HomeMy WebLinkAboutXR2023-2758 - PermitsQ ��W PORT City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit XR2U23-2758
e Community Development Department - Building Division X R 2 0 2 3 2 7 5 8
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No
G 2 Permit Counter Phone: (949) 718-1888 Issued Date : 10102/2023
.sue newportbeachca.gov/civic Final Date:
cqG/FORN�P Combination Type - SFP PLUM Permit Status: Issued
Work Class - Alteration 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: 218 DRIFTWOOD RD Legal Desc : N TR 1116 BLK LOT 19
Description: SFR PEX REPIPE, DRYWALL REPAIR AS NEEDED
Owner: JOHN HEFFERNAN
Address : 5100 BIRCH ST STE200
NEWPORT BEACH, CA 92660
Phone: (949)502-2345
Applicant: JOHN HEFFERNAN
Address: 5100 BIRCH ST STE200
NEWPORT BEACH, CA 92660
Phone : (949) 502-2345
owner/Builder: JOHN HEFFERNAN
Address: 5100 BIRCH ST STE200
NEWPORT BEACH, CA 92660
Phone : (949) 502-2345
Contractor
Address :
Phone:
Con State Lic
Lic Expire
Bus Lic:
Bus Lic Expire
Workers' Compensation Insurance
Carrier :
Policy No:
W. C. Expire:
Architect
Address
Phone:
State Lic
Engineer
Address
Phone:
Designer:
Address
Phone:
G A. 's
Ji di..y0 LE CCTC,rb t
Code Edition : 2022
Fire Sprinklers :
NO
Construction Valuation :
Type of Construction : V-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg
Occupancy Groups : U,R-3
No of Units :
1
Alteration sq. ft. Bldg :
Bldg Height :
No of Stories :
2
Added/New sq. ft. Garage
TOTAL sq. ft. :
Building Setbacks : Front: 30, 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: O/B AUTH SCANNED
$12,000.00
0
0
0
{ 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 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
:he 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 licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fore permit subjects the applicant to a civil ponalty of
Tot more than five hundred dollars ($500).
1 I, as owner of the property, or my employees with wages as their sole compensation, will do L), all of or U portions of the work, and the structure is notintended or offered for sale (Section 7044,
3USIrIOSS 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
Mants arenot intended or oReretl for sale. If, however, the building or improvement Is sold within ono year of completion, the Owner-Builtler will have the buMan of proving that €t was not builf or
r the purpose of sale).
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
n 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),
exempt from licensure 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 one year prior to completion of the improvements Gov red by this permit, I cannot legally
sell a structure that I have built as an owner-huilder it has not open constructed in Its entirety by licensed contractors. I understand that a copy of the. applicable law. Secti n 7044 of the BUsi GEE and
Professions Code, is available upon request whe Is a ice Is ub Itted or at the following Web site:http:llw .leginfo.ca.govlcalaw.html. r O
Signature of Property Owner or Authorized A t _ a l
LICENSED CONTRACTOR'S DEC
I hereby affirm under penalty of perjury Thai I am Icense un ter provisions of Chapter 9 (commencing 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
COMPENSATION DECLARATION
NA49Igr.; 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 ($100,0001, IN ADDITION TO THE
CCJT OF CC MPENSA'ION, DAMAGES AS PROVIDED FOR IN SECTION STDs OF THE LABOR CODE, INTEREST, ANO ATTORNEYB FEES.
hereby affirm under penalty of perjury one of the following declarations:
I 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, forth
perfurni o1 the work br which this permit is issued. Policy No.
have and will main In workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permitis issued. My workers'
rand carrier and poll number are:
Policy Number
Date
Agent _ _ _ Phone
y,(lhat, in it,u p9eormance 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 worke ' compensation laws of Callfomia. and agre
Id be\ol subject to the worker ' om a salion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
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r oiAZ,A __._ ... m.._--- TYM1. AI l��Il1Al(^_�!`r\M CYCIif` If4h1 CIJRIrJ A _CAIr^V 1.
areby affirm under penalty of perjuryihat her Is a construction landing agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
order's Nama Lenders 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 crtand County ordinances and state laws relating to building construction. /
I authorize representatives of this city or punt o ter 1 o a Tavo-Identified property for inspection purposes.-\\a7h/fl/ [ -nahim of Prooery Owner or Authorized A Print Prooerty Owners or Authorized ADent's N &'
ACTION I DATE. k BYu I DECLARATIONOF REG LILATIONS PAROMPLIANCE WITH CODEOF b1 OF TITLE 40 AND ACIMD RULERi�t i FOR OFFICE USE ONLY
PERMIT EXPIREO tJ I SURMI7TED A5RESTOS NOTIFICATION TO _
PERMIT g4NCELLED� �� i EPA
PERMIT EXTENDED { MO
PERMIT F7NAL_lvtZ� �%� 9EST' NOTIFICA'I'{ON IS POT APPLICABLE TO
OCCUPANCYCERFFiCATE ISSUEA I `,tl` SIGN 0 R {7EMOt�h V
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