HomeMy WebLinkAboutXR2023-2227 - Permits (3)�EWPD?T City of Newport Beach ��IIIIIIIIIIIII IIII IIIIIII IIIIIIIIIIIIIIIIIIIIII �� COMB Permit : XR2O23-2227
D� Community Development Department- Building Division X R 2 0 2 3 2 2 2 7
> 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No:
Permit Counter Phone: (949) 718-1888 Issued Date : 08/14/2023
.�. newportbeachca.gov/civic Final Date:
C9�IFp AH�P Combination Type - SFP ELEC MECH PLUM Permit Status: Issued
Work Class - Alteration 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 : 636 VIA LIDO SOUD Legal Desc : N TR 907 BLK LOT 140
Description: SFR KITCHEN AND BATHROOM REMODEL 210 SF *CITY STANDARD*
Owner: JERRYZAIDEN
Address : 636 VIA LIDO SOLD
NEWPORT BEACH, CA 92663
Phone : (714) 653-5080
Applicant:
JERRYZAIDEN
Address :
636 VIA LIDO SOUD
NEWPORT BEACH, CA 92663
Phone :
(714) 653-5080
Owner/Builder: JERRYZAIDEN
Address: 636 VIA LIDO SOUD
NEWPORT BEACH, CA 92663
Phone : (714) 653-5080
Contractor
Address:
Phone:
Con State Lie
Lie Expire
Bus Lie:
Bus Lie Expire
Workers' Compensation Insurance
Carrier :
Policy No:
W. C. Expire:
Code Edition : 2022
Fire Sprinklers :
NO
Type of Construction : V-B
Fire Hazard Zone :
NO
Occupancy Groups: R-3
No of Units :
1
Bldg Height :
No of Stories :
2
Building Setbacks : Front: 1.5, Front: 10, Front: 4, Side: 3
Flood Zone: X
Use Zone: R-1 - Single -Unit Residential
PROCESSED BY: FfC/
SPECIAL CONDITIONS:
Architect :
ICI_
Address
Phone :
!'a
State Lie
Engineer:
r1
Address
`.
Phone:
Designer
Address
Phone:
Construction Valuation : $18,000.00
Added/New/TI sq. ft. Bldg : 0
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage : 0
TOTAL sq. ft. : 0
OWNER -BUILDER DECLARATION
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 item(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
to 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 penalty of
of more than five hundred dollars ($500). %l�L'�
, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or tt�portions of the work, and the structure is not Intended or offered for sale (Section 7044,
ln usess and Professions Code: The ConfracReW State License Law does not apply to an owner of properly'C4wv}}3�1ss through employees' or personal effort, builds or improves the properly, provided [hat the
nprovements are not Intended or offered for sale, IL 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
nprovad for the purpose of sale).
11, as owner of the property, aln exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
ply to an owner of property who builds or improves thereon, 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:
y my signature below I acknowledge [hat, except for my personal residence in which I must have rasided for at least one year prior to completion of the Improvements covered by this permit, I cannot Iegall,
ell a structure that I have built as an owner -builder if it of been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Socti 044 of lho Business and
'rofesslons Code, is available upon request wh n appli is submitted or at the following Web site:http:li"m.leginfo.ca.gov/calaw.html,
ignature of Property Owner or Authorized Agen _� ��_ oat
ICENSED CONTRACTOR'S DECLARAT11
hereby affirm under penalty of perjury that I am Ile sed niter provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, nd my license is In full force
Fell effect. License Class License. No Date Contractor Signature
COMPENSATION
: 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 (6100,000), IN ADDITION TO
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 07QS OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEE&
hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure tot workers' Compensation, Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
ormance 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
ranee carrier and policy number are:
to of Agent
certify that, in the
, if I should becor
Policy Number
Date
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 agre
s' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /
nature of Applicant- Dalri,.-y —AI
CLARATiON REGA DI T TION LENDING AGENCY �kl'Jk�
ueby affirm under penalty f p j hat there is a construction lending agency for the performance of the work for which this permit is Issued (Section 3097, Ivll ode).
ider's Name Lender's Address
my signature below, I D I y to each of the following:
I am the property owner or authorized to act an 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 andcountyREIIInances and state laws relating to building construction.
I authorize representatives of this city or can y ente Gve-identiffed property for inspection purposes /��/,�/ q
nature of Prooehv Owner or Authorized Adenb /' Print Prooertv Owner's or Authorized Anent's Namely/ ,_ 6_ Dat
DATE BY V CjBfl7lTCN OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
I SU8MIT`1`ASBFRTOS NOTIFICATION TO
PERMIT CANCELLED
CERTIFICATE
q V pr gOpOSEtI �BESIQS OLITID I S HFPLICABLE TO
CERTIFICATE OF )I p 2J w�'~�
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