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HomeMy WebLinkAboutXR2022-3026 - Permits�EWPORT City of Newport Beach II IIIII I IIIIIIIII III II IIIIIIII IIIII IIIII II COMB Permit : XR2022-3026 Community Development Department -Building Division X R 2 0 2 2 3 0 2 6 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No Permit Counter Phone: (949) 644-3288 Issued Date : 1111612022 u S Inspection Requests Phone: (949) 644-3255 Inspection Area : 5 og4coaN�P newportbeachca.gov/inspections Combination Type - Work Class - Demolition 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 : 603 ACACIA AVE Description : DEMO SFR 964 SF 2 BEDROOMS Owner: LA21 G LLC Address : 26880 ALISO VIEJO PKWY STE100 ALISO VIEJO, CA 92656 Phone : Applicant: T J C HOME BUILDERS Address: 26880 ALISO VIEJO PKWY #100 ALISO VIEJO, CA 92656 Phone: Owner/Builder: Address : Phone Code Edition : Type of Construction Occupancy Groups: Bldg Height : Legal Desc : N TR 682 BLK LOT 64 Contractor: T J C HOME BUILDERS Address : 26880 ALISO VIEJO PKWY #100 ALISO VIEJO, CA 92656 Phone: Con State Lie : 1025507 Lie Expire : 04/3012023 Bus Lie: BT30059037 Bus Lie Expire : 05/31/2023 Architect Address Phone: State Lie: .0 . Engineer: Address Workers' Compensation Insurance Carrier: TECH NOLOGY+INSURANCE+COMPANY+INC Policy No: TWC4081048 W. C. Expire : 3/8/2023 2019 Fire Sprinklers : V-B Fire Hazard Zone: R-3 No of Units : No of Stories: Phone: Designer: Address Phone : NO Construction Valuation : NO Added/New/TI sq. ft. Bldg 1 Alteration sq. ft. Bldg : 1 Added/New sq, ft. Garage TOTAL sq. ft. : Building Setbacks : Front: 15, Side: 3, Side: 3, Rear: 5 Flood Zone : X Use Zone: R-2 - Two -Unit Residential PROCESSED BY: SPECIAL CONDITIONS: JD DEMO TO HAU EBRIS CERTIFIED RECEIPTS ATT TO PERMIT $0.00 0 I f hereby aHimt under penalty of perjury that I art exempt from the Contractors' Slate Lice nsa Law for the Toason (s) indicated below by the checkmark(s) I have placed next to the applicable Items) ' Beckon 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'ds 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 B (commencing with Section 7000)of Division 3 of the Business and Yofessrons Dade) or that he or she is exempt from Fcensure and the bans for the alleged exemption. Any violation of Section 7031a5 by any applicant for a permit subjects the applicant to a civil penalty of of more than fire hundred dollars ($500). 1 I, 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, usiness 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 nprovements 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 nproved for the purpose of sale). 1 1, 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 poly 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 I am exempt from ficensure under the Contractors' State License Law for the, following reason; ;y arty signature nalovt t acknowledge That, except for my personal residence in which I must have resided for at (east one year prior to completion of the Improvements covered by this permit, i cannot legaR) oil astructure that I have built as an owner -builder If it has not been constructed in its entirety by Irconsed contractors. I undorstand that a copy of the applicable law. Section 7044 of the Business and Irofessions Code„ is available upon request when this application is submitted or at the following Web site;tittp'(iwvnv.leginfo.ca.gavicalaw.html. signature of Property Owner OF Authorized Agent _ Date _ .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001F the Business and Professa a my Ito •rlsE.rB full fo e ad effect. License Class License No Data Contractor Signature V L VORKERS' COMPENSATION DECLARATION rARNING: FAILURE TC SECUP= WORKERS` COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS iSI D"0), dN ADDITION TO THE DST OF COMPENSA:.,T4, r.AAAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, ANO ATTORNEV'S FEES_ hereby affirm under penalty of perjury one of the following declarations: - J 1 have and will reel s-ain a certificate of consent to self -insure for workers' compensator, Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th, k-Itomtance of the work for which this permit Is issued. Policy No, Ind will atromvtn workers' Compensation `assurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' carrier facia pdINcy number are: Policy Number Expiration Date of :gent it that in the performance of the wo or which this permit is Issued. I shall not employ any person in any manner so as to become subject to the workers' compensation fawn of alifomia, and Egret lot, ,f I s,culd become, Subject to t ' work mpeAINOAG `provi-" ris of Section 3700 of the Labor Code, I shallforthwith comply with chose provisions. I iat. c of Applicant __ m,m, _______ Date 1 ,'. Ar2A710N ReG DING COW ION LEN : Cy hereby affirm unoe pel.�alty, of perjury that there Is a constructs lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code), enders Name Lender's Address y my signature below, I certify to each of the following: I ant 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 rdina 4d d state la re ting to building construction. r I authori> representatives of this city orcounty to/q/�9{��F th a -Id If party for inspection purposes. /n �,f)J O rrr/��t /�� yA �j/ �% .,snot o of Prnnr rt , n.,,nor nr u, thnmo�i Gnani / / \/1 � �i/�� Prim P,nn , rr,una�c nr n, rl.nri�arl n�,cnr < NIAM \I�Y/1,1 �V film �1 /L� i : Hare / I ACTION I DATE: BY DECLARATION REGULATIONS OF CO1 LI NT'EADHCODE AND OFNID FEDERAL RULE J FOR OFFICE USE ONLY ASBESTOS NOTIFICATION TO PERmth-EXrENOED PERibi1TFINAL ���� l./ c tj1ASBESIOr CERTIFlCHTE Of /, PROPOSED D OCCUPANCY ISSUED i SIGNATURE: ,=I • I S m ru ru • ru ruCore Priv cL U v. Er r, Cetlif$ ed Mail Fee I'I I Y.I _ r- $ r- 6Rra Smlces&Fees(checkbax, etl0 /eeaeplop ateJ ❑ Re m Receipt OavdcoFY) $ rl C rl O ❑%Wm Receipt lalemremol $ $II.[III y PC, 0 r% M O ❑Cel1HIeE Mall ReaVlclerl DeIIveN $ I 1111 t 'w }y'r cr- cp tip O ❑Mult Signature Racalretl S � N q ED �ALuh Signature Rannmaal Daiwa,$ Q Postage $(I.611 C3 ) d •, O t1 i 2�4 Er Q' �.�9 Tetal Postage and Fees O �� $7_��. O p$Yieef an p. .;ar ai IKdr_.TY. _._.. _..V....%______ ___ ____ _____ p r, (190l �p.C�f. r, Certified Mail service provides the following benefits: . A receipt (this portion of the Cerfiged Mail label). for an electronic return receipt, see a retail • A unique identifier for your mailpiece. associate for anistance.To analyst a duplicate • Electronic verification Mdelivery or attempted return receipt for no additional fee, present this delivery. USPSde-posbnarked Codified Mail recsl" the •A record of delivery(Including the recipient's retail associate.' signature) Ural is retained by the Postal Service' -ResMcted delivery servloe, which provides for a specified period. delivery N the addressee specified by name, or to the addressee's authorized agent. ImportantRendnders: - Adult signature service, which requires the • you may purchase Certified Mail service with signee to be at least 21 years of age (not Fist -Class Mail®,First-Class Package Services. available at retail. or Priority WHO service. - Adult signature restricted delivery service, which • Certified Mall service is notavailable for requires the signee to be at least 21 years of age International mall. and provides delivery to the addressee specified • Insurance coverage is notavailable for purchase byname, or to the addressee's authorized agent with Codified Mall service. However, the purchase (not available at retail). of Certified Mail service does not change the •To ensure that your Certified Mall receipt is insurance coverage automatically included with accepted as legal proof of mailing, it should beg certain Priority Mail hems. USES postmark If you would like a postmark on • For an additional fee, and with a proper this Certified Mail receipt, please present your endorsement on the mallplece, you may request Certified Mail Item at a Post Office' for the fallowing services: postmarking. H you don't need a postmark on this - Return receipt service, which provides a record Certified Mall receipt, detach the bamoded portion of delivery(including the recipient's signature). of this label, affix tits the mailpiece, apply You can request a treasury return raceiptgr an appropriate postage, and deposit the mailpiece. electronic version. For a hani cit return receipt, complete PS Forth 3811. RomeaepRenam Receipt, attach PS Form 3811to your mallplece; . IMPORTANC Save this recelpt for your records. PSFmm3800,Apd120ls(Reverse)PSN76s M4OO-W47 Certified Mail service provides the following bar 'fits: •Areceipt (this portion slime Certified Mall label). for an electronic return receipt, soa5 A •Aunique identifier for your mailpiece. associate for assistance. Trq recpivo a duplicate • Electronic verification of delivery or attempted return receiptfg no additional fee„piesentthis delivery. USPS®-postm-adced CerggebMail recciptto the •Arecord of del Ivory OncludIng the recipient's retail associate. signature) that is retained by the Postal Service- -Restricted delivery service, which provides tat a specified period. delivery to the addressee specified by name, or to to the addressee's authorized agent ImpartantRemindera: signature service, which requires the • You may purchase Certified Mall service with signee to be at least 21 years of age(not First -Class Mail-, First -Class Package Service•, available at retail. or Pontiff WHO sendce. - Adult signature indicted delivery service, which • Certified Mali service is notavailabla for requires the signee to be at least 21 years of age InW=Uonal mail. and provides delivery to the addressee specified • Insurance coverage is not available for purchase byname, or to the addressee's authorized agent with Certified Mail service. However, the purchase (not available at retail. of Certified Mail sernce does not change the • To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal prof of mailing, it should bear certain Pdonty Mail items. USPS postmark If you would like a postmark on • For an additional fee, and with a proper this Certified Mali receipt, please present your endorsement on the mailpiece, you may request Certified Mall item at a Post Ofice' for the following services: postmadkng. If you don't need a postmark on this - Return mceipt service, which provides a record Certified Mall receipt, detach the barooUed portion of delivery(including the recipient's signature). of this label, affix it to the mallplece, apply You can request a hardcopy retbm receiptar an apprdpdate postage, and deposit the mailpiece, electronic version. For a barratry return receipt, complete PS Form 3811, Osmesgc Rehm Receipt, allach PS Fenn 3811 to your mallplece; IMPORTANTrem this reralptfor your record•. Ps Farm 3800, Arm sets( Reverse) PSN yfiSU-02-0009 fir