HomeMy WebLinkAboutXR2022-2994 - Permits�FW,o�I
City of Newport Beach 11111111111111111111111111111111111111111111111111111111 II
COMB Permit: XR2U22-2994
4 - y
0
Community Development Department- Building Division
X R 2 0 2 2 2 9 9 4
u,
100 Civic Center Drive, Newport Beach, CA 92660
Plan Check No : PC2022-2852
w.
Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
� IAA f � �'". !i"�^;��, r'*�
�' '!y�
Issued Date : 72/05/2022
cgtepppN`P
�, t d�
Inspection Area : 5
newportbeachca.gov/inspections
Combination Type - SFP
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 : 300 JASMINE AVE Legal Desc : A TR CORONA DEL MAR BLK 237 LOT 2 CORONA DEL MAR LOT 2 BLK 2 37(AND SWLY 10 FT LOT
4
Description : SFR BALCONY EXPANSION 21 SF'122-3226"
Owner: CDM JASMINE HOLDINGS LLC
Address: 1500 CORDOVA RD STE302
FORT LAUDERDALE, FL 33316
Phone :
Applicant:
GOETZANDREW
Address :
2855 E COAST HWY #234
CORONA DEL MAR, CA 92625
Phone:
(949)673-3152
Owner/Builder : CDM JASMINE HOLDINGS LLC
Address : 1500 CORDOVA RD STE302
FORT LAUDERDALE, FL 33316
Contractor
Address :
Phone:
Con State Lie
Lie Expire
Bus Lie:
Bus Lie Expire
Workers' Compensation Insurance
Carrier :
Policy No
W. C. Expire:
Architect:
GOETZANDREW
Address:
2855 E COAST HWY #234 CORONA DEL
MAR, CA 92625
Phone:
(949)673-3152
State Lie :
Engineer:
Address
Phone:
Designer:
Address
Phone: Phone:
Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $2,000.00
Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0
Occupancy Groups : U,R-3 No of Units : 1 Alteration sq. ft. Bldg: 21
Bldg Height : No of Stories : 2 Added/New sq. ft. Garage : 0
TOTAL sq. ft. 0
Building Setbacks : Front: 20, Side: 3, Side: 3, Rear: 5
Flood Zone : X
Use Zone : R-2 - Two -Unit Residential
PROCESSED BY: 65 NO CONSTFRUCTION NOISE
SPECIAL CONDITIONS: HIGH DENSITY ZONE
STOP W ORK: 122-3226
ON THE WEEKEND
I hereby faffirm ,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
the permit to file a signed statement that he or she is licensed pursuantto 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 licensum 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).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U 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
Impr ved for the purpose of sale).
LYJ 1, as owner of the properly, am exclusively contracting with licensed Contractors to Construct the project (Section 7044, Business and Professlons Code: The Contractors State License Law does not
ra�ply to an owner of property who builds or improves thereon, and who contracts for the projectswith a licensed Contractor pursuant to the Contractors' State License Law).
LJ I am exempt frpm licensors under the Contractors' Slate License Law for the followtng reason:
By my signature below i acknowledge that, except for my personal residence in which 1 must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall7
sell a structure that I have built as an owner -builder if ithas not been constructed in its entirely 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 a €icati n' sub "jtte or at the following Web site:http:/,' w.leg nfo.ca.govlcalaw.htmi.
Signature o€ Properly Owner or Authorized Agent 1 r Date _
LICENSED CONTRACTOR'S DECLARATION'..
I hereby affirm under penally of perjury that I am license under provisions of Ch r 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
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS" COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNOREU THOUSANO DOLLARS (St00,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0T04 OF THE LABOR CODE, INTEREST. ANDATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
111 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
performance 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
Date
to of Agent ri vl Ic rr
certify that. in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to became subject to the workers' compensation laws of California, and agre
if I should become subject to the worlkers(fperiasjaGen provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
talureofApplicant ./�'L-2_,_.v� __ .__ Date
�reby affirm'under penaltygf perjury that there Is a consicction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Ider's Name Lender's 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 city and county ordinances and slate laws re Gng to building construction.
I authorize representatives of this city or county to a the above Id Itfied r0 erty for inspection purposes, !- r
neture of "rooerw Owner or Authorized Anent ` i t __t%� Print Property Owner's or Authorized Agent's Name . is _ p (, Ne,
ACTION
PE$WT EXPIRED
P` MIT CARCEFi En.
PE MIT EXTETvPE,^
PCFMITFINAI ---
CTPTIFICATE bF
orcuPANCY ISSUED
BY D§>`�ARATOII OF COMPLIANCOL ITH CODE OF FEDERAL FOR OFFICE USE ONLY
ULATIONS PART E1 OF TITLE40AND AQMD RULE
1403
I SuBMiTTED ASBESTOS NOTIFICATION TO
EPA
S3ESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMAIITION d _<�