HomeMy WebLinkAboutXR2022-2949 - Permits�EWPORT City of Newport Beach jai 111p1111111111111111111111111111111111111111111111111jj COMB Permit : XR2O22-2949
d Community Development Department- Building Division X R 2 0 2 2 2 9 4 9
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No
Permit Counter Phone: (949) 644-3288 Issued Date :
u r Inspection Requests Phone: (949) 644-3265
°gc�coaN'P Inspection Area : 2
newportbeachca.gov/inspections
Combination Type - MFP ELEC MECH PLUM
Work Class - Alteration
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 : 111 MARINE AVE, 1/2 Legal Desc : A TR BALBOA ISLAND SEC 4 BLK 1 LOT 8 '',QN
Description: MFR - R/R CEILING DRYWALL, EXHAUST FAN, SHOWER DOOR & DAMAGED TILE DUE TO FIRE DAMAGE
Owner: JUDYWELKER
Address : 111 MARINE AVE
NEWPORT BEACH, CA 92662
Phone
Applicant:
JUDYWELKER
Address:
111 MARINE AVE
NEWPORT BEACH, CA 92662
Phone :
Owner/Builder
: JUDY WELKER
Address:
111 MARINE AVE
NEWPORT BEACH, CA 92662
Contractor
Address :
Phone:
Con State Lic
Lic Expire
Bus Lic :
Bus Lic Expire:
Workers' Compensation Insurance
Carrier :
Policy No:
W. C. Expire:
Architec
AddrPhone
State Lic 01
Engineer
Address
Phone: INSPEU I
Designer
Address
Phone: Phone
Code Edition :
2019
Fire Sprinklers :
NO
Construction Valuation :
$20,000.00
Type of Construction :
V-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg :
0
Occupancy Groups :
U,R-3
No of Units :
2
Alteration sq. ft. Bldg :
36
Bldg Height:
No of Stories :
2
Added/New sq. ft. Garage:
0
TOTAL sq. ft.
0
Building Setbacks :
Front: 10, Side: 3, Side: 3, Rear: 5
Flood Zone :
X
Use Zone :
R-BI - Two -Unit Residential, Balboa Island
PROCESSED BY:
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penally of perjury that I am exempt from the Contractors' Slate License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable items)
ieclion 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
le permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Lew (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
rofesslons Code) or float he or she is exempt from licensum and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjacts the applicant to a Civil penalty of
of more than five hundred dollars ($500).
1, as owner of the property, or my employees with wages as their sole compensation, will do L) 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 who, through employees' or personal effort, builds or improves the properly, provided that the
nprovements are not Intended or offered for sale. ir, 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
npvoved for the purpose of sale).
5 1, 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
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).
am exempt tram licensors under the Contractors' State License Law for the following reason _
y 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, I cannot legally
i a structure that I have built as an owner-buildor if it has not been constructed'n its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of t o Business and
y
'rofessions Code, is available upon request when t s ppli at 's "mined o f Ito n Web site:http:/1www.leginto.ca.gov/calaw,btml. /mow.
signature of Property Owner or Authorized Agent _ __,_,�_�_ Da g/O �+ ems?
ACENSED CONTRACTOR'S DECLARATIO iT
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, andmy license is in full force
nd effect. License Class License No Date Contractor Signature
COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UPTO ONE HUNDRED THOUSANO DOLLARS 16100,0001, IN AOORION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370$ OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
J I have and wilt 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 Ih
erformance 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'
rance carrier and policy number are:
Policy Number
of Agent
Date
stilly that, in the performance of the work for which thispermit is issued. I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
I at df I should become subject to thh"}orrk�ters' c(rpm'pensali°ggq++d11{��i'ppprrrlppp/'{psi n f action 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant _ !/ `614 /
IECLARATtON REGA DING CONS UCTION L ING AGENCY
hereby affirm under penalty of perjury that there is onstruction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
enders Name Lenders Addeo,"
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 andthe information I have providedis 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 county to"er the pbcve-Iq"WiU0 p Ve9yy for inspection purposes. �, , ,/ _ n I D �i I 111112 1,_
Si nature of Property Owner or Authorized Age V Print Pro ert Uvrner s or Authorized .A enta Name ✓ U \ U V I I\c V Ua[e `� U �vU 41
ACTION DATE. R�-� NI bFCLARATiCi COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 51 OF TITLE 40 AND AQM D RULE
1403
PERMIT CANCELLED
_IT EXTENDED ....................._._—.___...._.
PERM
PERMIT FIMAL r�
CERTIFICATE OF
OCCUPANCY ISSUED a _
ASBESTOS NOTIFICATION TO
3ESTGS NJTi PICdrIJN IS NOT
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