HomeMy WebLinkAboutXR2023-0828 - Permitso�ae Po" City of Newport Beach
A' Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
u T Inspection Requests Phone: (949) 644-3255
c9[�FOaN�P newportbeachca.gov/inspections
Combination Type - SFP
Work Class - Other
11111111111111111111111111111111111111111111111111111111111COMB Permit: XR2023-0828
Plan Check No: 0651-2022
Issued Date : 03/29/2023
Inspection Area : 2
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 : 207 CRYSTAL AVE Legal Desc : A TR BALBOA ISLAND SEC 5 BILK 6 LOT 25
Description: SFR CONSTRUCT U X 170LF BLOCK WALL @ P/L PER CITY STANDARD PLANS **DETAIL 3A & 3B FTG** PERMANENT MARKERS ONSITE. (X2022-0724)
Owner: DOUGLAS KERSTNER
Address : 207 CRYSTAL AVE
NEWPORT BEACH, CA 92662
Phone: (949)212-0316
Applicant: THE POOL CONNECTION INC
Address : 7740 E DOHENY CT
ANAHEIM, CA 92808
Phone: (714)401-9930
owner/Builder:
Address :
Contractor:
THE POOL CONNECTION INC
Architect
Address :
7740 E DOHENY CT
Address
ANAHEIM, CA 92808
Phone:
(714)401-9930
Phone:
Con State Lie
: 1062685
State Lie
Lie Expire :
01131/2024
Bus Lie:
BT30078754
Engineer:
Bus Lie Expire : 05/31/2023
Address
Workers' Compensation Insurance Phone
Carrier: STATE COMPENSATION INSURANCE FUND
Policy No: 9269572 Designer
W. C. Expire: 2/10/2024 Address
Phone
Phone:
Code Edition : 2022
Fire Sprinklers :
NO
Construction Valuation
Added/New/Ti sq. ft. Bldg
Type of Construction : V-B
Fire Hazard Zone :
NO
1
Alteration sq. ft. Bldg :
Occupancy Groups : U
No of Units :
1
Added/New sq. ft. Garage:
Bldg Height :
No of Stories :
TOTAL sq. ft. :
Building Setbacks : Front: 6, Side: 3, Side: 3, Rear: 5 NO - �—
Flood Zone X CONSTRUCTION ����_
�
Use Zone: R-BI - Two -Unit Residential, Balboa Island �ry i�t WEEKEND
'!
PROCESSED BY: _ N THEN EEKEND
SPECIAL CONDITIONS:
I
$15,000.00
0
0
0
OWNER -BUILDER DECLARATION
I hereby affirm under penally 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 ftem(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 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 lieensure and the basis for the alleged exemption. Any violation of Section 703t5 by any applicant for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500),
11 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or(-) 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 Differed 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
improved for the purpose of sale)-
0 I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 70", Business and Professions Code: The Contractors' State License Law does not
apply 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 Contractors' State License Law for the following reason:
By my signature below t 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 legall
sell 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 acpy of the. applicable law, Section 7044 of the Business and
Professions Code., is available upon request when this application is submitted or at the following Web site:http:/Iwww.leginfo.ca.gov/calaw.htmi.
of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9(commencing with Section 0) of Division 3of the Business and Profess rode, and my license is In full force
and effect. License Class License No Date q 1; Contractor Signature
WORISERS' COMIDEN£ATION DECLARATION
NARNING: FA,fLURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES OF TO ONE HUNDRED THOUSAND DOLLARS ($t00,D00J, IN ADD€IION TO THE
tog r Or LUMPENSAT,ON. DAMAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, AND ATTIERNEY'S FEES.
hereby affirm unda, penalty of perjury one of the following declarations:
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
e 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 p,licy number are:
Policy Number
� E'Al ent
Dale
certify Inat. in In,. ourfr ,rmance of the work for which this Ipermit 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
J 18aI utd become subject Ie cap rkers' Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
�alure or Apptics it _ 1 ,�
:LARATION REGAR'. IN ONSTRLIGTiON LENnINr, er,FNry Data,/ �%, 3
Ireby affirm under penaltyrof perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Ides s Name Lender's Address
my signature below. I certify to each of the following:
I am the property owner or autttorized 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 cdty and county or5oyrdesand state laws relating to building. construction.
I authorize representatives of this city or county ter hEr4Ove-ideniifled property for inspection purposes. p �,
ACTION
EXPIRED
or Authorized Agent, _ Print Propert)
DATE BY jj F COMPLIANCA E WITH CODE OF FEDERAL
REGULATIONS PART 61 OF TITLE 4n AND AgNID RULE
PERMIFEXTENDED
PER,,,ViiTFirvaL OW13/2y k i
CERTIFICATE OF
OCCUPANCYISSUED DR
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Or
FOR OFFICE USE ONLY
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