HomeMy WebLinkAboutXR2022-2573 - Permitsrr,R
City of Newport Beach
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Community Development Department - Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
newpertbeachca.gov/inspections
Combination Type - SFP
Work Class - Alteration
COMB Permit : XR2022-2573
Plan Check No :
Issued Date : 09/26/2022
Inspection Area : 5
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON, S�h1)Ik3tF
ISSUANCE DATE
(DAYS IN ALL AREAS
Job Address : 225 POPPY AVE Legal Desc : A TR RESUB OF CO EL MAR BttiL�eA•'3 LOT 17
Description : SFR REMODEL BATHROOM PER CITY STANDARD PLAN.10
Owner: LAWRENCE SULLIVAN AND RITA SULLIVAN Contrac TN BUILDERS INC ca_ 0 6� �rchitect
JOINT LIV U
Address : 22395 PINEGLEN ddress : 136 PORT ENUE Add
MISSION VIEJO, CA 92692 STIN C 92780 k'
Phone : - /�jt (714 'y097D ��d Phone
/L on State L6q: State Lic
L jk ExpG`a d2/28/2023 ->
Applicant: c NBUILDE INC �•<+?�,�• {t Lic: BT30056339 Engineer:
Address : 13681 NEWPO T AV �JE #8 .cx trsLtc Expire: n8/31/2023 + Address
TUSTIN, CA 92 0�,,��''''
Phone: (714) 713-109.7 r ,49orkers' Compensation Insurance Phone: $�
Carrier: STATE COMPENSATIOJ NCE FUND i
Owner/Builder : P,�rllclo 9111,360 De S DERS INC
Address : - . _600W: C.-�xplre : 9/4/ 023' • .. J'A s 13 81 NEWPORT Al
Phone :
Code Edition : 2019
Type of Construction : V-B
Occupancy Groups: R-3
Bldg Height :
Building Setbacks
Flood Zone
Use Zone :
PROCESSED BY:
Front: 20, Side::
X
R-1 -Single-Unit
SPECIAL CONDITIONS: HIGH DENSITY
CITY STANDARD PLANS
Y Fire Sprinkle7r�s� �toN
Fire Hazard 7,
No of is �d `�"1
A hies$: a 2
.,,�''•'` 0Y(1�.1STIN, CA 92780
P oSk-a kk2 4) 713-1097 '
"'�* r,\o Construction V io 0 0
It
NO CONSTRUCTION NOISE
ON THE WEEKEND
I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' State License Law for the reasci indicated below by the Gheckmark(s) I have placed next to the applicable items)
3edion 703E.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
is 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
rofassions Code) or that he or she is exempt from licensors and The basis for the alleged exemption, Any violation of Section 703T5 by any applicant for a permit subjects the applicant to a civil penalty of
at more than five hundred dollars X00j_
11, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
rosiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' ar personal effort, builds or Improves the property, provided that the
nprovemonts 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),
„! 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 trot
ply to an owner of property who builds or improves thereon, and who contracts far the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I am exempt Imm, licensure, under the Contractors' State License Law for the following reason
y my signature below iI 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 Iegall
all a structure that I have bout as an owner -budder if it has not haen constructed in its entirety by licensed contractors. I understand there copy of the applicable law, Section 7044 of the Business and
'rofessions Code, is available upon raquest when this application is submitted Drat the following Web sits:htfp:/twaaw.legdnfo.ca.gov/Dffiaw.html.
ignature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (Commencing with Section TOO) of Division 3 of the Business and Profession�,0ode nd my I' erase is in full force
nick effect. License Class License No Date Contractor Signature C.L
JORKERS' COMPENSATION DECLARATION
ARNINC: FAILUH" TO SECURE WORKERS' COMPENSATION COVERAGE la UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIM FINES Up TO ONE HUNDRED THOUSAND DOLLARS LIuxi 0001, IN AODi TO THE
DST OF 4D.d."NSA, rLON, DAMAGESAS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES.
her,bv di:irm indtr penalty of perjury one of the following declarations:
J I -have aa w'll 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
er`ormar.co of the work for which this permit is issued. Policy No.
hove end 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'
Jrance caner snit policy number are'.
Policy Number
:€me of Ag smt
,,I certify OiaL in the performance of the work for which this permit is issued, I shall not employ any parson in any manner so as to become subject to the workers' Compensation laws of California, and afire
rut. IS I should become subject to the arkers' cot frensSttan provisions of Seotiorr 3700 of the Labor Code, I shall forthwith comply with those provisions. �g
Igneture oI Anphcnnl _�_ Date 1 /Z6 /Z -Z ..__.
&.'LA:P4r'ON REGARDING CONSTRUCTION LENDING AGENCY
rhereoy aff'.m L'ndar 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).
ender's Name - Lenders Address
y my signature below, I certify IQ 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 wdh all applicable city and county ordinances and state laws relating to building construction
I authorize representatives of this city or county to enter the_9tWvc,1dentq0d property for inspection purposes. A I
or Authorized Anent Name
ACTION DATE BY DECLARATIONOF COMPLIANCE WITHCODEOF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 51 OF TITLE 40 AND AQMD RULE
403
PERMIT EXPIRED SUBMITTED ASBESTOS NOTIFICATION TO
.._.._____ _�.___
PERM7T CANCELLED ---Toe
PERMITONAL I �}JASRESTOSNOTIFICATIONISNOT APPLICABLE TO
CERTIFICATE OF E PROPOSED DEMOLITION
OCCUPANCY ISSUED € SIGNATURES ca
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