The URL can be used to link to this page

Home My WebLink AboutX2021-1797 - Permits,,W pr City of Newport Beach o Community Development Department- Building Division F 100 Clvlc Center Drive, Newport Beach, CA 92660 t Permit Counter Phone: (949) 644-3288 �.' c,�LFa Inspection Requests Phone: (949) 644-3255 newportbeachca.gov/inspections Combination Type - SFP Work Class - Other IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIillllllllllllllllllllCOMB Permit : X2021-1797 Plan Check No : 0942-2020 Issued Date : 1212312022 Inspection Area : 1 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 : 619 36TH ST Legal Desc : A TR,CANAL SECTION BLK 636 LOT 10 Description: SFR BLOCK WALL U HIGH MAX X 190 LF INSIDE P/L Owner: JEFFTHEDERS Address: 11216 RESERVOIR SANTA ANA, CA 92705 Phone: (949)922-1833 Applicant: JEFF THEDERS Address : 11216 RESERVOIR SANTA ANA, CA 92705 Phone: (949)922-1833 Owner/Builder : JEFF THEDERS Address: 11216 RESERVOIR SANTA ANA, CA 92705 Phone : (949) 922-1833 Contractor Address : Phone: Con State Lic Lic Expire Bus Lic: Bus Lic Expire Workers' Compensation Insurance Carrier : Policy No W. C. Expire Architect : LIGHT CHRISTIAN R Address : 1401 QUAIL ST #120 NEWPORT BElHGF�,' CA 92660 Phone: (949)851-8345 State Lic Engineer : MOKHTAR TAREK. .. , Address : 31645 S COAST HWY LAGUNA BEACH, CA 92651 Phone: (949)499-6254 Designer: Address : Phone: Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $50,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/Ti sq. ft. Bldg : 0 Occupancy Groups : U No of Units : 0 Alteration sq. ft. Bldg : Bldg Height : No of Stories : 0 Added/New sq. ft. Garage : 0 _ TOTAL sq. ft. D Building Setbacks : Front: 5, Front: 25, Side: 3, Side: 3 ; s' Flood Zone : AE, 8 FT; X A�4 �� Use Zone: R-2 - Two -Unit Residential �� 2�1 PROCESSED BY: SPECIAL CONDITIONS: t V <.d Y tom, �_/ I I hereby of inn under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable Bemis) (Section 7031.5. Business and Professions Code: Any city or county that requires a permit to construct, after, improve, demolish, or repair any structure, prior to Its issuance, also requires the applicant for the permit to file a signedstatement that lie or she is liconsed pursuant to the provisions of the Contractors' State License Low (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). 0 1,, as owner of the property, or my employees with wages as theirsolecompensation, will do U 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 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 improvements are not intended or offered for safe. 11, 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 Im ved 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 projects with a licensed Contractor pursuant to the Contractors' State License Law), i I am exempt from licensure under file Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal rosidence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally sell a structure that I have built as an ovmcr-budder if it has not been constructed in its entirety by licensed Contractors. I understand that a copy of the applicable. taw, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the Web site httpJtwww.leginfo.ca.govlcalaw.html. J„ 1�� j�� / Signature of Prapnrty Cyner or A CTORAuthorized Agent. ' i� � �,I,�L�� Date �7J/,/ /�,�__P„__ LICENSED CUN TRACTOR'S DECLARATION jam' i hereby affirm under penalty of penury that I am licensed under provisions of C apter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License OlAsz License No Date Contractor Signature I. WORKERS' COMPENSATION DECLARATION AARNli:(.: FAILURE TO SECURE WORKERS" COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO' ONE HUNDRED THOUSAND DOLLARS (St Q0,000). IN ADDITION TO THE COST OF COMPENSATIOP, DAMAGES AS PROVIDED FOR IN SECTION 3TQ6 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I oerahv affirm unaer penalty of perjury one of the following declarations: C1 I Care and vJI 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 In( perrormmnce of the work for which this permit is issued, Policy No. hold and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work far which this permit is Issued. My workers` rancE carrier and pol.cy number are: ii;_. _ _ Policy Number Expiration Dale iw a: Agent , _ Phone # _ certify that, in the performance of the work for which this permit is Issued, I shall notemploy any person in any manner at) as to become subject to the workers' compensation laws of California, , if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions_ of Date® £CLARATION REGARDING CONSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued {8eation3097, Civil Code), ender's Name Lender's Address y my aignabre 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 state laws relating to building construction. I authorize representatives of this city or county to enter the above -identified property for inspection purposes. itlnature of Property Owner or Authorized Agent _ _ Print Property Owner's or Authorized Agent's Name ACTION DATE. BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY I REGULATIONS PART 61 OF T€TLE 40 AND ADMIT RULE i 1403 PERMITEXPPREO I I I L1 I SUBMITTED ASBESTOS NOTIFICATION TO PERMITFINAL 1 '7(131 � . 1(` I L,JASBE510$ NONTICA710N IS NOT APPLICABLE TO CERTIFICATE OF NII VPROPOSED DEMOLITION OCCUPANCYISSUED i SIGNATURE: