HomeMy WebLinkAboutX2021-2081 - Permits�EWPpRT City of Newport Beach �� III II II IIIII I III IIII IIIIIII IIIII ��
p� @ Community Development Department- Building Division X 2 0 2 1 2 0 8 1
100 Civic Center Drive, Newport Beach, CA 92660
n Permit Counter Phone: (949) 644-3288
U }s S Inspection Requests Phone: (949) 644-3255
c9(/FnpV»P newportbeachca.gov/inspections
Combination Type - SFP ELEC MECH PLUM
Work Class - Alteration
COMB Permit : X202� -20s�
Plan Check No: 1801-2021
Issued Date : 01/1712023
Inspection Area : 5
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 : 4 SURFSPRAY BLUFF
Legal Desc : N TR 16425 BLK LOT 2
Description: SFR PRIMARY BATH ALTERATION 345 SF. NEW
LIGHTING IN CLOSET, REPLACE WINDOW ON 1ST FLOOR
Owner: Leslie Eldridge
Contractor: NEILSON DAVID H CONSTR INC
Architect : WALZ JOHN ROBERT
Address : 4 Surfspray Bluff
Address : 1451 E CHAPMAN AVE
Address : 510 LARKSPUR AV CDM, CA 92625
Newport Coast, CA 92657
FULLERTON, CA 92831
Phone: (408)656-4529
Phone: (714)B12-6855
Phone: (949)836-5977
Con State Lie : 787748
State Lie :
Lie Expire : 11130/2024
Applicant: WALZ JOHN ROBERT
Bus Lie : BT30073966
Engineer:
Address : 510 LARKSPUR AV
Bus Lie Expire : 01/31/2023
Address
CDM, CA 92625
Phone: (949) 836-5977
Workers' Compensation Insurance
Phone: ;
Carrier: CALIFORNIA+INSURANCE+COMPANY >
Owner/Builder :
Policy No : 468460900113
Designer:
Address :
W. C. Expire: 12/1/2024
Address
Phone:
Phone: '
Code Edition: 2019
Fire Sprinklers : NO
Construction Valuatiut : $5b 000.to
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/TI sq. ft. Bldg : 0
Occupancy Groups : U,R-3
No of Units : 1
Alteration sq. ft. Bldg : 1,039
Bldg Height:
No of Stories : 2
Added/New sq. ft. Garage : 0
TOTAL sq. ft. 0
Building Setbacks
Flood Zone: X
Use Zone: PC - New ort Coast
PROCESSED BY:
SPECIAL CONDITIONS:
I� 1,
�� I
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the resson(s) indicated below by the checkmark(s) I have placed next to the applicable item(s)
Section 7031.5. Business and Professions Code: Arty 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
To permit to BIG a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State Licenso Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
'rofessions Code) or that he or she is exempt from licensors and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
of more than five hundred dollars ($500).
1 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure Is not intended or offered for sale (Section 7044,
iusiness 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 It was not builtor
nproved for the purposeof sale).
*1 h 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
pp€y 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).
3 1 am exempt from icensure under the Contractors' Stale 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, 1 cannot legally
oil 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
rrofessions Code, is available upon request when this application is submlited or at the following Web site:http:/Iwww.leginfo.ca.govlcalaw.html.
Idgnature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of p ury that I am licensed under previsions of Cho ter 9,(commenctng with Sectio 7000)j f Di vision 3 of the Business and P f sions ody and my�:ease is In full force
.rid effect. License Class � License .No "ZC'1`7-lit Dot l Z�-` Contractor Signatu� f&I �IJIG�/
VORKERS'COMPENSATION DECLARATION 14
rARNING; 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
OST OF CONPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3740 OF THE LA13OR CODE. INTEREST, AND ATTORNEY'$ FEES,
hereby affirm under penalty of pe j'Iry one of the following declarations:
7 ( have and V 11 mPlntaip a certificate of consent to sell -insure for workers' compensation, Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for IN
e rmance of the wog k fat which this permit is issued. Policy No.
have and will maintrin 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' compensatior
Tsurance carrier and p3iic camber are:
:arrlerkzls _) r' S� _I', _„�— Policy Number t.,USD fiSFlinL-1 C� Expiration Date �z'`�'Z-3
lame of Agent Phone #
It certify that, in the performance or 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 agrw
Tat, if I should become snub/ject to AJlkers' compensation p visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
llgnatureofApplicant. 1�' q,A +�
IFCt ARATtnN RFr` %,, 1t1C r`n 1 .TCI:CTInN l PIVMIJ AC NICV TTT
ireby affirm under GcoElty of perjv'y that there is a constfl ction lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil Code).
Idar'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 building construction.
I authorize representatives of this city or countyytd enter the abovJlter(Aed property for inspection purposes.
ACTION DATE BY DECLARATIONOF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART fit OF TITLE 40 AND AQMD ROLE
1403
PERMIT EXPIRED I LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITFINAL 1- 7-3_ , ` WASBESTOS N 1IF)CATION 15 NOT APPLICABLE TO
CERTIFICATE OF PROPOSEODE _ LRiQN�- �
OCCUPANCYIS5UEO SIGNATUR fit, fn.