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HomeMy WebLinkAboutE2023-0764 - Permits�gwcoRT City of Newport Beach IIIII�IIII II IIIIIII IIIIIIIIIII III IIIIII III III COMB Permit : E202.3-0764 r�h�1. y. 0Community0 Civic enter Drive, Newport Beach, CA 9nt Department - Building Division 26 DE 2 0 2 3 0 7 6 a Plan Check No: -'` ` ? Permit Counter Phone: (949) 718-1888 ' newportbeachca.gov/civic Issued Date : 08/29/2023 c _ P Final Date: 9�/F00.N� Combination Type - Permit Status: Expired Work Class - Simple Inspection Area : 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 : 2406 HOLIDAY RD Description : 200 amp meter panel upgrade Owner: Address Phone Applicant : Mark Steven Bright Address : 1208 E. Walnut Street Unit I Santa Ana, CA 92701 Phone: (714)801-9871 Owner/Builder : Address : Phone Code Edition : Type of Construction Occupancy Groups: Bldg Height : Building Setbacks Flood Zone: Use Zone: PROCESSED BY: SPECIAL CONDITIONS: Legal Desc : Contractor : Architect Address : Address Phone: Phone: Con State Lic : State Lic Lic Expire Bus Lic : Engineer Bus Lic Expire : Address Workers' Compensation Insurance Phone: Carrier: Policy No : Designer: W. C. Expire: Address Phone: Fire Sprinklers : NO Construction Valuation Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 No of Units : Alteration sq. ft. Bldg : No of Stories : Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 0 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the ContractorsSlate 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 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). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) 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 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 improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 am 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 covered by this permit, I cannot legall) sell a structure that I have built as an owner -builder if it has not been constructed in its entirety 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:http://www.leginfo.ca.govicalaw.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) of Division 3 of the Business and Professions Code, and my license is in full fame and effect. License Class License No Date Contractor Signature COMPENSATION DECLARATION 'ARNING: 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 ($10(1,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 07H OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 7 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 370D of the Labor Code, for IN 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 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 become subject to the workers' compensation laws of California, and , if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignalure of Applicant Dale_ IECLARATION REGARDING CONSTRUCTION LENDING AGENCY hereby 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). enders Name Lenders Address y 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 state laws relating to building construction. I authorize representatives of this city or county to enter the above -identified property for inspection purposes. ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40, AQMD RULE PERMIT EXPIRED L l I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED DEPA PERMIT EXTENDED LJAQmo PERMITFINAL CERTIFICATE OF OCCUPANCY ISSUED L A5BE5TOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION SIGNATURE: 4r' F+ coW sz x z X o v W O a d F Uo Z O W o V pNj � o a) M h+� W °' v Z Z 00 Am Q O rn E mp: N CL O w 9Z-o Z 0U� A 0) LL_ ° p 0 'j" c00 m X U O QOLLi W wAmm mo z wgoo 0LL" A a0 1—Jma :.iW O���� >0 c o LU Cl) �y rFi z LU o cri W U o y-U 0 O o y _ U J 0 co C 0 U Q a) N C U J 0 _ 9 @ 0 m C -0 N d t ° t�l1 UCL_O a) .N3 �. 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