HomeMy WebLinkAboutX2022-0859 - Permits-
City of Newport Beach
Building Division
�,EWPORT
Community Development Department -
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100 Civic Center Drive, Newport Beach, CA 92660
U S
Permit Counter Phone: (949) 644-3286
Inspection Requests Phone: (949) 644-3255
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newportbeachca.gov/inspections
Combination Type - MFP ELEC MECH PLUM
Work Class - Alteration
II III III I I II COMB Permit : X202,2-0859
Plan Check No : 0789-2022
Issued Date : 09/12/2022
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 : 135 JASMINE CREEK DR Legal Desc : N TR 7967 BLK LOT 66
Description: SFR REMODEL 2,445 SF. ADD REAR BALCONY 345 SF. EV CHARGER @ GARAGE
Owner : LEVY DAVID TR
Address : 135 JASMINE CREEK DR
CORONA DEL MAR, CA 92625
Phone
Applicant: KRISTI HENDERSON
Address : 14645 RED HILL AVE
TUSTIN, CA 92780
Phone: (714)454-4513
owner/Builder: KRISTI HENDERSON
Address : 14645 RED HILL AVE
TUSTIN, CA 92780
Phone : (714) 454-4513
Contractor
Address :
Phone:
Con State Lic
Lic Expire ;
Bus Lic :
Bus Lic Expire
Workers' Compensation Insurance
Carrier :
Policy No
W. C. Expire
Architect :
BDAIWI MUSTAFA
Address :
601 PARKCENTER DR #204 SANTA ANA,
CA 92705
Phone:
(714)673-6611
State Lic
Engineer: JALALPOUR MOHAMMAD
Address : 152 DEERFIELD AVE
IRVINE, CA 92606
Phone:
Designer: KRISTI HENDERSON
Address: 14645 RED HILL AVE
TUSTIN, CA 92780
Phone: (714)454-4513
Code Edition :
2019
Fire Sprinklers :
NO
Construction Valuation :
$195,600.00
Type of Construction :
V-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg :
0
2,445
Occupancy Groups :
U,R-3
No of Units :
1
Alteration sq. ft. Bldg :
0
Bldg Height:
No of Stories :
2
Added/New sq. ft. Garage :
Building Setbacks :
Front: 15, Side: 5, Rear: 15
Flood Zone :
X
Use Zone :
PC - Jasmine Creek
PROCESSED BY:
SPECIAL CONDITIONS:
O/B FORM & LLC ATTACHED
OWNER -BUILDER DECLARATION
I 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 file applicable items)
(Section 7031,6, 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
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 ficensure and the bans for the alleged exemption. Any violation of Section 7031,5 by any applicant fora 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 do (_) all of or U portions of the work, and the structure is notintendedor offered for sale (Section 7044,
Business and Professions Code: The Contractors' Slate 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
red for the purpose of sale).
a 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
apply 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).
:1 I am exempt from lieensure under the Contractors' Slate License Law for the following reason: _
ly my signature below I acknowledge that, except for my personal residence in which 1 must have resided for of least one year prior to completion of the Improvements covered
Of 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, Sacti 71
'rofassions Code, is available upon request wh Ih _ app'.al'S s miffed' ositathltp:Gwww.leginioca,govlcalaw.html.
,ignature of Property Owner or Authorized Agen or he follwing We bate
ACEN:SED CONTRACTOR'S DECLARATI
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, ai
nd effect. License Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E100,000), IN ADDITION TO'
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one 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
erformance of the work for which this permit is issued. Policy No.
this permit, I cannot
of the Business and
my license is In full force
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'
Fence carrier and policy number are:
Policy Number
of Agent
Date
11 certify that in the performance of the work for which this permit is issued, I shag not employ any person in any manner so as to become subject to the workKCIMC-C
'mpensation laws of California, and agre
Tat, if I should becc�Sacto the wZLEXI
'Lion provisions of section 3700 of the Labor Code, I shell forthwith comply with those provisions.dgnatme of Applfua ___ DarBCLARATfON REN RGAG NCY
hereby affirm under penalty of erjL that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097,ode).
ender's Name, Lenders Address
ty my signature below. I certify to each of the follo ing:
I ant the property owner or authorized to act on the properly 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 cocinly ordinances and slate laws rotating to buildin conslrucLlon.
spect�J1
I authorize representatives of this city or cou 1 r o�.aoyentihed ppperty for in' n purposes.
ACTION
i DATE
By V ' DECLAhATIIQN. OF COMPLIANCE WITH CODE OF FEDERAL
REGULATIONS PART 61 OF 1ITLF 40 AND AQMD RULE.
1,103
FOR OFFICE USE ONLY
PERMIT EXPIRED
jL J I SU8MI'TEC AS8EST0' NUT HLATION TO
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