HomeMy WebLinkAboutX2018-1761 - Permits�EWPORr City of Newport Beach IIIIIIIIIIII II
p ; 6 Community Development Department -Building Division X 2 8 -
Fygr 100 Civic Center Drive, Newport Beach, CA 92660
J, ,z Permit Counter Phone: (949) 718-1888
newportbeachce.gov/civic .p\�
oaµ`P Combination Type - SFP G??r
Work Class - Alteration �����
PERMITS EXPIRE 180 DAYS AFTER ISSUAN OR LAST VAII��qq�1 PECT
NO CONSTRUCTION RELATED NOISE ON S RDAY OR SUNDAiriN HIGbkO�
Job Address : 3 HARBOR POINTE
Description : SFR REMODEL (2) i
Owner: LACKNERTHOMA
Address : 3 R DF
CORONA D AR, C,
Phone: n�.
Applicant:
Address
c
Phone
Owner/Buil
Address :
Phone
Code Edition :
Type of Construction
Occupancy Groups:
Bldg Height :
Building Setbacks
Flood Zone
Use Zone :
PROCESSED BY:
"Permit
ermit : X2018-1761
No : 1364-2018
711012018
T NO LATER THAN 3 YEARS`
AREAS AND NO WORK ON S
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c R 10625 BLK LOT 4 �'✓
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tractor.:a �l Arch
i/dress010 ale Addp
`. Phone
on State LFc
Lic Expipa :
�OOMAS Bus Uc :
POI DRV Bus Lic Expire
DE A A 92625 ...
Workers' Compensation Insurance
Card r
e
Poli
W. ire:
„'ryjr Sprinkle
V- �0 Fire Haze Zone : N
U,R- - No of its:
No Sforie 2
Front:20, Sift,t6,Xce: 6,
R-1-6000 -
SPECIAL CONDITIONS:
minimum lot area)
E weer
\�/4,ddress
i
Phone
Designer
Address
Phone:
NAL ISSUANCE DATE
HOLIDAYS IN ALL AREAS
Construction Valuation :
Added/New/Ti sq. ft. Bldg : 0
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage: 0
TOTAL sq. ft. : 0
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I hereby affirm under penalty of perjury that I. am exempt from the Contractors' State License Law for the reason(s) ind ad below b e checkmark(s) I have placed next to the applicable item(sj
(Section 7031.5. Business and Professions Code: Any city or county that requires a permit to Construct, alter, improve motish, or repair AV structure, prior to its issuance, also requires the applicant for
the permit to Pilo a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State ' nse Law (Chapter (c mencing 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 viola' of Section 7031.5 bi\y a Nalicent for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all o L) portions of the rk, and the sir to is not Intended or offered for sale (Section 7044,
Business and Professions Coda: The Contractors' Slate License Law does not apply to an owner of party w4i4,;d)nrough vbbyees' or pe net elf` , builds or improves the property, provided that the
improvements are not Intended or offered for sale. If, however, the building or Improvement is so ilhln cl r of gorlion, the O r-Builder will ave the burden of proving that It was not built or
improved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to co rust lhg p l {Seep 7044, Bustins and Professions Code: a Contractors' Stale License Law does not
apply to an owner of property who builds or Improves thereon, and who contracts for I projects ,A'6 a lice0.r>$@Confractor p uant to the Contractors' State arse Law).
El am exempt final licensure under the Contractors' Slate License Law for the owing reason _ 5,fv.,, _.._. --- — -----
By my signature below I acknowledge that, except for my personal residence i h'Ich I must Ilav0 resfor at lea ae year prior to completion of the improvem is covered by this permit, I cannot legally
sell a structure that I have built as an owner-buJtlor if It has not been cons tad in Its an' oty oy Ilconsad contrt'ers. I understand that a copy of the applicable law, action 7044 of the Business and
Professions Coda, is available upon request when This application is s Itted or at t1 ollawl 'Neb site;I;i,": v+.leginfo.ca,govIcelaw.html.
Signature of Property Owner or Authorized Agent _ l___
LICENSED CONTRACTOR'S DECLARATION..,
I hereby affirm under penalty of perjury that I am IIcensed u r prpvisioni3" Chapter enQIN„ 4th Section 7000) of Division 3 of the Bus Professions Code, rid my license is in full force
and effect. License Class Licens t� �'.. .z�ate Coptra r i nature
WORKERS" COMPENSATION DECLARATI Ps3A�5Gi,
WARNING: FAILURE TO SECURE WORKERS
COMPENSAT COVERAGE 1 NLAWFUL Arf�'H CT AN EMP R RIM L PENALTIES AND CIV TOE HUNOREO THO ANDVOL Si 06,0001, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED F SECTION 37 F THE L O iN r AND AT EY,flF
I hereby affirm under penalty of perjury o f Inc follovi dacla lionsI' a?r r'>xSr"
❑ I have and will maintain a Cork ae Of Cons t0 self Ins- ,Wp ers' enmpe t issl' V the. DifeGiO ♦ '.la RP.latfons as prOV d to tly e n 3700 of the Labor Code, for th
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parformanco of the work for �mhi is permit s'uod. Pf 7" — —! '�": , P
❑I have and will maintai rksrS' censahon in ante, s quired bythe Labor Co . fo e rf`arlggnce of the we for \Y}�R[1 lhi ermit is issued. My workers` compensator
insurance carrier and poll numb,,�r,,. ; `' ", \'v_ SR
.Carrier 4-` - Poi 7ulnber e`, E Iratio�e
Name of Agent �`. _ _ . Phone ?i�
iShaIY centre of Applicant
ntould hep rne Su a of in ork or this p t sue I shawl not. employ person in any manner so' G beco su ct to the workers' compensation IawS of C2lffomia, and ogre
y p �p C
ignature
P ,p g ...._--� pY h Rrovisions. ..
ens, lion r on' action 3700 i r ode, I shall forthwith m I w�
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D'EC RATION EGARDIN off pe h OThaOre EN entlin a en r e I nca of thew for whi lhf rmd is Issued (Section 3097, Civil Code).
hereby affirm
Lenders Name _ _ _ .__...__.. _.-. .@. endt(1(Mdress —
By my signature below, I certify to Gap a Ilowit _
I am the property owner or authorize . 't 1 the properly owrre vl
I have read this application and the info io have pro
I agree to comply with all applicable city a �u ordl d slate WE relating t uilding str on.
authorize representatives of this city or co iko far[[ ve-Identified propert or inspe n poses.
Si nature of PropolY Owner cr Authorized Agent P nl party Owner's of Authorized Agent s Name Date
ACTION DATE By .CL ATION OF CON4PL EE'A D FEDERAL FOR OFFICE USE ONLY
1 ill ON PA$tv�4 T1F1'ITLE4 N MD RUI€.
i4 5 lVJ
PERMITEXPIRED 1j2-2o-22 ` .�}✓ 1$ I DASBEST N CATION TO
PERMIT CANCELLED
PERNAT EXTENDED LJIAO `
PERMI7 FIPIAL I ❑ASBEST05 I IFICARON 15 NOT APPLICABLE TO
CERTIFlCATE Of PROPOSFO DENIOUTION
OCCUPANCY ISSUED SIGNATURE: ---- ---