HomeMy WebLinkAboutXR2022-1847 - Permits&�EWPORr City of Newport Beach
G Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
.x. Inspection Requests Phone: (949) 644-3255
cq4 FO%N�P newportbeachca.gov/inspections
Combination Type - SFP ELEC MECH PLUM
Work Class - Addition/Alteration
II III I I I II I II I III II I II II II COMB Permit : XR2022-1847
Plan Check
N o/: PC2022-1703
I
Inspection Area : 3
INSFEECTOR
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 : 1521 KATHLEEN LN Legal Desc : N TR 1806 BLK LOT 4
Description: REMODEL EXTG MAIN HOUSE 1569 SF/ADD STUDY AND LAUNDRY ROOMS
Owner: JERRY/CARA WEICHMAN
Address: 1521KATHLEEN
NEWPORT BEACH, CA92660
Phone:
Applicant: f9ison %�"Gk�',45 CA Q26/g
Address: q-1c, w.(dy
Phone: r{aq,-4.0-Uaq:3
Owner/Builder :
Address:
Contractor:
HAVEN DEVELOPMENT GRP INC
Address :
14271 JEFFREY RD #502
IRVINE, CA 92620
Phone:
(949)788-9227
Con State Lic:
827901
Lic Expire :
01/31/2024
Bus Lic:
BT30046360
Bus Lic Expire : 02/28/2023
Workers' Compensation Insurance
Carrier: EXEMPT
Policy No: EXEMPT
W. C. Expire:
Architect: OLSON ARCHITECTS
Address: 470 WALD IRVINE, CA 92618
Phone : (949) 450-0093
State Lic :
Engineer: EOSAKULDISSAKORN
Address : 15 STUDEBAKER
IRVINE, CA 92618
Phone: (949) 752-1612
Designer
Address
Phone:
Phone:
Code Edition :
2019
Fire Sprinklers :
YES
Construction Valuation :
$750,000.00
Type of Construction :
V-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg :
2,553
1,569
Occupancy Groups :
R-3
No of Units :
1
Alteration sq. ft. Bldg :
0
Bldg Height :
No of Stories :
2
Added/New sq. ft. Garage :
Building Setbacks :
Front: 20, Side: 6, Side: 6, Rear: 6
Flood Zone :
X
Use Zone :
R-1-6000 -
Single -Unit Residential (6000 indicates minimum
lot area)
PROCESSED BY:
SPECIAL CONDITIONS: HAULER: ROBERT'S WASTE
CMSD: SD21-0065
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 checkrnark(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
the permit to file a signed statement that he 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 licensura and the basis for the alleged exemption. Any violation of Section 70315 by any applicant fora permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500).
❑ I, As owner of the property, or my employees with wages as their sole compensation, will do f-) all of or L) 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 also, 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-Buflder 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
apply 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),
0 1 am exempt from licensura under the Contractors' State License Law for the following reason: _.,
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least ono year prior tD completion of the rmpravements covored by this permit, I cannot l_egall,
sell a structure that I have built as an owner -builder if it has not been constructed in its Dntiroty 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:httpalwww,teginfo.co.gov)calaw.html,
Signature of Property Owner or Authorized Agent _ _ Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) f Div" ion 3of the Business and Profession Code, and my license is In full force
and effect. License Class License No Date d ii "�� Contractor Signature
WORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1S100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
-1 1 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 th
jerformance 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'
ranee carrier and policy number are:
Policy Number Expiration Date
of Agent
certify tBaL inthe performance of the work for which thispermit is issued, I shall notemploy any person in any manner so as to become subject to the workers' compensation laws of Cattfomia, and agre
1, if I should become subject to t workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of AUDlicant _ Data�r1
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
oreby affirm under penalty 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).
Idler's Name Lender's Address
my signature below, I certify to each of the following: ---
I am the properly owner orauthorized to act on the property owner's behalf.
I have read this application and the information I have provided is correct.
I acre,, to comply with all applicable city and county ordinances and state laws relating to buildingconstruction. sG 77- ^�
I authorize representatives of this city or county to tified property for inspection purposes.
naluro of Properant the a en
y Owner or Authorzed Agent Print Property Owner's or Authorized Agent's Name Dar, Sr 3a
TION DATE BY I DECLARATION'. OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
?. REGULATION5 PART 61 DFTITLE 40 AND AQNID RULE
PEK1,111 EXPIRED
PE RA-1 t0
I SUBMITTED ASBESTOS
PCPIIVIv ANAL ASBESTOS NO] 1FICA'I'ION 15 NOT APPLICABLE To
OCLLFA,4CY OF I0.111r 1 PROPOSED DEUiOLITIgN
OCLGfA,dCy155UC-J 1 I SkGNATn RE: i�Y