HomeMy WebLinkAboutXR2022-2390 - Permits�EWp RTC
City of Newport Beach
Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone: (949) 718-1888
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newportbeachca.gov/civic
Combination Type - SFP ELEC MECH PLUM
Work Class - Addition/Alteration
111111111111111111111111111111111111111111111111111111111jj COMB Permit : XR2022-2390
Plan Check No : PC2022-2239
Issued Date : 07/25/2023
0, t r- R°'°e r .;"°�!`�. °�' Final Date:
iz °m. is i Permit Status: Issued
Inspection Area : 4
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 : 2200 ARALIA ST Legal Desc : N TR 4705 BLK LOT 10B
Description : SFR ADD 320 SF TO ENLARGE (E) MASTER BEDROOM. ALT 195 SF
Owner: DONALD & GAIL SLAUGHTER
Address : 2200 ARALIA ST
NEWPORT BEACH, CA 92660
Phone: (949)644-1457
Applicant: JASON BLACKMORE
Address : 600 ANTON BLVD, 11 FL
COSTA MESA, CA 92626
Phone: (949)274-6585
Owner/Builder : DONALD & GAIL SLAUGHTER
Address : 2200 ARALIA ST
NEWPORT BEACH, CA 92660
Phone : (949) 644-1457
Contractor
Address :
Phone:
Con State Lie
Lie Expire
Bus Lie:
Bus Lie Expire
Workers' Compensation Insurance
Carrier :
Policy No
W. C. Expire:
Architect
Address
Phone:
State Lie
Engineer: JAFARI MASOUD
Address: 23.ORCHARD #250
LAKE FOREST, CA 92630
Phone: (949)206-9929
Designer: JASON BLACKMORE
Address : 600 ANTON BLVD, 11 FL
COSTA MESA, CA 92626
Phone : (949) 274-6585
Code Edition :
2019
Fire Sprinklers : NO
Construction Valuation :
$90,000.00
Type of Construction :
V-B
Fire Hazard Zone : NO
Added/NewITI sq. ft. Bldg :
320
Occupancy Groups :
U,R-3
No of Units : 1
Alteration sq. ft. Bldg :
195
Bldg Height :
No of Stories : 1
Added/New sq. ft. Garage :
0
TOTAL sq. ft.
320
Building Setbacks :
Front: 10, Side: 6, Side: 6, Rear: 6
Flood Zone :
X
Use Zone :
R-1-6000000j�Siingle-Unit Residential (6000 indicates minimum lot area)
... .
PROCESSED BY:
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
t hereby alfirm under penally 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 ftem(s)
;Section 703L5, 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 licensers and the basis for the alleged exemption. Any violation of Section 7031,5 by any applicant fora 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 of 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 property, provided that the
niprovements 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).
U 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
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).
El I am exerupt from licensere 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 Businoss and
Professions Code, is available upon request when t is applicabo ' Se m or at the following Web site:http:/iWm,w.leginfo.ca.gov/calaw.btmI Signature of Property Owner or Authorized Date
LICENSED CONTRACTOR'S DECLARATION_Y abra m._.__,��.,..�.____..�..�.�,�....____
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 force
and effect. License Class License No Date Contractor Signature
COMPENSATION DECLARATION
ING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE
OF COMPENSATION, DAMAGES AS PROVIDED FOR 1N SECTION 3TO6 OF THE LABOR CODE. INTEREST, AND ATTORNEYS 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 or the Labor Code, for
'ormance 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' compersa
trance carrier and policy number are:
Policy Number
of Agent
Date
yl certify that, in the performance of the work for which this permit is issaed, I shell not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia, and agre
ial, if I should become subject to the workers' compensa Ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Iignalure of Applicant _ _u_. ___ ,�_�� .__ ._� __.__„ ... __._______�_ Date T Z S 2-3IECLARATION REGARDING CONSTRUC trL'�N�O'NG AGENCY
hereby affirm under penalty of perjury that t nstruction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
order's Name _ _ _ _ Lender's Address
Iy my signature below, 1'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 renrasematives of this city or Court to��r[�r t Identified property, for inspectlon purposes, t'v
Iienature of Prooert,, Owner or Authorzed Agent Id" / '-m� Print Prooerty Owner's or Authorized .Acent's Name
ArT'(`l" j DATE BY OE.CLWTION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE DD AND ACINID FILL F.
_ I 11103
FFR. v,;i lXFIRF"0LJI SURMITTFD ASBESTOS NOTIFICATION TO
r FRLi7 CANCFdcr1 LJCPA
........ .__ r ._.. ..._-... ...._.
PCR OYT FA'TEv('ED ❑AgN1D
PCh LHT FINAL SBESIOS NOT ITICAI ION I5 NOT APPLICABLY '1'O
(.Cr7 I ICATE OF PROPOSED {JOLTN
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