HomeMy WebLinkAboutXR2023-0984 - Permits (2)aEwPoR� City of Newport Beach IIIIIIIIIII IIII I IIIIII IIIIIIIII III IIIII II COMB Permit : XR2023-0984
o� Community Development Department- Building Division X R 2 0 2 3 0 9 8 4
> 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No
}h S Permit Counter Phone: (949) 644-3288 Issued Date : 04/17/2023
Inspection Requests Phone: (949) 644-3255 Inspection Area : 2
newportbeachca.gov/inspections P
Combination Type - PLUM
Work Class - Alteration
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: 322 CORAL AVE Legal Desc : A TR BALBOA ISLAND SEC 3 BILK 16 LOT 12
Description: SFR BATHROOM RETILE; REVISE 4/24/23 TO ADD SHOWER PAN AND VALVE
Owner:
HAVIKEN MICHAEL R TR M R
Address:
35 RISA ST
RANCHO MISSION VIEJO, CA 92694
Phone :
(949) 632-2888
Applicant:
HAVIKEN MICHAEL R TR M R
Address :
35 RISA ST
RANCHO MISSION VIEJO, CA 92694
Phone:
(949) 632-2888
Owner/Builder : HAVIKEN MICHAEL R TR M R
Address: 35 RISA ST
RANCHO MISSION VIEJO, CA 92694
Phone : (949) 632-2888
Contractor : Architect
Address : Address
Phone:
Phone:
Con State Lic :
State Lic
Lic Expire:
Bus Lic:
Engineer
Bus Lic Expire :
Address
Workers' Compensation Insurance
Phone:
Carrier:
Policy No:
Designer
W. C. Expire:
Address
Phone:
Code Edition :
2022
Fire Sprinklers :
NO
Construction Valuation : $3,800.00
Type of Construction :
V-B
Fire Hazard Zone :
NO
Added/New/Ti sq. ft. Bldg : 0
Occupancy Groups :
U,R-3
No of Units :
1
Alteration sq. ft. Bldg :
Bldg Height:
No of Stories :
2
Added/New sq. ft. Garage : 0
TOTAL sq. ft. 0
Building Setbacks :
Front: 8, Side: 3, Side: 3, Rear: 5
Flood Zone :
X; AO 1
Use Zone :
R-BI - Two -Unit sidential, Balboa
Island
UPLICATP
PROCESSED BY:
! � 1 � 4"�''� �T�
_
1 I \i f� Yl 7 CI Q
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
t hereby affirm 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 item(s)
(Section 7031-5, Business and Professions Code: Any city or county that requires a pevnit to construct, alter, improve, demolish, or repair any structure, poor 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 licensors 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 their sole compensation, will doL) 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 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)..
111, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Slate License Law does net
a p]y to an owner of property who builds or Improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I am exempt from licensers under the Contractors' State License Law for the following reason:
By my signature below I acknowledge that, except for my personal residence In which I must have resided for at least one year prior to completion of the Improvements covered by this permit, I cannot legal],
sell a structure that I have built as an owner-ouiidar if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Professions Code, is available upon request when this application is submitted orat the following Web siteihttp:lAvww.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 Code, and my license is In full force
and effect. License Class License No Date Contractor Signature
COMPENSATION DECLARATION
IARNINGa 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 ]51U0,000), IN ADDITION TO
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0709 OF THE LASOR CODE, INTEREST, AND ATTORNEY's Fees -
hereby affirm under penalty of perjury one of the following declarations:
I I 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
erformance 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'
ranee carrier and policy number are:
Policy Number
of Agent
Date
I certify that. in the performance of the 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 egret
L if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant Date—
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
arsby affirm under penalty of perjury that there is a construction lending agency for the performance of the Work for which this permit Is issued (Section3097, Civil Code).
)does Name Lender's Address
my signature below, I oerlify to each of the following:
I am the property owner or authorized to act on theproperty owner's behalf.
I have read this application and the information 1 have provided is correct,
I agree to comply with all applicable city and county ordinances and state laws relating to building consUuction.
I authorize representatives of this city or county to enter the above -identified property for inspection purposes.
nature of ProDertv Owner or Authorized Aeent Print Prooertv Owner's or Authorized Ar ent's Name Date
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 6t OF TITLE 40 AND AQMD ROLE,
1403
PERM}TEXPIRED ( I ISUBMITfEO ASBESTOS NOTIFICATION TO _
PERMITCANCELLED I L.JEPA
PERMIT FINAL L" J fc- U ASBESTOS NOTIFICAl ION IS NOT APPLICABLE TO
CERTIFICATE OF PROPOSED DEMOLITION
OCCUPANCY ISSUED SIGNATURE:
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