HomeMy WebLinkAboutXR2023-1932 - PermitsaeWPo�r City of Newport Beach II III I I I II I IIII IIIII IIIIIIII III I II COMB Permit : XR2O23-1932
Community Development Department -Building Division X R 2 0 2 3 1 9 3 2
F r• �' 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No
Permit Counter Phone: (949) 718-1888 Issued Date : 07/17/2023
newportbeachca.gov/civic Final Date:
C9[/co PN�P Combination Type - SFP Permit Status: Issued
Work Class - Other Inspection Area : 8
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: 301 EVENING STAR LN Legal Desc : N TR 4224 BILK LOT 141 I i !i � pL�.`'� TCR
Description: SFR YARD DRAINAGE 'CTY STD
Owner: MAMEY JERRI LYNN TR
Contractor: HQ REMODELING & DESIGN
Architect
Address : 301 EVENING CANYON RD
Address : 9114 ADAMS AV STE 574
Address
CORONA DEL MAR, CA 92625
HUNTINGTON BEACH, CA 92646
Phone :
Phone : (415) 770-5732
Phone
Con State Lic : 1041842
State Lic
Lic Expire : 07/31/2024
Applicant: HQ REMODELING & DESIGN
Bus Lic: BT30OB1609
Engineer:
Address : 9114 ADAMS AV STE 574
Bus Lic Expire : 05/31/2024
Address
HUNTINGTON BEACH, CA 92646
Phone: (415) 770-5732
Workers' Compensation Insurance
Phone:
Carrier: STATE COMPENSATION INSURANCE FUND
Owner/Builder :
Policy No : 9276323
Designer
Address :
W. C. Expire : 5/19/2024
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 : 0
Occupancy Groups : U
No of Units : 0
Alteration sq. ft. Bldg :
Bldg Height:
No of Stories : 0
Added/New sq. ft. Garage : 0
TOTAL sq. ft. 0
Building Setbacks : Front: 10, Side: 6, Side: 6, Rear: 6
Flood Zone : AE, 8 FT; X
Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area)
PROCESSED BY: (_
SPECIAL CONDITIONS
OWNER -BUILDER DECLARATION
( hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reasons} indicated below by the checkmark{s) I have placed next to the applicable fteri
(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 et)piicant far
the permit to file a signed statement That he or she is licensed pursuant to the provisions of the Contractors' Stole License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and '..
Professions 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
not more than five hundred dollars ($500).
0 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,
Business 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
improvements 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
Improved for the purpose of sale)_
❑ 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
app€y 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),
I am exempt from licensure under the Contractors' State License Law for the following reason.
By my signature below t 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
sell a structure that I have built as an owner -builder it 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
Professions Code, is available upon request when this application is submitted or at the following Web site:http:liwww.leginfo.ca.govlcalow.html.
Signature of Property Owner or Authorized Agent � Y____ Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with S ciio 70 ) If Iv' ion 3 of the Busine and Professions ode, and my license is In full force
and effect. License Class License No ate, Contractor nature
WORKERS' COt,47ENSATION DECLARATION
WARNING: FAILURE TC "FP IRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLDVER TO CRIMINAL PENALTIES AND CIVILFINES UP TO ONE HUNDRED THOUSAND DOLLAR SiOgWej, IN ADDITION TO THE
OGST OF CJMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, ANDATTORNEYS FEES.
II kereby &(firm undo, penalty of perjury one of the following declarations:
D I have and will maintain a certilicate 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 the
performance of the work for which this permit Is issued. Policy No.
�4ve and will mamtOrl workerscompensation 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
rance carrier and policy number are:
ter Policy Number Expiration Date
to of Agent Phone #
Lertlf, that, in Ire od,rormasi 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 agree
1f I should beLcme tublect to It Drkers compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. j
Iufu e W ATIP ,'f' .___......._.
hereby affirm under penalty of perjury that there is 6` �struction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code)
enders Name _ Lender's Address
Iy 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 out dinances and state laws relating to building construction.
I authorize representatives of this cit or ounty to ente be identified property for inspection purposes. ih.11_ i1-�1
signature of Property Owner or Authori Agent Print Property Owner s or Authorized, A ent's.N ie.
4CTION GATE BY I DECLARATION O MPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 6'3 OF TITLE 40 AND AQNID RULE
1403
PERMITEXP/RED I I I I. -I I SUBMITTED A58ESTOS NOT]
PERMITEXTENDED I L_IAQMD
PERM17 FINAL L.IASBESI O5 NOT IFICA[ION 15 NOT APPLICABLE TO
CERTIFICATE OF PROPOSED DEMOLITION
OCCUPANCY ISSUED I SIGNATURE: _