HomeMy WebLinkAboutXR2023-1326 - PermitsCity of Newport Beach
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COMB Permit : XR2O23-1326
Community Development Department- Building Division
X R 2 9 2 3 1 3 2 6
100 Civic Center Drive, Newport Beach, CA 92660
Plan Check No : PC2023-1186
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Permit Counter Phone: (949) 718-1888
newportbeachca.gov/civic
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5 6 , 6'�` �4 ,.�.
Issued Date : 05/19/2023
Inspection Area : 3
qG/F00.N `r
Combination Type -
3
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 : 1936 GALAXY DR Legal Desc : N TR 4224 BLK LOT 19
Description: SFR - (5) CAISSONS FOR REMEDIATION OF SLOPE
Owner; HOLIDAY FAMILY REVOCABLE TRUST
Address : 1700 E OCEAN BLVD
NEWPORT BEACH, CA 92661
Phone:
(949) 630-8991
Applicant:
HOLIDAY FAMILY REVOCABLE TRUST
Address:
1700 E OCEAN BLVD
NEWPORT BEACH, CA 92661
Phone :
(949) 630-8991
Owner/Builder : HOLIDAY FAMILY REVOCABLE TRUST
Address : 1700 E OCEAN BLVD
NEWPORT BEACH, CA 92661
Phone: (949)630-8991
Contractor
Address :
Phone:
Con State Lie
Lie Expire:
Bus Lie :
Bus Lie Expire
Workers' Compensation Insurance
Carrier :
Policy No:
W. C. Expire
Architect
Address:
Phone :
State Lie
Engineer: ANTONIO LUIS CRUZ
Address: 710 W HARRIET ST
ALTADENA, CA 91001
Phone: (626)831-9645
Designer
Address
Phone :
Code Edition :
2022
Fire Sprinklers :
NO
Construction Valuation : $40,000.00
Type of Construction :
V-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg : 0
Occupancy Groups :
U
No of Units :
0
Alteration sq, ft. Bldg :
Bldg Height:
No of Stories :
0
Added/New sq. ft. Garage: 0
TOTAL sq. ft. 0
Building Setbacks :
Front: 10, Side: 6, Side: 6, Rear: 6
Flood Zone :
X
..
Use Zone :
R-1-6000 - Single -Unit Residential (6000
indicates minimum
lot area)
,
PROCESSED BY:
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty 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 io the applicableiterl
Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct. alter, improve, demolish, or repair any slructure, prior to its issuance, also requires the applicant for
is permit to file a signed statement that lie 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
professions 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 fora permit subjects the applicant to a civil penalty of
are than five hundred dollars ($500).
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,
rosiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' ar personal effort, builds or improves the property, provided that the
nprovements 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 buitt or
nproved for the purpose of sale).
1 1, 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
poly to an owner of property who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I I am exempt from licensure under the Contractors' State License Law for the following reason:
iy my signature below t 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!
ell a structure that I have built as an owner-buildar 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
'rofesstons Code, is available upon request when t plicatio is�su mi ' at a fall. Ing Web site:htip:llwvnv.legmfo.ca gov)calavr html �/,r
ilgnahue of Property Owner or Authorized Agent _ _ Date al
.ICENSED CONTRACTOR'S DECLARATIC
hereby affirm under penalty of perjury that I am I ed under provisions of Chapter 9 (cam ncing with Section 7000) of Division 3 of the Business and Professions Code. and my license is In full force
no effect. License Class License No Date Contractor Signature
COMPENSATION DECLARATION
ING: 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),I14 ADDITION TO THE
OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 31 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
I have and wilt 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
"ormance of the work for which this permit is issued. Policy No.
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' compensa
Trance carrier and policy number are:
Policy Number
9af Agent
lertify that, in the performance of the work for which
If I should become s ct to the yyprkeirs' c ri
sture of Applicant
Date
is issued'.. I shall notemploy any person in any manner so as to become subject to the workers' compensation laws of California, and agre
.ions of Section 3700 of the Labor Code I shall forthwith comply With those provisions.
/'p
� Date
„_...-.J1>_�-_,�....._...,._
hereby affirm under not perjury that there is a constructi6a,1e7nding agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
ender's Name Lender'sAddress
ly my signature below, I certify to each of the following:
I am the prop^.rty owner or authorized to act on the property owner's behalf.
I have read this application andthe information I have provided is correct.
I agrEa to compov wdh all applicable city and county ordinances and slate laws relating to building construction.
I authorize represantatives of this city or coon Hier i It tiff property for inspection purposes,
il naP_ e of Pro en Owner or Authorized Age __ fvill Property Owner's or Authorized Agent's Name
1{ilOh DATE. BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
I i REGULATIONS PART 51 OFTITLE40 AND ACNID ROLE
NOTIFICATION TO
RErUXT CANCELLED
PCRlvrri FINAL SRESTOSNOTIFICATION15NOl'APPLIL.IrCABLE TO
L1C1CATE (SF t�'I ,J PROPOSED DE tON
OCCUCUPANCYISSGEO SIGNATUR /I ��/•
19