HomeMy WebLinkAboutXR2022-2593 - Permits�EwpoR City of Newport Beach
0�. A Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
y. Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
cgG�FppN�P newportbeachca.gov/inspections
Combination Type - SFP ELEC MECH PLUM
Work Class - Alteration
II II I III II COMB Permit : XR2022-2593
Plan Check No: PC2022-2426
Issued Date : 09/29/2022
Inspection Area: 2
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 : 1 LINDA ISLE Legal Desc : N TR 4003 BILK LOT 1
Description: SFR INTERIOR ALTERATION 416 SF. KITCHEN, BATH LAUNDRY
Owner:
ANDERSON GARRET J JR TR
Contractor:
PENINSULA CUSTOM HOME BUILDERS
Architect:
INC
Address :
1 LINDA ISLE
Address :
101 SHIPYARD WAY
Address
NEWPORT BEACH, CA 92660
NEWPORT BEACH, CA
Phone:
Phone;
(949)723-0147
Phone:
Con State Lic
: 842666
State Lic:
Lic Expire :
07/31/2024
Applicant :
WALZ JOHN ROBERT
Bus Lic :
BT3008665
Engineer:
Address :
510 LARKSPUR AV
Bus Lic Expire: 01131/2023
Address
CDM, CA 92625
Phone:
(949) B36-5977
Workers' Compensation
Insurance
Phone:
Carrier :
Owner/Builder:
Policy No:
EXEMPT
Designer:
Address :
W. C. Expire:
Address
Phone:
Phone:
WALZ JOHN ROBERT
510 LARKSPUR AV CDM, CA 92625
(949)836-5977
Code Edition : 2019
Fire Sprinklers :
NO
Construction Valuation :
$12010b8`ti0
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 :
416 6 a
Bldg Height:
No of Stories :
2
Added/New sq. ft. Garage :
0 -
Building Setbacks : Front: 10, Front: 25, Side: 4, Side: 4
Flood Zone : AE, 8 FT; X
Use Zone: R-1 - Single -Unit Residential
PROCESSED BY:
SPECIAL CONDITIONS: AUTH LETTER ATTACHED
a
oa,c:
L41TA 1:4a 3UI�u7737
I hereby affirm under penalty of perjury that I our exempt from the Contractors' Slate License Law (or the mason(s) indicated below by the checkmark(s) I have placed next to the applicable items)
Section 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
he 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 Dusinoss and
'rofessions 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
lot more than five hundred dollars ($500).
1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sate (Section 7044,
31.1siness 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
mprovemenls are not intended m 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
mproved for the purpose of sale).
7 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 net
Ipph7 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 am exempt from licensure under the Contractors' Stale License Law for the following reason
3y 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 permitI cannot legall,
sell a structure that I have built as an owner -builder 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:httpJ/www.leginfo.ca.govlcalaw.html.
iignatume of Property Owner or Authorized Agent _,- _ �w Date
_ICENSED CONTRACTOR'S DECLARATION _
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0) of Division 3 of the Business and Pr scions ode4nmy I rise s In full fort
Ind effect. License Class License No Date Contractor Signatur
VORKERS' COMPENSATION DECLARATION
YARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNORED THOUSAr O ARS n . IP nION TO THE
:DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION ADS OF THE LABOR CODE, INTEREST, AND ATTORNEY-9 FEES -
horeby affirm underpenally of perjuryone of the following declarations:
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 to
orformaece 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: I _
of Agent
Iffy that, in the peritl Monte of
1,1H should ber.om%SN-6
factth ork r: Top nsab n or
nature of AppliL r ,
Cl. OP TION FF 5 RU N LE L IN
:reby affirm under penalty of perjury a are Is a construchc
)Jer's Name
my-i3nalure below, I certify to each of the following:
am the property cwrer or authorized to act on the property
I hn'e read this application and the information I have pmvi
' a,,rva to compy with all applicable city and courtly ordin I
Rnthorfze representatives of this city or county "ter Vve
of PfooeTv Owner or Au
ACTION OAT[. I BY
Date
is issued. I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agra
,ions of SO bon 3700 of the Labor Code, I shall forthwith comply with those provisions.
Date
;Y
mding agency for the performance of the work for which this permit is issued (Section 3097, Civil ode).
- Lender's Address
61
relating to building construction.
yggrW for inspection purposes.
RULE
PERMIT EXPIRED_ _ i LJ I SUBMITTED ASBESTOS NO _FICATION
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PERMIT EXTENDED OMD
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PERMIT FINAL I AS STOS NOiIW N NOl'A' f ICAB E TO
OCCUPANCYISSUED -1 I I �7 SI('NATNR �EMOtjJ'10 / INN
vaer's or Authorizeo Ag
FOR OFFICE USE ONLY
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