HomeMy WebLinkAboutXR2023-0491 - Permits�gWPORT City of Newport Beach Illlllllllllllullllllllllllll II
c� Community Development Department- Building Division X R 2 0 2 3 0 4 9 1
100 Civic Center Drive, Newport Beach, CA 92660
? Permit Counter Phone: (949) 644-3288
.aH Inspection Requests Phone: (949) 644-3255
C9C/F00.N`P newportbeachca,gov/inspections
Combination Type - SFP ELEC MECH PLUM
Work Class - Alteration
COMB Permit : XR2023-0491
Plan Check No : PC2023-0407
Issued Date : 02/22/2023
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
Job Address : 300 BAY AVE E
Legal Desc : A TR NEWPORT BAY TR SUB OF
BLK C BLK LOT 77
Description: SFR - INTERIOR REMODEL 500 SF
Owner: SPIEGEL DAVID A TR THE
Contractor:
Architect:
SPIEGEL-CORTNEY FAMILY TR
Address : 6074 JOHN MUIR RD
Address :
Address : >
HIDDEN HILLS, CA 91302
,
Phone:
Phone:
Phone: .. ,
Con State Lie :
State Lie:
Lie Expire
Applicant: SPIEGEL DAVID A TR THE
Bus Lie
Engineer: „
SPIEGEL-CORTNEY FAMILY TR
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Address : 6074 JOHN MUIR RD
Bus Lie Expire :
Address
HIDDEN HILLS, CA 91302
Phone :
Workers' Compensation Insurance
Phone
Carrier :
Owner/Builder : SPIEGEL DAVID A TR THE
Policy No:
Designer
SPIEGEL-CORTNEY FAMILY TR
Address: 6074 JOHN MUIR RD
W. C. Expire :
Address
HIDDEN HILLS, CA 91302
Phone:
Phone:
Code Edition : 2022
Fire Sprinklers : NO
Construction Valuation : $60,000.00
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/TI sq. ft. Bldg : 0
Occupancy Groups : R-3
No of Units : 1
Alteration sq. ft. Bldg : 500
Bldg Height :
No of Stories : 3
Added/New sq. ft. Garage: 0
TOTAL sq. ft. : 0
Building Setbacks : Front: 7, Side: 3, Side: 3, Rear: 5
Flood Zone : X; AO 1
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Use Zone: R-1-Single-Unit Residential
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PROCESSED BY:
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SPECIAL CONDITIONS: FLOOD; HIGH -DENSITY
OWNER -BUILDER DECLARATION
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, alter, improve, demolish, or repair any structure, prior to Its issuance, also requires the applicant for
me 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 [)[vision 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 fora permit subjects the applicant to a civil penalty of
rat ore 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 safe (Section 7044,
USinass 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
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 4 was not built or
nproved for the purpose of sale).
3 I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does not
�piy 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 am exempt from licensure under the Contractors' State License Law for ilia following reason:
'ry 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 structura that I have built as an ommer-bulldor if It has not been constructed in its ontirob b_ y licensed contractors. I understand that a copy of theapplicable law, Section 7044 of the Business and
rofessions Code., is available upon request when this application is submitted_ o t the o o site: http:/Iwww,teginfo.ca,goNdcalaw.htni
gnature of Property Owner or Authorized Agent l _ _Date :n;-Z Z ZZ2_-3-
.ICENSED CON i Rt CTOR'S DECLARATION
hereby affirm ur"r penalty of periury that I am Licensed nder 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 effoc. License -:ass License No Date Contractor Signature
PORKERS' COMPENSATION DECLARATION
rrRNING- FAILURE TL SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TD.ONE HUNDRED THOUSAND DOLLARS (6100,000), IN ADDITON TO THE
DST:' COMPENSATION DAMAGES AS PROVIDED FOR IN SECTION 1706 OF TH£IISOR CODE, INTEREST, AND ATTORNEY'S FEES.
herety affirm under penalty of perjury one of the following declarations:
I idve and w''I mui,nain a certificate of consent to self -insure for workers' compensation., Issued by the Director of Industrial Relationsas provided for by Section 3700 of the Labor Code, for
xa.ance of inn vrorY for which this permit is issued. Policy No.
J, nave and will n,aintain workers' compensation insurance, as required by Section 3700 of the Labor Code.. for the performance of the work for which this permitis issued. My workers"
sd,ance carrier and pD:.cy number are:
Policy Number Expiration Date
of Agent Phone It _
certify that, in the performance of the work for which this permit is issued., I shall notemploy 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 Code, I shell forthwith comply with those provisions.
nature of Applicant __ ____ __ Date
CLARAT€ON 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).
Idei 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 budding construction.
I authorize representatives of this city or county to enter the above -Identified p y fction purposes.
nature Of Property Owner or Authorized Agent Print Property Owner's orAuthorized Agent's Namepate
FOR OFFICE USE ONLY
' RFGULATIONS PART 61 DF TITLE. 40 AND AQMD RULE
1403
PERMIT EXPIRED ILJ I SUFnvI TTEDA5BEST05 NOTIFICATION TO
PERIWIT EXTENDED
PERMIPFINAL �7 -2 `,' I MASBESTOS NOTIFICATION 15 NOT
CERTIFICATE Of V ; PROPOSED DEMOLITt
OCCUPANCrI55UED i TaIGNATtIRE: