HomeMy WebLinkAboutXR2023-0975 - PermitsF`�WPo T City of Newport Beach
D e Community Development Department- Building Division
> `y" 100 Civic Center Drive, Newport Beach, CA 92660
n Permit Counter Phone: (949) 644-3288
G. x
c.Inspection Requests Phone: (949) 644-3255
cqG/Fp0.N�P newportheachca.gov/inspections
Combination Type - SFP
Work Class - Alteration
IIIIIIIIIII1111111111111111111111111111111111111111111111 jj COMB Permit : XR2023-0975
Plan Check No:
Issued Date : 04/14/2023
Inspection Area : 6
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: 3901 PARK GREEN DR Legal Desc : N TR 6634 BILK LOT 7
Description: SFR -REPAIR AND PATCH EXIST'G STUCCO ON SOUTH EXTERIOR WALL
Owner: GEORGE LIVINGSTON
Contractor :
Architect:
Address : 1776 PARK AVE STE4
Address :
AcAress
PARK CITY, UT 84060
Phone : (415) 652-1108
Phone:
Phone:
Con State Lie :
State Lie :
n ° ° ° °
Lie Expire
Applicant: GEORGE LIVINGSTON
Bus Lie :
Engineer
Address : 1776 PARK AVE STE4
Bus Lie Expire :
Address :
.. _ ...
PARK CITY, UT 84060-
Phone: (415) 652-1108
Workers' Compensation Insurance
Phone
Carrier :
Owner/Builder : GEORGE LIVINGSTON
Policy No:
Designer:
Address : 1776 PARK AVE STE4
W. C. Expire:
Address
PARK CITY, UT 84060
Phone : (415) 652-1108
Phone:
Code Edition : 2022
Fire Sprinklers : NO
Construction Valuation :
$25,000.00
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/TI sq. ft. Bldg:
0
Occupancy Groups : 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: 21, Side: 6, Side: 6, Rear: 6
Flood Zone : X
Use Zone: R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area)
PIL
PROCESSED BY:
-
!' f
SPECIAL CONDITIONS: O/B FORM ATTACHED
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkrnark(s) I have placed next to the appleartEe ftem(s)
cfion 7031.5, Business and Professions Code: Any city or county that requires a permit reconstruct, alter, improve, demolish, or repair any structure, prior to Its issuance, also requires the applicant for
permit to file a signed statement that ho or she is licensed pursuant i o the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
fossions Code) or that he or she is exempi from Iicensure, and the basis far the alleged exemption. Any violation of Section 7031:5 by any applicant for a permit subjects the applicant to a civil penalty of
more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do l_) all of or U 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 improvemant 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).
Ias 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
ly 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 licensureunder the Contractors' State License Law for the following reason:
,y my signature below I acknowledge that, except for my personal residence fit which I must have resided for at least one year prior to completion of tl
ell a structure that I have built as an owner -builder i has not been constr ad in its antItaly by licansod-contractors. I understand that a copy of the
'rofesslons Code, is available upon request when I application' submit d or at the fo trig Web Silo:httpalwww.leginfo.pa.gov/calaw.hfml.
ignature of Property Owner or Authorized Agent �-
.ICENSED CONTRACTOR'S DECLARATION
ments covered by this permit, I cannot
taw. Section 7044 of the Business and
Date
hereby affirm under penalty of perjury that am licensed nder provisions of Cha er 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full farce
Del effect. License Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
ARNING: FAILURE TO SECURE WORK ERS� COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLDYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS (S1D0,000), IN ADDrrION TO THE
o3I uF LOMPENRX-11!', DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, ARID ATTORNEY'S FEES.
herehv affirm under penalty of perjuryone of the following declarations:
I I `lrve 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 th
Pformance of the wort. 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'
rnrce carrier ano policy number are:
Policy Number
:I'Agent
Date
certify that, In the parformance of the work for which this permit is Issued, I shall notemploy any person in any manner so as to become subject to the workers' compensation laws of Califamia, and
, 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 ACp'icep+: Date—
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
areby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
ider's Name Lender's Address
my signature below, I certify 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 I have provided is correct.
I agree to comply with all applicable city and county ordinances an state laws relating to building construction.
I authorize representatives of this city or co u y anter the aboyk-id'�$,,/i�`'ad property for inspection purposes.
nature of PmriRrtv Owner or Authorized Aae I —a„ _,A X / t \ Print Prooenv Owner's or -Authorized Aaenfs Name 1 `�II4—�C'�,9� LIU i
ACTION DATE I BY l MCLARATtON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQNID RULE
1403
PERMIT EXPIRED I I SUBMITTED ASBESTOS NOTI NCATION TO
PER+AWT EXTENDED
PERNf1T FINAL_
CERTIFICATE Or
OCCUPANCYI55UEO
NOTIFICATION 15 NOl'APPLICABLE TO
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