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Home My WebLink AboutXR2022-2791 - Permitsoe" City of Newport Beach 111111p1111111111111111111111111111111111111p111111111111COMB Permit:XR2O22-2791 Community Development Department- Building Division X R 2 0 2 2 2 7 9 1 100 Civic Center Drive, Newport Beach, CA 9266D Plan Check No Permit Counter Phone: (949) 644-3288 Issued Date : 10/2012022 Inspection Requests Phone: (949) 644-3255 Inspection Area : 5 newportbeachca.gov/inspections Combination Type - Work Class - Alteration 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: 413 FERNLEAF AVE, 1/2 Legal Desc : P BK 277 PG 36 PAR 1 UN 1 PM 277-36, PAR. 1 OF PROJECT 938-0 1 LOCATED ON Description: MFR CHANGE OUT (3) WINDOWS *NO HEADER CHANGE* Owner: TAYLOR CRARY Address : 413 FERNLEAF AVE CORONA DEL MAR, CA 92625 Phone : Applicant: MATTSON & MATTSON CONST Address: 2137 E WILSON AVE ANAHEIM, CA 92807 Phone : (714) 628-9425 Owner/Builder: Address : Phone: Contractor: MATTSON & MATTSON CONST Address: 2137 E WILSON AVE ANAHEIM, CA 92807 Phone: (714)628-9425 Con State Lie : 772811 Lie Expire : 12/31/2023 Bus Lie: BT30052509 Bus Lie Expire : 09/30/202S Workers' Compensation Insurance Carrier: BENCHMARK+INSURANCE+COMPANY Policy No : CST5023659 W. C. Expire : 6/1/2023 Code Edition : 2019 Fire Sprinklers : NO Type of Construction : V-B Fire Hazard Zone : NO Occupancy Groups : R-3 No of Units : 2 Bldg Height: No of Stories: 3 Building Setbacks : Front: 15, Side: 3, Side: 3, Rear: 5 Flood Zone : X Use Zone: R-2 - Two -Unit Residential Architect Address: Phone: State Lie Engineer: Address Phone: Designer Address: Phone: Construction Valuation : Added/New/Tl sq. ft. Bldg Alteration sq. ft. Bldg : Added/New sq. ft. Garage TOTAL sq. ft. Bldg : 0 r0 $7,200.00 S o :NCi QNSTRUCTiON NOISE PROCESSED BY: SPECIAL CONDITIONS: ON THE WEEKEND 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 items) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, all 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 Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exemptfrom lieensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fore permit subjects the applicant to a civil penalty of Tot 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 L) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply loan owner of property who, through employees' or personal effort, builds or improves the property, provided that the .mprovements are notintended or offered for sale. If, however, ilia 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 improved for the purpose of sale). 71 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 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). 0 I am exempt from lieensure 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, gall a structure that I have built as an owner -builder if it has not boon constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code,, is available upon request when this appliraton is submitted or at the following Web site;http:llwww.leginfo.ca.gov/calaw.html. 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 7000) of UQvision 3 of the Business and POTS, a�, ode. and my license is In full farce and effect. License Class License No Date 0- `)' 3- Contractor Signaturo�� NORKERS' COMPENSATION DECLARATION V NARNING: 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 (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: -11 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 "INformance of the work for which this permit is issued. Policy No. p��Nava 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` compensatiol I',su anca carrier and policy number are: Policy Number of Agent Phone # Date certify thet, 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 agre t, if I should become subject to the worms-earnpeesatie istons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant_ e -'� D_�U CLARATION REGARD CONSTRUCTION LENDING AGENCY na by affirm under pane 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). irises Name Lenders 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. /�^ �/,1� �� nature of Property Owner or Authorized Agent V ��— Print Prooertv Owner's or Authorized Aaent's Name X / w wu V tr r r / I rx n . Date FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMO RULE 1403 EXPIRED PERMITEXTENDED CEAYtFICANEOF \�+�� SI OPOSE.RASBf5Tp DEMS NOTOLITION TICATION 15 NOT APPLICABLE 'TO OCCUPANCYISSUEp