HomeMy WebLinkAboutXR2023-1070 - PermitsCity of Newport Beach
WP
Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
? Permit Counter Phone: (949) 644-3288
e,< 1.nspection Requests Phone: (949) 644-3255
C9(./pepN�P newportbeachca.gov/inspections
Combination Type -
Work Class - Other
111111111111111111111111111111111111111111111111111111111jj COMB Permit : XR2023-1070
Plan Check No : 1271-2022
Issued Date : 04/25/2023
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: 107 HIGHLAND ST Legal Desc : A TR SEASHORE COLONY TR BLK K LOT 10 SEASHORE COLONY TR LOT 10 BLK K SWLY 30 FT
Description: MFR CHANGE WINDOW W/NEW HEADER, REPLACE DECK GUARDRAIL @ 2ND & 3RD FLOOR DECKS *STOP WORK 122-0202 (RENEW EXPIRED PERMIT)
Owner: JOHN VON DER AHE
Address : 107 HIGHLAND ST
NEWPORT BEACH, CA 92663
Phone : (949) 400-7047
Applicant:
JOHN VON DER AHE
Address :
107 HIGHLAND ST
NEWPORT BEACH, CA 92663
Phone:
(949)400-7047
Owner/Builder
: JOHN VON DER AHE
Address:
107 HIGHLAND ST
NEWPORT BEACH, CA 92663
Phone :
(949) 400-7047
Code Edition : 2019
Type of Construction : V-B
Occupancy Groups: R-3
Bldg Height:
Building Setbacks : Front: 3, Side: 3, Side: 3, Rear: 10
Flood Zone: X
Use Zone : R-2 - Two -Unit Residential
PROCESSED BY
SPECIAL CONDITIONS: O/B FORM ATTACHED
Contractor
Address :
Phone:
Con State Lie:
Lie Expire
Bus Lie:
Bus Lie Expire
Workers' Compensation Insurance
Carrier :
Policy No:
W. C. Expire:
Fire Sprinklers :
Fire Hazard Zone
No of Units :
No of Stories
Architect: BRIAN ARIEL
Address: 1200 YOCUM STREET PASADENA, CA
91103
Phone:
State Lie : C 27582
Engineer:
Address
Phone:
Designer
Address
Phone:
NO Construction Valuation :
NO Added/New/TI sq. ft. Bldg
2 Alteration sq. ft. Bldg :
3 Added/New sq. ft. Garage:
TOTAL sq. ft.
t`PN.
,P11
$30,000!0
0
`d
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(,,) indicated below by the checkmark(s) I have placed next to the applicable items)
ction 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
permit to file a signed statement that he of she is licensed pursuant to the provisions of the Contractors' Stato License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
fessions 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 olvil penalty of
more than five hundred dollars ($500),
1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
iness 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
rovements 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
roved 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
" 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),
J I am exernpt from licensure under the Contractors' State
y my signature below I acknowledge that, except for my pet
ell a structure that I have built as an owner -builder if it he r
'rofessions Code„ is available upon request Wh t. s app'
ignature of Property Owner or Authorized Agen
.ICENSED CONTRACTOR'S DECLARATI
hereby affirm under penalty of perjury that am Iicens d n
❑d effect. License Class
lowing reason'
:h I must have resided for at least one year prior to completion of t1
its entirety by licensed contractors. I understand that a copy of the
Ira-filtoaWing Web site:http:/rwww.leginfo.ca.govlcalaw.btml.
law, Section
der provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions
License No Date Contractor Signature
and
22-�
my license is In full farce
VORKERS' COMPENSATION DECLARATION ✓
rARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 19 UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (S100,000), IN AUCTION TO THE
IOST OF COMPENSATION: DAMAGES AS PROVIDED FORIN SECTION 0706 OF THE tASOR CODE, INTEREST, AND ATTORNEY'S FEES,
hereby affirm under penalty of perjury one of the following declarations:
I I have and Wilt 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 lh
arformance of the work for which this permit is issued. Policy No.
31 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` compensation
Isurance carrier and policy number are:
:arrier Policy Number Expiration Date
tame of Agent I Phone N
�1 certify that, in the performs Zef ewoissued: I shall not employ any person in any manner so as to become subject to the workers'compensate ❑ laws of California, and agreIaLiffshould becomes jecorker ' rap ns i .pro "oAi Section 3700 of the Labor Code, I shall forthwith comply with those provisions.p ignature of Applicant _ Dato,ECLARATION 9 UCTION (^ENDING AGENCYhereby affirm under pe ,It, Ierjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civi)Code).
enders Name-fl-rlY/ Lenders Address
y my signature below, I oeNi 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.
agree to comply with all applicable city and coo y or ancep n ate Taws relating to building construction.
I authorize representatives of this city Or coo en i;/a� -i. e 'ed-property for inspection purposes. \ ` / r I - q 1
nature of Property Owner Or Authorized Agent V Print Propertyp Owner's or Authorized Agent's Name J�f+N tl �!� {%F�- f7Ffi- ate
%CTION DATE BY
ItARATPON OF COMPLIANCE WITH CODE OF FEDERAL FOROFFICEUSEONLVT
LATIONS PART 6I. OF TITLE AO AND AONID RULE
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT FXTFNDED
PERMIT FINAL
CERTIFICAT€ OF
OCCUPANCYISSUED
ASBESTOS NOTIFICATIr)r! TO
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