The URL can be used to link to this page

Home My WebLink AboutX2017-1191 - Permits (3)e`�Wr City of Newport Beach o @ Community Development Department- Building Division 1 DO Civic Center Drive, Newport Beach, CA 92660 ' ? Permit Counter Phone: (949) 718-1888 1� newportbeachca.gov/civic C9q Fo 0.N�P Combination Type - SFP w..s Work Class -Alteration IIX�IIII�IIII�II��II��IIIII�IIII�IIIII�III II COMB Permit : X2O17-1191 la Check No : 0744-2016 suee d Date : 04/13/2017 Fi I Date: 12/17/2021 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPE90N, BUT NO NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HI DENS ARE rd�\\ NC Job Address: 3 HARBOR POINTE LegalZDeNTR2 B COT aDescription: SFR WINDOW (10) AND DOOR (6) C/O LIKE FORIN�DOW 9.8.0' PROGRESS* Z �O Owner: THOMAS LACKNER Address: 3 HARBOR POINTE DR CORONA DEL MAR, CA 92625 Phone: Applicant Address Phone: Owner/Builder : Address Phone: Code Edition : V Type of Construction Occupancy Groups: Bldg Height: Building Setbacks Flood Zone Use Zone: PROCESSED BY: /�Contrac r : �O Addr s ones=-.. Con4tate Lic „, ' t4ic Expire 14, Bus Lie:lip,ayi -Bus Lic Expire: Ilt :on Expired �tion Area : 6 T2�THAN 3 S FROM ORIGINAL ISSUANCE DATE RND NOW K O SUNDAY AND HOLIDAYS IN ALL AREAS FRONT DOOR) , PEX REPIP ND. EXTERIOR LIGHTING *WORK IN Architect{, Add eet� `�, P11�e to Lic Rgmeer: _ ��ddress Workers' Compensation Insurance O�� Pho —\5 Carrier Policy No Nk es i0r: W. C. Expire : A Bras L _ 1ire Sprinkler, 0 Fire Hazard NO U, No ofUr's 1 No r s:�eC�12 Front: 20,. e: Sid Rear: 6 X p� R-1-6000 - Si -(J Res i 000 ates mi in lot a SPECIAL CONDITIONS: C` Construction Valuation : Added/New/TI sq. ft. Bldg Alteration sq. ft. Bldg : Added/New sq. ft. Garage TOTAL sq. ft. : OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the ma (s) indicate slow 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, tiller ' prove, demolish, 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 Contractor tale License Lawn�rcha or 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. violation of SeetioP31.5 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 11� ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do all of or L) part! the work, dine rUCture is not intended or offered for sale (Section 7044, Business and Professions Code: The Confincers' State License Law does not apply to an ow r of pre who + r�flagh emplo ..s' or per; 1 effort, builds or improves the properly, provided that the improvements are not intended or offered for sale. If, however, the building or improvemel sold one Y . f completi , the Owner -But r will have the burden of proving that it was not built or improved for the purpose of sale). fir✓ < > ' _ El 1. as owns; of the property, am exclusively contracting with licensed Contractors construji, 1�,�e nciJI, Section 7 , Business and Professions de: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts the p jj s wilftd 6oLn"a Cont cfor pursuant to the Contractors' to License Law). ❑ I am exempt from licensure under the Cunlrerlors' State License Law for . followingJg Teason 0"t___ _... By my signature below I acknowledge that, except for my personal maiden in which I must N 51ded f east no year prior to completion of the impr menta:covered by this permit, I cannot legall sell a structure Ihat have built as an owner -builder it it has not boon co ructod in its entirety license he i understand that a copy of the applicabl w Section 7e44 of the Business and Professions Code, is available upon request when this application is mltted or the following'Neb liftp:/�wvnv.leginfo.ca.gov/calaw.htmL Signature of Property Owner or Authorized Agent �'Sfl Date • __ _�,_ LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of parjury that I am licensed u r provisio of Ch r n cing with Section 7000) of Division 3 of try op mess and Professi Cc , and my license Is In full force and effect. License Class License Date C ractor Signature WORKERS' COMPENSATION DECLARATIO -�\] WARNING: FAILURE TO SECURE WORKERS' COMPENSATIO OVERAGE IS &AWFUL. D SHA S JECT A MP ER `T -3GRIMINAL PENALTIES IL FIN p w'TO ONE NO ED IT AN OLLARS IE100,000), IN ADDITION TO THE COST OF COMPENSATION DAMAGES A; PROVIDED FOR ECTION 310 F THE O OE,1 REST AN OR ; ; \� I hereby affirm under penalty of perjury one he followi decla CD'�3\ ❑ I have and will maintain a cedii of Consort C Tinsu .rsco uo'n^ Ad by the Di oLdhdus6a1 Relations prnv�L�d f y Section 3700 of the Labor Cade, for lh performance of the work far which lhi ermil is is eery P o. a V ❑I have and will maintain wor compen insuran ,g:^i Lnred by S �00 c the Labor for e rmance of a wosk.far y h this permit is issued. My workers' Compensatio insurance carrier and policy n an are: : r , + \ 5 Carrier �ry _ Patg be Expiration to Name of Agent M�y •5, ._ _ _ P no F 1 codify that, in area .o of th o r vhirh this per it i s fall not emptoyn�y person in any manner as to b o subject to the workers' compensation laws of Cslifnrnia. and ogre that, if 1 should b uect to th - orkers yflpens tlo a eon f Section 3700 of IM(L�or Code, I shall forth h comp wi hose provisions. Signature of Applies ' t _ _ .t" 3*'�. ` _ Date— DECLARATION REGA !a' NST LE G AG I hereby affirm under pen - p 'try th tare i- _ uction ending agency fora ;mae of the k for v ch s permit Is issued (Section 3097, Civil Code), Lender's Name _^ .._. °a^', ennxees�lnddress By my signature below, I cart! c f the �°i \' 1 am the properly owner or au ` e act f eriy owner's I have read this application and fq lion a provided' - I agree to comply with all applicabl ar county ordinals a ate toting to tiding c sir an. I authorize representatives of this city �" u to enter a e-iden property t imspec' oses. Signature of Property Owner or Authorized A Pri P any Owner's or Authorized Agent's Name Date -_ ACTION I DATE IiY`. fl i CLAR 6N OF COAAP LIANC rITH Cb .O OERAL FOR OFFICE USE ONLY ! -RE LATIONS PART 5117E LE AO A A 0 RULE PERMIT EXPIRED of 1 ISUB TTFESTO5 N FI ION TO PERMIT CANCECCEO71h--,-y]1E�A rEITWIT EXTENDED ... _.............. - LJAtTr D ... ..... .._._ I -.-fir . .-._ __ ...._ PERMIT FINAL hJ ASNESTOS-NOT NISNOT APPLICABLE TO CERTIFICATE OE PROPOSED DEii,00i OCCUPANCY ISSUER i SIGNATURE: