HomeMy WebLinkAboutXR2023-1862 - Permits�EwvoRT City of Newport Beach
C�, e Community Development Department - Building Division X R 2 0 2III 111111111111111111111111 1 8 2 II COMB Permit : XR2U23-1862
F 1, n 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No:
u s Permit Counter Phone: (949) 718-1888 Issued Date : 07/1012023
.ram newportbeachca.gov/civic Final Date:
F00.N�P Combination Type - SFP Permit Status: Issued
Work Class - Other 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: 4521 ORRINGTON RD
Legal Desc : N TR 3357 BLK LOT 75
Description: SFR -BLOCK WALL (INSIDE P/L) 6' HI X 9'4"
L
Owner: DE GENNARO GLORIA J TR JED FAMILY TR
Contractor :
Architect
Address : 1000 E ALESSANDRO BLVD
Address :
Address
RIVERSIDE, CA 92508
Phone: (951)323-8455
Phone:
Phone:
Con State Lic :
State Lic
Lic Expire
Applicant: DE GENNARO GLORIA J TR JED FAMILY TR
Bus Lic :
Engineer
Address : 1000 E ALESSANDRO BLVD
Bus Lic Expire :
Address
RIVERSIDE, CA 92508
Phone : (951) 323-8455
Workers' Compensation Insurance
Phone
Carrier :
Owner/Builder : DE GENNARO GLORIA J TR JED FAMILY
Policy No:
Designer:
TR
Address : 1000 E ALESSANDRO BLVD
W. C. Expire:
Address
RIVERSIDE, CA 92508
Phone: (951)323-8455
Phone:
Code Edition : 2022
Fire Sprinklers : NO
Construction Valuation :
$1,000.00
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/Ti sq. ft. Bldg :
0
Occupancy Groups : U
No of Units : 1
Alteration sq. ft. Bldg :
Bldg Height:
No of Stories : 1
Added/New sq. ft. Garage:
0
TOTAL sq. ft.
0
Building Setbacks : Front: 6, Front: 30, Side: 6, Side: 6
Flood Zone : X
Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area)
PROCESSED BY:
—--.—`
SPECIAL CONDITIONS:
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 items)
(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
lthe permit to file a signed statement that be or she is licensed pursuant to the provisions of the Contractors' State 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 licensure 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).
11 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 70",
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, binds 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
a ply\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).
2m exempt from licensure under the Contractors' State License Law for the wing reason:
By m signature below I acknowledge that, except for my person esid ce l No I st have resided for at least one year prior to completion of the improvements covered by this permit, I cannot kegall
soli structure that I have built as an owner -builder if It has not on cons ru d in i a iroty by licensed aantractors. I understand that a copy of the applicable taw, Section 7044 of the Business and
esslons Code., is available upon request when this a plies' n is sub. i. d or h. ollowing Web site:http:liwww.leginfo.ce.govkalaw.htmi. J+7_ 7 _
Signature of Property Owner or Authorized Agent _
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed and rovisions of Chapter 9 (Commending with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force
and effect. License Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: FATLURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN AODRION TO THE
COST OF COMPENSATION, DAMAGES "PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
'.❑ I have and will maintain a Certificate of consent to self insure tot workers' compensation, Issued by the Director of mdustnal Relations as provided tot by Section 3700 of the Labor Code, for thil
'.. performance o1 the work for which this permit is issued. Policy No.
Eli 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' compensatio
insurance carrier and policy number are:
Mar Policy Number Expiration Date
e of Agent Phone #
rtify that, in the performenc of the work 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 ogre
Vat
i I should m becoe subj t the worker comp ation provisions of Section 3700 of the Labor Code; I shall forthwith comply with those provisions. / �7
ure of Applicant Date--,'
DECLARATION REGARDI uIS TION LENDING AGENCY T_
I hereby affirm under pena Bury that there is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil
Lender's Name Lender's Address
By my signature below, I certify to each of the following:
I am the property owner Or authorized to act on the prope neJteac
lf.
I have read this application and the information I have rovidetl .
I agree to comply with all applicable city and county rdinances nlaws relating m building construction.
I authorize representatives of this city or county i ter the a. veied property for inspection purposes. 1' _
Signature of Pro en Owner or Authorized A ant int Property Owner's or Authorized A ot's Name Date �U
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMITEXPIRED __ __ 1 SUBMITTED ASBESTOS NOTIFICATION TO
PERAMTCANCELLED _rTEPA
PERMlT C EXTENIIEII QMD
PERMA'PINAL 1p / r1iL .II ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
CERTiflLATE OF PROPOSED DEMOLITION
OCCUPANCYISSUED SIGNATURE: ___