HomeMy WebLinkAboutXR2023-1843 - Permits��EWPORT City of Newport Beach
D @ Community Development Department- Building Divisior
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 718-1888
u fie,. newportbeachca.gov/civic
C9[/FO R��P Combination Type - SFP
Work Class - Other
COMB Permit : XR2023-1843
Plan Check No: PC2023-0693
Issued Date : 07/07/2023
Final Date:
Permit Status: Issued
Inspection Area : 4
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 : 1013 GRANVILLE DR Legal Desc : N TR 14839 BLK LOT 2 UN HOLD
Description: DELTA 4 REVISION & ADD'L SCOPE FOR (N) SLAB AT DINING ROOM 200 SF
Owner:
CLARKE JAMES A TR
Address :
127 HARBOR ISLAND RD
NEWPORT BEACH, CA 92660
Phone :
(619) 318-0900
Applicant :
EBTA ARCHITECTS
Address :
22 CORPORATE PARK, 200
IRVINE, CA 92606
Phone:
(949)293-9990
Owner/Builder :
Address
Phone:
Contractor
Address :
Phone:
Con State Lie
Lie Expire
Bus Lie:
Bus Lie Expire
Workers' Compensation Insurance
Carrier :
Policy No:
W. C. Expire:
Architect: TAJUDIN AMAT K
Address : 22 Corporate Park, 200 IRVINE, CA 92606
Phone: (949)955-3282
State Lie
Engineer
Address
Phone :
Designer:
Address:
Phone:
Code Edition :
2022
Fire Sprinklers : NO
Construction Valuation : $15,000.00
Type of Construction :
V-B
Fire Hazard Zone : NO
Added/New/Ti sq. ft. Bldg : 0
Occupancy Groups :
U,R-3
No of Units : 2
Alteration sq. ft. Bldg :
Bldg Height:
No of Stories : 2
Added/New sq. ft. Garage: 0
TOTAL sq. ft.: 0
Building Setbacks :
Front: 3, Front: 15
- - -
Flood Zone:
X
Use Zone:
RM - Multiple Residential
PROCESSED BY:
SPECIAL CONDITIONS:
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
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 licensure 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 penally 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 L) all of or L) 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 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 bunt 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' Stale License Law does not
��5pp y 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 am exempt from licensure under the Conlrectors' Stale License Law f following re n:
By my signature below I acknowledge that, except for my personal r e in c m esmd or at teat one year prior to completion of the improvements covered by this permit, I cannot iegail!
sell a structure that I have built as an owner -builder if it. has not on uc its lice o ntr ors. I understand that a copy of the applicable law, Section 704A of o Bus' oss and
Professions Code., is available upon request when this app' do m r I'. 1 Ite; ahwww.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLAIl
I hereby affirm under penally of perjury that I am cen under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my 1 cone is in full force
and effect. License Class License No Date Contractor Signature
COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORXERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (ETOD,DSDi.1N ADDTTION TO THE
'.DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3709 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES
herebyaffirm under penalty of perjury one of the following declarations:
3 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 lh
erformance 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 which this permit is issued. My workers`
rance carder and policy number are:
Policy Number Expiration Date
}e of Agent
certify that, in the performance
if I should become subiecLW
of Applicant
hereby affirm undre—Den. wof perjury that there is a Lr
onder's Name /
iy my sigrelure below, I certify to each of the following
I am the property owner of authorized to act on the
I hav-I read this application and the information I ha
I aome to comply with all applicable city and co
I authorize reprosen.atives of this city or courtly M
ACT'CN I DATE
PEdNn T EXPIRED
PERMIT CANCELLED
PERMI
T ��� � �
CERTIFICATE
CATE OF
OCCUPANCYISSUED
t ,OGIsd, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
IPons of Section 3700 of the Labor Code. I shall forthwith comply with those provisions.
Date_` _ ±
ICY o
lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Cod
Lender's Address
behalf.
g to building construction.
for inspection purposes.
DE LARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
1403
1 SUBMITTED ASBESTOS NOTIFICATION TO
-44
NamesZJ
�l Ltl/I/tL
Z
0
W
d
U)
Z
J
U
W
d
U)
LL
0
0-
W
2
Q
w
m
F—
o
0-
W
Z
LL
0
H
U
NM
Cl)
ui
p
N
LO
O
OD
N cc
M
C
M
x Q
O
O '
Q
p
a)
N
C
ca
co
QZO
a) p c Cm
O O
m
a
U°
O O U a
7 E
a
Qw-°
i 0a) a) Fa
o -
m[r
a
o c >
c
C�
w
W
(D
Z
a) °> 0 0 aCD
m
°
LU
x cn CL
°
W
o .S x a) a) LO
.N N ° x E
a O
N� a
00
m c
X O N. V
O �p U
Z a) C.O
U"
a) O a)
tN C 'y R C N 06
L N
Q C
O ❑ 1
m co
XO
,C
L
N N O
a) N a c
°- Ed' EN �M
a x -
E
a)
U
Y Q O O U L
E
0
L
O � � 00 Na UMNa
�_ a
a
U
C
O
_ N c O O U
a) w a)
'C X
coCL
a)
m
N
O1 Cfl 0 m a) m CN
��M
E C
a) QQ
N
L
r
N
.0 ,CN C(n
3 E_ 3 N m QUNa'N
w
o f
cwa
°
m
3 Co M x o ��v
c Qo
Co E
O
N
vO U '00 4'S �, U) Z � L<7
C OL
N
c
Z
�
O O F- N a) .r Q
°
N a7 -O Q
r- m acn a)ro vEc
o
O
O a ca M fn U to N
a � C 'O
a)>
N
C
E
a) ... y C N i
Ca
�o
c m (D o C
L
0
mm.
C.
W
cU
u)c ao3
�-M
3ur 3
Z
L
ma °a ° o m�M
3 a NNL
3 �c
0
H
v�Q
�QW
v,
oCD Lm �°
a� -0 $2 .oL�
- co 0
CL
°
U
W
m
O ca N O N a)(n�
�a� n-
w
O
Y
W
uj
d
a) L S c=
c E X
(n
3 a) O M
Cc
•p` H
Z
co
Q�
r
O fa .0 N C C ° M M
N 7 C Cl)
U
U
- Ca
O
3
O
I—
LLJ>
.O C L C „)e N
C
a N
wZ
OUO
�N
`O� n�� OWONLOO
La a)
a)
-2 �f- E
�Od
a¢a
)m vaN)=
0 Am �aa
-a¢Un
11
m
co rnU
� o
O
N IN
N LL
_- IN
N
vo W
�U
0
O r U
U O CdN
a) Mm0)
Q O M
EnNNN
comoo
ZNm,
C o 6 w
No o ❑
N Q
0OO (`)
oO
z f1j Q
c0ZU
orOZ
rn C) <
Ua
ILUw
Y
LL H w H p
a) U W W
>0L)
a)mUU
UJUUQ