HomeMy WebLinkAboutXR2023-0957 - PermitsP_
City of Newport Beach
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COMB Permit; XR2023-0957
Ck
(immunity Development Department -Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Plan Check No : 0175-2020
Permit Counter Phone: (949) 644-3288
Issued Date: 0411312023
Inspection Requests Phone: (949) 644-3255
Inspection Area:
For,
newportbeachca.govTinspectons
Combination Type - SFP ELEC MECH PLUM
Work Class - Other
Lq
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PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT N(
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY,.0
Job Address : 6071 KINGS PL L
Description: "RENEW EXPIRED PERMIT X2020-0201** SFR
RECEPTACLES. 345 SF
Owner: Jody Madden C,
Address : 601 Kings PI 'A
Newport Beach, CA 92663
Phone P
ss,
Applicant: Jody Madden 1399-'Mc: 1.
W=_.
Address 601 Kings PI 's W
Newport Beach,_QP42663
Phone or ers'Co s ti
arrier
1 1
T, I
Owner]Builder: Jody Mad. P0
Address 601 Kings
Newport (each, C 63
Phone
12,
Code Edition 2011J ire Sprinklers NO
Type of Construction V-B Fire Hazardf ne NO
Occupancy Groups: U,R-3 No of UnftA
Bldg Height:
No "o
Building Setbacks
Flood Zone:
Use Zone:
PROCESSED BY:
SPECIAL CONDITIONS: **RENEW EXP1REDjPgFUArT X2
rance
R THAN 3 YeXRS FROM ORIGINAL ISSUANCE DATE
AND NO A,RK6kSUNDAY AND HOLIDAYS IN ALL AREAS
OORS & DOVV R _CATE WATER HEATER, BATHROOMS) (N)
Architec SRAVESJORDAN
Address 4r"`%%WTON BLVD # 150 COSTA MESA, CA
2&2.6,
Phone: q). 33&2603
State Lic
ARM
jAdes! ner.._-,-O`�
res
OWNER -BUILDER D-ECLARA'110N
t hereby.af€irm I
tundea penalty of pejury that I am exempt from the Contractors' State License, Law, for the reason(s) indicated beloOby the checl arks) i have pieced next to the: applic�sble €tr ara(s)
(eot3on 7 31. , B siness and Professions Code; Any:city ar ��unt�A that re��i es e Permit to constr�uot, after, improve,, dernolish, car r4valr- +� stru�tur . Rr�crr Ja its isssza�ce, also r��ire� ire :�ppli ii for
this permit tca file a� s grTeci Statement that heor she isll .rased pumuantto the provisTcans of the Contrabto:s' State. Licahse, Law �� •' immending vrNth Sactisara T�it�} ilivisicrra � of e J ttsirtess �r d
Professions Code)or Est he or she is exe€4p frca li nstare and the. basis ferfhe allegory exempttcarr. Arr violation of Secti '703I �y an ti n€ fcrr psara t suf�) is the tppllzaant to a of i! Penaltyrat
not more than e hauruiretl adhere (SSW), �
I, as owner of the property, ar myemployees %vith wages as: theirsole compensation, will doL) all of Or U port%can f the VV=l and tnLtakstrUGtiir 5 raot intended at• of€ereld for sals ( ection 7044,
owness and Pro ssions brace: The.Coritractor* State License Law does not apply to an bwrw 01' proper y What t ugh employees` det ull S or improves the Oroperfy; pravidett that the
improvements is are riot intended car offered for sale. If, however, the bvil�ng or improvement is sold +it�in on.. ye . s�f crarr�pietic n, ��� aver r e the borden ofptoving that €t was not huiEt or
tmproved for the purpose of sale).
1, as cmmer of the property, am exclusively contracting with licensed Contractors to coristructt'se projec ection 7044, BL j p a Pro ssIons Pontractors' State License Law. does not
€apply to an Oaarler of property, builds or €mproves thereon, acid who contracts fbr the pro ects �ith i' nsed W'rractciP�uattt.ita Lis a�ntr�ciars' tee i avr),
€ .t t am exam lat from lic'errsure uncerthe Contractors° State License Law for the fogoydng reason;
By my signature below; I iaci�tio:xiedge that, except for my personal resld:en In which 1 most have Sided �eaaf cars year p€ or compleNon of tl IrnpCo rnenfs cavere by th€S permit, 1. annot hall)
seal a structure that l ha;re built as ark ra er L ersCdc€ if It t een constructs iEa `[ts entirely ' tcerlse tract understa that a�copy of tho': applicable w ,, ec i rs Z s✓ .the e 'n fsss and
lrtrFessaan Code a ar€ably a�pcara eeguestiTen ttai Bois Ti Is.suii d o€a th flto r�eh�ttsoleginfv. .gcso�°t°saiavr.3itt.
Signature of Property 014rreror.Authorized Awt (0 C.—
LICENSED CONTRACTOR"S DECLARATION
I here#ay affirm under perTaCty oaf pea jug tYuat l em license# under 1 ions of Chapter' '(cornm racing witotion 7, � Division 3 & t c� Business and pE ons err �t�lscense is in tact force.
anti effect. Lic:ohse Class License .No Data . antractaarvir�rsa� �F
WORKERS'COMPENSAnON DECLARATION
WARNING' FAILURE TO SECURE *RXERS' COMPENSATION COVERAGE IS. UNLAWFUL, AN e/9 S9JT AN: R TO NAL PENALTIES AND CIVIL FLNES UP, TO 0 THOUSA IDOL S('
,(�;0�� ADDITION TO THE
COST OF CO?KPENsATFtxTT, T3AMA.C,ES kS PROVIDED FOR IN SECTION 3706 OF THE Lib VOE? , IN AND
I hereby affirm arnder penalty of perjury one of th.0 following dectaraiion
a. certificate of consent toself-'Trrsur or roM tics � by. th l f Industrial fletati e. Firm r � the Labor Code, for th
performance of the erkitarl hi this permit is issued, Policy
e �
(nave dndr�t eharntai
I have and Will mairitairi workers' compensation its uran , as req. by o till Mite Lab e perfor�aat � thy; w0*Ai which 1h' perm i is �. My rkers .00mpensaVi.Ot
insurance carrier and policy ntrmber are:
V 'g rDatecytcr partier ® a
Name of Agent 9
°
iu
v
i certify that. in the ger`rsrt ia' nce of the work for ��ahicia thi p�K .i� not, g an in a rrl er s � to e SLable ra!'tl� �r � coo risatior .a �s c; l f�ar�iia, and ogre
that, if I should beoomp s.ub he Worke'rs` pens ucan ; € ns. qti Sri 370 r ode, I shalt fo vu rnpCy�those p uissxxn�:
f
Signature,ofApplicatat :. / Date � O�
I hexer s under f�ena ty et pe .0 that there as a car€struction i' .ung ag _ orrTrsrrc� of tt rc fear fitiaich this per l ' asses S Iran 3tI93, Civil Code)
n r A dress.
By trays€gdature below, C Certify to each of the foliov ng. �.
i am the property dv ei or authorized to act on th.K:: pr�aperty
I have read this appitcago land the info.m. ation I have provided' rrec�
I agree to comply With all appli l l� city acid court ordinar ces afa aTe Cawt relatin todcn orau�Tciian:
i authorize reprrr ertfatiaies of this city ar couruty ant ' 'the
i` t fied' roperty f cri ses.
Si nature of PT c�rer#� c�xYrter trE Aut�acarl� l #�� . _ r?rt er y i34�'ru s pr �rz i " A ersJ'� i � late
ACTION DATE BY � RCLA � €ON OF COMPTIANC6 :VI'TH. OD EE°7ER�L OR OF E E C3f�3L5
€ RE I1L, "I"iO1''l5 PART5t OF TtTIL40AND WAD W E
1405
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