � .� :. on e
Lame of Agent ` Phone M
U,
r �
It certify that, in the performahce the work for '� �f i Shall not employ any person in any dal i{�iarr ttb ecome sub[ ci to the worke s' coin
tat, if� I should become subiectto t vorkers' c v l s o e ion 3700 of the Labor Code, I shall forthwith comply with those provisions.
an6lure of Applicant
ireby affirm under penalty OiPT
thilari a rss"
iders Name
my signature below. I certify toe h of the room.
I am the property owner or aifth
I have read this application and the information
I agree to comply with all applicable city and cc
I authorize representatives of this city or county
EXPIRED
PERMIT EXTENDED
PERNHT PINAt
CERTiRCATE OF
OCCUPANCYISSUEO
agency for the performance of the work for which this Ibg lwg
I nnAer'c AAA—-9•'• t
i have provided is correct.
wiry ordinances and state laws relating to building construction.
tli enter the above -identified property for inspection purposes.
Pont Property Owner's
DECLARAT€ON. OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
rIC.aTIJN TO
U ASBESTOS N01 HCATION 15 NOT 9LE 10
PROPOSED DEtvtCVriON�----�
this permit, 1 cannot legal])
of the Business and
nyl Ilforce
[5100,000]..IN ADDITION TO THE
of the Labor Code, for th
My workers' compensafioi
iws of California, and agre
Date