HomeMy WebLinkAboutXR2023-2341 - PermitsPO,PT
City of Newport Beach
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COMB Permit XR2U23-2341
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Community Development Department- Building Division
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Plan Check No : PC2023-2049
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100 Civic Center Drive, Newport Beach, CA 92660
08/23/2023
Permit Counter Phone: (949) 71 B-1888
Issued Date :
newportbeachca.gov/civic
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Final Date:
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Combination Type - SFP ELEC MECH PLUM
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Permit Status: Issued
Work Class - Alteration
Inspection Area : 6
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 : 619 JASMINE AVE Legal Desc : A TR CORONA DEL MAR BLK 63B LOT 19
Description: SFR REMODEL KITCHEN AND REPLACE (E) WALL WITH BEAM. 150 SF
Owner: CHUCK EBNER
Address : 619 JASMINE AVE
CORONA DEL MAR, CA 92625
Phone: (949) 31 D-0556
Applicant: CHUCK EBNER
Address: 619 JASMINE AVE
CORONA DEL MAR, CA 92625
Phone: (949)310-0556
Owner/Builder: CHUCK EBNER
Address : 619 JASMINE AVE
CORONA DEL MAR, CA 92625
Phone: (949)310-0556
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: PETER STEPHEN B
Address: 1519 CALLE VALLE
SAN CLEMENTE, CA 92672
Phone: (949)492-3735
Designer: CHUCK EBNER
Address : 619 JASMINE AVE
CORONA DEL MAR, CA 92625
Phone: (949)310-0556
Code Edition :
2022
Fire Sprinklers : NO
Construction Valuation : $25,000.00
Added/New/Tl sq. ft. Bldg 0 :
Type of Construction :
V-B
Fire Hazard Zone : NO
1
Alteration sq. ft. Bldg : 150
Occupancy Groups :
U,R-3
No of Units :
No of Stories : 2
Added/New sq. ft. Garage: 0
Bldg Height :
TOTAL sq. ft. 0
Building Setbacks :
Front: 20, Side: 3, Side: 3, Rear: 5
' ,
Flood Zone :
X
R-2-Two-Unit Residential
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NO CONSTRUCTION WORK
Use Zone:
PROCESSED BY:
SPECIAL CONDITIONS: HIGH DENSITY ZONE ON SATURDAYS
I hereby Arm under penalty of perjury that G am exempt from the Contractors' State License Law for the reasons) 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 toils 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 fcensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora pennitSubjects the applicant to a Civil penalty of
not more than five hundred dollars ($500),
Ell, as owner of the property., or my employees with wages as their sote 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 properly, 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
im roved for the purpose of sale).
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
a�lply 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),
LJ I am exempt from licensure under the Contractors' Stale License Law for the following reason: ------ __.____
By my siggnalur0 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 tcannot Iega11,
sell a structure that I have built as an owner builder if It has no been constr tad 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 IN a ti n i;suaigniled or at the following Web site;http:li w ,leginfo ca govlcalaw,html.
Signature of Properly Owner or Authorized Rgent 4� _ DateZ ZOz S
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penally 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
LNORKERS' COMPENSATION DECLARATION
NARNING: FAILURE 70 SECURE WORMERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (f100,000), IN ADDITION TO THE
COST OP COMPENSATION, DAMAGES AS PROVIDED FORM SECTION 37N OF THE LABOR CODE, INTEREST, AND ATTORNEY'; FEES.
hereby affirm under penalty of perjury one of the following declarations:
-11 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
3erforma rice 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 whichthis permit is Issued. My workers'
ranee carrier and policy number are:
ier Policy Number Expiration Date
of Agent
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 agre
if I should become so works y;�rv�pmpensatlon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /
Tature of Appiicanl „_ T =�`" Date
]LARATION RFGAR❑i NO CONSTRI. IrTI nN I Guns Mr Aa=ury
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)..
ender's Name Lender's 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 cou Word' arias and state laws relating to building construction.
I authorize representatives m biis city or count to e YQy fentified property for inspection purposes. 1� ��
ignature of Pi :: r Owner or Authorized Agent -. Print Property O
Owner's or Authorized Aaent`s Name � petet� V__ 1%
JATd I BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FCR OFFICE USE ONLY
REGULATIONS PART al OF TITLF40 AND AQMD RULE.
SUBMITTED
PERMIT EXTENDED I 4M D
........_ _. __-....... _. _ = _
PERMIT FlNAC / ASBESTOS NOTIFICATION 6 NOT APPLICABLE TO
CERTIFICATE Of ,/ill PROPOSED DEMOLITION
OCCUPANCYlSSUtD �/¢1961 /�" vn..Ti tor.