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HomeMy WebLinkAboutXR2023-1794 - Permits�EwroRr City of Newport Beach IIIIIIIII IIIIIIII IIIIIIIIIIIIIIIIIIII II COMB Permit : XR2U23-1794 0� Community Development Department -Building Division X R 2 0 2 3 1 7 9 4 y 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2022-1951 Permit Counter Phone: (949) 718-1888 Issued Date : 0613012023 u may. newportbeachca.gov/civic Inspection Area : 8 c9�IF00.H�P Combination Type - SFP Work Class - Repair 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 : 1618 HIGHLAND DR Legal Desc : N TR 3800 BLK LOT 7 Description: DELTA 4 - ADD'L SCOPE -RE-ROOF 8 SQ COMP SHINGLE @ 2ND FL (REV2023-1250) Owner: JUSTIN MOREHEAD Address : Phone : (949) 394-4515 Applicant: DAWN VAUGHT Address : 1041 W 18TH ST, A106 COSTA MESA, CA 92627 Phone : (714) 488-8003 Owner/Builder: Address : Phone Contractor: MATTHEW MARSTON CONSTRUCTION Address : 3510 SECOND AVE NEWPORT BEACH, CA 92625 Phone: (949) 233-3280 Con State Lie : 942845 Lie Expire : 01/31/2024 Bus Lie: BT30079887 Bus Lie Expire : 10/31/2023 Workers' Compensation Insurance Carrier: NO EMPLOYEES Policy No: 9331777 W. C. Expire: 1/20/2024 Code Edition : 2022 Fire Sprinklers : NO Type of Construction : V-B Fire Hazard Zone : NO Occupancy Groups : U,R-3 No of Units : 1 Bldg Height: No of Stories : 2 Building Setbacks : Front: 20, Side: 6, Side: 6, Rear: 6 Flood Zone : X Use Zone: R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area) PROCESSED BY SPECIAL CONDITIONS: Architect Address Phone: State Lie Engineer: GHAZLANI ANDY Address : 4202 ATLANTIC AVE #204 LONG BEACH, CA 90807 Phone : (562) 253-2385 Designer: JASON RICHART Address : 1041 18TH W, A106 COSTA MESA, CA 92627 Phone : (949) 422-9191 Construction Valuation : $5,000.00 Added/New/Ti sq. ft. Bldg : 0 Alteration sq. ft. Bldg : Added/New sq. ft. Garage : 0 TOTAL sq. ft. : 0 INSPECTOR I hereby affirm under penalty 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 items) 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 to its Issuance, also requires the applicant for in 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 'rofessions Code) or that he or she is exempt from lieensure 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 of more than five hundred dollars ($500). "1 I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 nprovements 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 nproved for the purpose of sale). 1 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 poly to an owner of property who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law), I I am exempt from hcensure under the Contractors' State License Law for the following reason 1y 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 legally all 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 Business and 'rofessions Code., is available upon request when this application is submitted or at the following Web site:http:liwww.leginfo.ca.gov/calaw.btmi. lignatum of Property Owner or Authorized Agent _ __ Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that. I am licensed under provisions of Chapter 9 (commencing with Section 702of Division 3 of the Business and Professions C tie, s iy license is In full force nd effect. License Class License No Date o - 9L Contractor Signature,TV VORKERS' COMPENSATION DECLARATION `� rARNING: FAILURE TO SECURE WOR%ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E100,000), IN ADDITION TO THE OST OF COMPENSATION: DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, Me ATTORNEY's FEES. hereby affirm under penalty of perjury one of the following declarations: I 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 Seclion 3700 of the Labor Code, for th. e rmance of the work for which this permit is issued. Policy No. 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' carrier and policy number are! is of Agent certify that, in the performance of the , if I should become subject to the wo Policy Number Date 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 anon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / Signature of Applicant \ Date (� —3 U " 0X DECLARATION REGARDI STRUCTINDINO AOENCY I 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 30 , ivil Code). Lenders Name Lender's Address By 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 rect. I agree to comply with all applicable city and county ordinance Ping to building construction. I authorize representatives of this city or county to e ter th ove-idenlif' d property for inspectlon purposes. Si nature oT Pro ett Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Date ACTION DATE BY 1LtffdAfATION OF COMPLIANCE W17H CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 51 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED L.J I SUBMITTED ASBESTOS NOTI FICAVON TC PERMIT CANCELLEDOEPA FEAMiT FXTENOED __ _I- QMD PERMIT FLNALBESTOS NOihF1CATIO I5 NOT APPLICABLE TO CERTIFICATE OF !'vl Z PROPOSED DEMOLI710 OCCUPANCY I5SUED StGNATURE:V