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Home My WebLink AboutXR2022-2305 - Permits�fx'n0� City of Newport Beach I IIII III II I I �I II II COMB Permit : XR2022-2305 Community Development Department- Building Division I I 100 Civic Center Drive, Newport Beach, CA 92660' Plan Check No : 0837-2021 u ! z Permit Counter Phone: (949) 644-3288 Issued Date : 08/25/2022 Inspection Requests Phone: (949) 644-3255 CqG/FORN�P newponbeachca.gov/inspections Inspection Area : 3 Combination Type - Work Class - Other 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 : 418 SIGNAL RD Legal Desc : N TR 1218 BLK LOT 75 Description: SFR - ADD NEW DETACHED ACCESSORY DWELLING UNIT@ REAR OF PROP 742 SF (RENEW EXPIRED) Owner: SIGNOL LAUREN L Contractor: JM KELLEY BUILDERS INC Architect Address: 22 PLAZA AVILA LAKE ELSINORE, CA 92532 Address : PO BOX 12019 COSTA MESA, CA 92626 Address: Phone: Phone: (949)873-0740 Phone: Con State Lie : 1061852 State Lie Applicant: SIGNOL LAUREN L Lie Expire : 12/31/2023 Address: 22 PLAZA AVILA LAKE ELSINORE, CA 92532 Bus Lie: BT30070527 Engineer: Phone: Bus Lie Expire : 01/31/2023 Address : Owner/Builder : Address Phone: Code Edition : Type of Construction Occupancy Groups: Bldg Height: Building Setbacks Flood Zone Use Zone: PROCESSED BY: 2019 V-B R-3 Front 20, Side: 4, Side: 4, Rear: 10 X R-1 - Single -Unit Residential Slz SPECIAL CONDITIONS: Workers' Compensation Insurance Carrier : Policy No: 9264786 W. C. Expire : 11/25/2022 Fire Sprinklers : NO Fire Hazard Zone : No No of Units : 1 No of Stories: Phone Designer: Address Phone: SMITH BR DFORro' 425 30TH ST #22 NEWPO� BEACH, CA 92663 (949)631-3682 ' ROHRER PAUL DUANE 1527 E. AUTUMRIDGE- 92866 (714)272-9579 . Construction Valuation : $0.00 Added/New/TI sq. ft. Bldg : 0 Alteration sq. ft. Bldg : Added/New sq. ft. Garage : 0 CT ORANGE, CA 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) 1 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 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 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 (_) 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 (hat 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). ❑ 1, as owner of the property, am exclusively contracting with licensed Contractors to construct tine project (Section 7044, Business and. Professions Code. The Contractors' Stale License Law does not ra�rply to an owner of property who builds or Improves thereon, and Who contracts fa the projects with a licensed Contractor pursuant to the Contractors' State License Law). aI sm exempt from licensure under the Contractors' Slate License Law for the following reason ..... _..._. Y - permit, — ----- 9- By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year nor to completion of the improvements covered b this I cannot legally sell a structure that I have built as an owner-bui(der if it Ines not boon constructed in its entirety by licensed contractors. I undorstend that a copy 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:htipa/v.Nvw,leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 of Division 3 of the Business and Professions e y lice sin full force and affect. License Class License No Date �. Contractor Signature WORKERS' COMPENSATION DECLARATION !W"PN'N9FAILURE TO SiECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS t$100.008). IN ADDITION TO THE 'DST OF -OMPEN-.AT'ON, PAMAGES AS PROVIDED FOR IN SECTION 3708:OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. rI —L1erety affirm under penalty of perjury one of the following declarations: L J. 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 thi rfori a ince of 'he c,Or9 for which this parrnit is issued. Policy No. have and will m'evntain 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' compensatior I-urance carrier and Ddlicy number are: Carrier Policy Number Expiration Date Name r1 Agent ._ _ Phone ❑1 certify that, n. the parfonnance of the work for which th} F, mit is issue shall not employ any person in any manner so as to become subject to the workers' compensativn laws of Callfomia, and agree ''hat, if I should bscomr subject to the workers corn all to provislvn S cfidr o the Labor Code. I shall forthwith comply With those provisions. ISlynalure of Applicanl,J neby 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, Civil Code). ides 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 properly 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 county to enter the abqNe-irpient\ified property for Inspection purposes. mature of Property Owner or Authorized Agent T�5O k SE/�K1Y Print Property Owner's or Authorized Agent's Narn2::�� _ Dale ACTION DATE By' i DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND ACME RULE 1403 PERMIT EXPIRED 1 SUBMITTFD ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA All required alarms, latches gates and fences which serve as part of apool/spa battier, shall --- N — be in place prior to approval to fill pool/spa St shall remain in place & be maintained for the PERMIT EXTENDED QMD PERMIT FINAL I �� 7 ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO life of the pool. CERTIFICATE OF I ` i PROPOSED DEMOLITION OCCUPANCYISSUEO I SIGNATURE: