HomeMy WebLinkAboutXR2022-2937 - Permits�EvuaoFA City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XRZOZ2-2937
D� Community Development Department - Building Division X R 2 0 2 2 2 9 3 7
y �cD, 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No :
_.� Permit Counter Phone: (949) 644-3288 Issued Date : 11/07/2022
n.. Inspection Requests Phone: (949) 644-3255 Inspection Area : 1
c4(�pppN�P newportbeachca.gov/inspections
Combination Type - SFP
Work Class - Repair
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
1918 OCEAN FRONT W, 2 Legal Desc : A TR FIRST ADD TO NEWPORT BEACH BLK 19 LOT 9 FIRST ADD TO NE WPORT BEACH LOT 9
BLK 19 ALL
SFR REROOF W/OWENS CORNING MIDNIGHT SKY 12 SQ CL"A" T/O SHINGLES
Owner: HANNA ALBERT TR ST JOHN TR
Address : 13241 TIBURON WAY
TUSTIN, CA 92782
Phone:
Applicant
Address
Phone:
Owner/Builder : HANNA ALBERT TR ST JOHN TR
Address: 13241 TIBURON WAY
TUSTIN, CA 92782
Phone:
Contractor
Address :
Phone:
Con State Lie
Lie Expire
Bus Lie :
Bus Lie Expire
Workers' Compensation Insurance
Carrier :
Policy No
W. C. Expire:
Code Edition :
2019
Fire Sprinklers :
Type of Construction :
V-B
Fire Hazard Zone
Occupancy Groups :
R-3
No of Units :
Bldg Height:
No of Stories
Building Setbacks :
Front: 5, Side: 3, Side: 3, Rear: 5
Flood Zone :
X
Use Zone:
R-1 - Single -Unit Residential
PROCESSED BY:
SPECIAL CONDITIONS
Architect:
44%;""�
Address
Phone:
State Lie
Engineer:
Address:
Phone:
Designer
Address
Phone
NO Construction Valuation : $0.00
NO Added/New/Ti sq. ft. Bldg : 0
1 Alteration sq. ft. Bldg :
2 Added/New sq. ft. Garage : 0
�IJONSiRUCTION NOISE D
,0N '?HE WEEKEND
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 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' Stato 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 forthe alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
,or more than five hundred dollars I$500),
1, 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,
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 that the
uprovements 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
Vpro for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors t0 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 improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
1 am exempt from licensure under the Contractors' State 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 legall,
all 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
'rofesslons Code„ is available upon request when lhfs pplicatfon is submitted or at the following Web site: httpJiwww.iegmfo.pa.govjcalaw.html,
>ignature of Property Owner or Authorized Agent . 2J3___L�-/j,-�J� Date /�
.ICENSED CONTRACTOR'S DECLARATION
_
hereby affirm under pen;;lly of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3of the Business and Professions Code, and my license is in full force
rd effect. License Class License No Date Contractor Signature
VORK&IS' COMPENSATION DECLARATION
'APNING' FAILURE TO SECU,^.E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, MO SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), iN ADDITION TO THE
SST OF COMPENSATION, DAMAGES AS PRGVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm urI cenalty of perjury one of the following declarations:
.r I have and will -re-Imam 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
erformance of the work for which this permit Is issued. Policy No. _
hri-o and roll 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'
ranee carrier and policy number are:
:arrier_ _
ITmi o+Agent
Policy Number
Date
Ue,tify that, in thi, performance of the work for which this permit is issued, I shall riot 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 provisions of Section 3700 of the Labor Gods, I shall forthwith comply with those provisions.
signature of Applicant T Date
IECLARATION REGARDING CONSTRUCTION LENpIN6 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).
Ender's Name Lenders Address
ly 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 informatlon I have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction. j
I authorize representatives of this city or county tenter the above-idenfified property for inspection purposes.
ACTION DATE: BY/ j DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
14UB REGULATIONS PART al OF TrrLF 40 AND AOMD RULE
NOTIFICATION TO
PERMITEXTENDED _ f-_ _ _ lJAOMD _
PCRMfT FINAL 6�(ur�t � AS ESTOS NUTiHCA11UN 154r APPLICABLE TO
CERTIFICATE OF 1 L E OP(E60�{q�LITjD
OCCUPANCY15SUED i