HomeMy WebLinkAboutU2025-0061 - Permits�EwPok>. City of Newport Beach
p Community Development Department - Building Division
l` y. 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 718-1888
newportbeachca.gov/civic
Combination Type -
Work Class - Addition/Alteration
11111111111111111111111111111111111111111111111111111111�IIJillCOMB Permit : U2025-0061
Plan Check No
Issued Date : 02/0312025
Final Date:
Permit Status: Issued
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 : 330 AMETHYST AVE Legal Desc : A TR BALBOA ISLAND SEC 3 BILK 18 LOT 15
Description: MISC - (N) BLOCK WALL 40 LF X 24" HIGH & 40" HIGH COLUMNS (4) WITHIN P/L, SITE DRAINAGE. PER CITY STANDARD *125-0414*
Owner: BRADESON FAMILY TR SURVIVORS T
Address : 330 AMETHYST AVE
NEWPORT BEACH, CA 92662
Phone :
(714) 932-6608
Applicant:
MARGARET BRADESON
Address :
330 AMETHYST AVE
NEWPORT BEACH, CA 92662
Phone:
(714)392-6608
Owner/Builder : BRADESON FAMILY TR SURVIVORS T
Address : 330 AMETHYST AVE
NEWPORT BEACH, CA 92662
Phone : (714) 932-6608
Code Edition :
Type of Construction
Occupancy Groups:
Bldg Height :
Contractor : OWNER/BUILDER
Architect
Address :
Address
Phone:
Phone:
Con State Lic : OWNER/BUILDER
State Lic
Lic Expire
Bus Lic:
Engineer
Bus Lic Expire :
Address
Workers' Compensation Insurance
Phone:
Carrier: EXEMPT
Policy No: 0000
Designer
W. C. Expire:
Address
Phone:
2022 Fire Sprinklers : NO
Construction Valuation :
$10,000.00
Fire Hazard Zone : NO
Added/New/T] sq. ft. Bldg :
0
U Fire Alarms : NO
Alteration sq. ft. Bldg :
0
No of Units :
Add/New sq. ft. Garage:
0
No of Stories :
TOTAL sq. ft.
0
No of Basement:
Building Setbacks : Front: 10, Side: 3, Side: 3, Rear: 5
Flood Zone : X
Use Zone : R-BI - Two -Unit Residential, Balboa Island
PROCESSED BY: 9
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License taw 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 ficensure 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).
❑ 1, 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 ContractorsState 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
improved 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 pmjects with a licensed Contractor pursuant to the Contractors State License Law).
❑ 1 am exempt from licensure under the Contractors' Stale License Law for the follovng reason:
By 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 legall,
sell a structure that 1 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
Professions Code, is available upon request whenrtffi p )icatsumrt or at the following Web site:http:/Lwww.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent f '� 7f� KM.I� r 1g",�L")�
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed und611rovi5ion5 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
ING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100.0001, IN ADDITION TO THE
OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
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
3rmance 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 compensa
rance Carder and policy number are:
Policy Number Expiration Date
ae of Agent Phone #
certify that, in the 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
. it I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
_ of Applicant _. _ Date____
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
�reby 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 3097
lder's Name Lenders Address
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 correct.
I agree to comply With all applicable city and county ordinances and stale laws relating to building construction.
I authorize representatives of this city or cou enter the abpve-i ntifie property for inspection purposes.
ii nature of Pro Owner or Authorized A ent 1. /- I— Print Property Owner's or Authorized Ag
ACTION DATE BY DEGLA TION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
RE TIONS PART 61 OF TITLE 40 AND AQMD RULE
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CERTIFICATE OF
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SIGNATURE:
Civil Codoi
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