HomeMy WebLinkAboutXR2023-1657 - PermitsCity of Newport Beach
O
@ Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 718-1888
u pe% r newportbeachca.gov/civic
Combination Type - SFP
Work Class - Alteration
11111111111III ��III�IIII��III�IIIIIIIII�IIII111111111111111COMB Permit : XR2O23-1657
Plan Check No
Issued Date : 06/1612023
Inspection Area : 2
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 : 2562 WAVERLY DR Legal Desc : N TR 1014 BLK LOT 45
Description: SFR R/R REPLACE 1 WINDOW LIKE FOR LIKE SAME SIZE;
Owner: Richard & Jill Valenstein
Contractor : AMERICAN VISION
Architect
Address : 2562 Waverly Dr
Address : 2125 N MADERA ROAD#A
Address
Newport Beach, CA 92663
SIMI VALLEY CA 93065, CA 93065
Phone : (949) 565-0008
Phone: (888) 563-0008
Phone
Con State Lic : 778326
State Lic
Lic Expire : 05/31/2024
Applicant: james richard drainer
Bus Lic : BT30020889
Engineer
Address : 2125 madera road
Bus Lic Expire : 10/31/2023
Address
simi valley, CA 93065
Phone: (714) 425-8393
Workers' Compensation Insurance
Phone:
Carrier: INSURANCE CO OF THE WEST
Owner/Builder :
Policy No: WSD505899301
Designer:
Address :
W. C. Expire: 1/1/2024
Address
Phone:
Phone:
Code Edition : 2022
Fire Sprinklers : NO
Construction Valuation
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/TI sq. ft. Bldg
Occupancy Groups : U,R-3
No of Units : 1
Alteration sq. ft. Bldg :
Bldg Height:
No of Stories : 2
Added/New sq. ft. Garage
TOTAL sq. ft.
Building Setbacks : Front: 10, Side: 4, Side: 4, Rear: 10
Flood Zone : X
Use Zone : R-1 - Single -Unit Residential
PROCESSED BY: P�7
SPECIAL CONDITIONS:
$5,000.00
0
I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law fey 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
ie permit to file a signed statement that he or she is licensed pursuant to the provisions of theContractors' State License Lew (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
'rofessions Code) or that he or she is exempt from Iicensure and the basis for the alleged exemption. Any violation of Section 7031.6 by any applicant for a permit subjects the applicant to a civil penalty of
of more than five hundred dollars ($500).
11, 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,
Iusiness and Professions Code: The Contractors' Stale 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 it was not built or
nproved for the purpose of sale).
3 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Slate License Law does not
pply to an owner of property who builds or Improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' Slate License Law).
I I am exempt from licensure under the Contractors' Stale License Law for the following reason:
,y 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 bythis permit, I cannot legall
all a structure that I have built as an owner -builder if it has not boon constructed in its entirely 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:/fwww.leginfo.ca.govlcalaw.btml.
'dgnature 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 3of the Business and Professions Code, and my license is In full force
nd effect. License Class License No Date Contractor Signature
COMPENSATION DECLARATION
FAILURE TO SECURE WORMERS' COMPENSATION COVERAGE 19 UNLAWFUL. AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
:OMP£NSATION,. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AMC) ATTORNEV'S 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 in
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' compensadoi
Rance comer and policy bar ore: er/ /�
riar�/J.s • f�'�Ge L� Policy Number �.S �(A O ! / Expiration Date /�
ne of Agent Phone #
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 agre
If I should become su t two tthoe�workp ll ,C,ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
iature of Applicant/��f°u— N'(�1/L%l Date LO/%//27i
hereby affirm under pens y 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).
-tinder's Name ((// Lender's Address
3y 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 slate taws relating to building construction.
I authorize �epmse itatives of this city or county n r the a. ve-identlfied property for Inspection purposes.
>ignatu•e of Property Owner or Authorized A enl. Print Property Owner's or Authorized A ent's Name �/%�� �llL�� �v Date
4CIION DATE BY DECLARATIONOF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
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PERMiTEXPIRED _ I SUBMITTED ASBESTOS NOTIFICATION TO
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^ERV FINAL 77 ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
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