HomeMy WebLinkAboutXR2023-1077 - Permits (2)"EWRjar
City of Newport Beach
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Community Development Department- Building Division
1
100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
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newportbeachca.gov/inspections
Combination Type - SFP
Work Class - Alteration
111I��III��111111111111111111111111111111111111111111111 JillCOMB Permit: XR2023-1077
Plan Check No : PC2023-0960
Issued Date : 04/26/2023
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 636 LOT 19
Description: SFR REPLACE DAMAGED DRYWALL/INSULATION; REROOF T/O COMP REPLACE WITH METAL ROOF 3.8 SQ (ESR 2385); T/O ROLLED ASPHALT ON FLAT
ROOF REPLACE WITH ROLLED ASPHALT 7 SQ
Owner: EBNER CHARLES K TR EBNER LIVING TR
Contractor :
Architect ;
EBNER
Address : 619 JASMINE AVE
Address :
Address
CORONA DEL MAR, CA 92625
Phone: (949)310-0556
Phone:
Phone:
Con State Lie :
State Lie
Lie Expire
Applicant: EBNER CHARLES K TR EBNER LIVING TR
Bus Lie
Engineer:
EBNER
Address : 619 JASMINE AVE
Bus Lie Expire :
Address
CORONA DEL MAR, CA 92625
Phone : (949) 310-0556
Workers' Compensation
Insurance
Phone
Carrier :
Owner/Builder : EBNER CHARLES K TR EBNER LIVING TR
Policy No :
Designer
EBNER
Address : 619 JASMINE AVE
W. C. Expire:
Address
CORONA DEL MAR, CA 92625
Phone: (949)310-0556
Phone:
Code Edition : 2022
Fire Sprinklers :
NO
Construction Valuation
Type of Construction : V-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg
Occupancy Groups : U,R-3
No of Units :
1
Alteration sq. ft. Bldg :
Bldg Height:
No of Stories :
2
Added/New sq. ft. Garage
TOTAL sq. ft. :
Building Setbacks : Front: 20, Side: 3, Side: 3, Rear: 5
Flood Zone : X
Use Zone : R-2 - Two -Unit Residential
PROCESSED BY:
SPECIAL CONDITIONS:
NO CONSTRUCTION NOISE
ON THE WEEKEND
$24,700.00
0
0
0
I hereby afi'mn under penalty of perjury that I am exempt frorn the Contractors' State License Law for the reason(s) indicated below by the checkmarkjs) I have placed next to the applicableiterl
(Section 7031-5, Business and Professions Code; Any city or county that requires a permit to construe€. alter, improve, demolish, or repair any structure, poor 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 Iicensure 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),
El 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended proffered 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
im roved 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).
El 1 am exempt from Iicensure 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 readied for at least one year prior to completion of the Improvements covered by this permit, I cannot legal],
sell a structure that I have built as an ownar-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 whe(� thi—s p td Is submitted or at the following Web s]te:http:/iWnw.leginfo.ca.gov/caiaw.html.
Signature of Property Owner or Authorized Agent yJ--� Date Zia AOa�- ZD z 3
LICENSED CONTRACTOR'S ❑ECLARATI N
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
COMPENSATION DECLARATION
1ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUMORED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LAeOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm unde, pzr,alty of perjury one of the following declarations:
I have 3nd 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
ormenre of the wor¢ for which this pernldt is issued. Policy No.
Gave 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' compensa
irons carrier and policy number are:
Policy Number Expiration Dale
C Agent Phone M
certify (hat, in she 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 would become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
igaalJre �f Applicant.,__,___ Date_ _
IECLARA:nON RIE?4RDING CONSTRUCTIGN LENDING AGENCY
hereby affirm under penally 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).
enc:e:'; 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 infomiallon 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 9,rTaVft"bcve-identified property for inspection purposes. -
of
or
ACTION I DATE BY ECLARATION OF
PARTCOMPLIANCE
WITH 40 AND OFQNLD FEDERAL I FOR OFFICE USE ONLY
PERMi7CANCEUED
PER+b41T UTEWdo
WWII- FMlAL
CERT0CAr'E OF
OCCUPANCYISSUEO
ASBESTOS NOTI FICATION TO
NOT RCASION 15 NOT APPLICABLE TO
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