HomeMy WebLinkAboutXR2023-2291 - Permits,zgpoR City of Newport Beach II IIIIIIIIIIIIIIIIII III IIIIIII IIII III IIIIIII II COMB Permit : XRZO23-2291
Community Development Department - Building Division x R 2 9 2 3 2 2 s 1
dam, yF 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-2002
Permit Counter Phone: (949) 718-1888 Issued Date : 0812112023
newportbeachca.
Combination Type 9 - SFP ELEC MECH PLUM
Final Date:
Permit Status: Issued
Work Class - Alteration Inspection Area : 2
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: 4 HARBOR ISLAND Legal Dose: N TR 802 BLK LOT 4 TR 802 LOT 4 ALL -INC BET SAME
Description: SFR - KITCHEN & BATHROOM REMODEL (5) 1000 SF, PEX RE -PIPE. UPGRADE SUBPANEL
Owner: FTK 2 LLC Contractor: RICK HATFIELD Architect
Address : 20409 YORBA LINDA BLVD Address : 10048 SAN PABLO CT Address:
YORBA LINDA, CA 92886 FOUNTAIN VALLEY, CA 92708
Phone: Phone: (909)851-4228 Phone:
Con State Lie : 421768 State Lie:
Lie Expire : 04/30/2024
Applicant: RICK HATFIELD Bus Lie; BT30082275 Engineer: MANNING BRUCE
Address : 10048 SAN PABLO CT Bus Lie Expire : 08/31/2024 Address : 41892 ENTERPRISE CIR. SOUTH #E
FOUNTAIN VALLEY, CA 92708 TEMECULA, CA 92590
Phone: (909) 851-4228 Workers' Compensation Insurance Phone: (951) 296-1044
Carrier: NORGUARD INS CO
Owner/Builder : Policy No: RIWC430157 Designer: RICK HATFIELD
Address : W. C. Expire : 8/2/2024 Address : 10048 SAN PABLO CT
FOUNTAIN VALLEY, CA 92708
Phone: Phone: (901851-4228
Code Edition : 2022 Fire Sprinklers : NO Constructior"i-val $180,000.00
Type of Construction : V-B Fire Hazard Zone : NO Added/New/Ti sii,, .g : 0
Occupancy Groups : U,R-3 No of Units : 1 Alteration sq. ft. Bldg 1,000
Bldg Haight: No of Stories : 2 Added/New�s.q�. ft. Gara:_ 0
TOTAL sq. {V - 0
Building Setbacks : Front: 15, Front: 15, Side: 4, Side: 4
Flood Zone : X
Use Zone : R-1 - Single -Unit Residential
PROCESSED BY:
SPECIAL CONDITIONS:
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OWNER -BUILDER DECLARATION
t hereby affirm under penalty of perjury that 1 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 tegoiros 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 his or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (Dommencmg,with Section 7000)of Division 3 of the Business and
Professions Code) or that he or she is exempt from Iicensureand 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).
El 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 Coda: 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 sole. If, however, the building or 9mprovement is sold within one year of completion.., the Owner-Buitder will have the burden of proving that it was not bultt or
mproved for thepurpose of sale).
I, as owner ofthe property, air exclusively contractingwith licensed contractors to construct the project.(Secllon 7044, Business and Professions Code: The Contractors' State License Law does not
Bp7pty to an owner of properly who builds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' Slate License Law),
J 1 Am exempt Term llcaneure 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 compla[Ion of the improvements Do.vared by this permit, Lcannol iel
sell a structure [hat I have built as an owner-bulldor 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'vi'eb sitethttp:llwww.leginfo.ca..govYcalaw.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 4 Drvl "on 3of the Business and Prof ssio MAY
I e is In full force
and effect. License Class ( License No 2(7Co Date Contractor Signature
NORKERS' COM'.PENSATION CIE
(VARNING: FAILURE TO SECURE WORKERS' COMPENSA7ION COVERAGE IS UNLAWFUL, AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS f ID0,0001, IN ADDITION TO THE
:OST OF COMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 0706OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
1 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
a>edo—rmance of the Work for which this permit is issued. Policy No.
JI ave and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this Small is issued. My :workers' compensatior
nsu once caui nof poIf n }}er are: ^� Q
me �/2 �iv !/ Policy Number Aj f vy G Y 0 `:5 / Expiration Date ® 2
r
d—a5me of Agent 14 Phone M
JI certify that in the performan of th w��iffi 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 agre
hat, if ! shDWd become su61a t the oyfi rs' pensatidn provisions of Section 3700 of the Labor Code;. I shall forthwith comply with those provisions.
3Ipnature of Applican'�
)ECLARATION RE(i'dRIiING CO 9TRUC /ON LENDING AGENCY I
hereby affirm underponalty of perjury that there is a construction fending agency for the performance of the work forwhich this permit is issued (Section 3097,. Civil Code).
_onder's Name _ _ Lender's Address
3y my signature below, Icertfy to each of the following: /',
I am the property owner or authorized to act on the property owner's behalf. &Z 1*7F/E4 t?
I have read this application and the information I have pr ded. incorrect.
I agree to comply with all applicablecity and county or encase tat al/ alatinl building cen51truc4en
I authorize representatives of thiscityor county to e the d if o propert, io;"Inspection purposes.
gnature of Property Owner or Authorized Ageht Prif-i c arty Owner's �f Aud ori�ed A one's Name Date.$ -21 2013
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ACTION DATE. By ,. DFr_LA A+rfON C P:LIANCE W114 CODE OF FEDERAL FOR OFFICE USE. ONLY
E REGULATION ART 51 OFTITLE40AND AOMD RULE
i 1403
PEAMiT EXPIRED I5PHM'TTED-15I3FST01 NO'r'RCATION TO
PERMIT CANCELLED
PEFivfiT EXTENDED R
PCRMAT FINAL .. 1 �_ ._
ESTOSNOTIFIC ON TO
CESTIFA�ArE OFOCCUPANCY SUED �%,�,� � SGNATURED-�/ LI AA/%//�/