HomeMy WebLinkAboutXR2022-2628 - PermitsD4 �gwaoR� City of Newport Beach
' d Community Development Department- Building Division
F 100 Civic Center Drive, Newport Beach, CA 92660
in► ¢ Permit Counter Phone: (949) 644-3288
aK Inspection Requests Phone: (949) 644-3255
CqC/FppN�P newportbeachca.gov/inspections
Combination Type - SFP ELEC PLUM
Work Class - Alteration
COMB Permit : XR2022-2628
Plan Check No:
Issued Date : 10103/2022
Inspection Area : 3
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 : 1936 GALAXY DR Legal Desc : N TR 4224 BLK LOT 19
Description: SFR -REPLACE (10) WINDOWS (8) DOORS L/L NO CHANGE IN LOCATION, INSTALL (1) NEW GAS LINE AT KITCHEN AREA, ELEC PNL Un-_PADE 200A, T/O
& R/R WITH METAL WESTERN STANDING SEAM (58 SQ)
Owner:
Adam Holiday
Address :
1936 GALAXY DR
NEWPORT BEACH, CA
Phone:
(949)630-8991
Applicant:
Adam Holiday
Address :
1936 GALAXY DR
NEWPORT BEACH, CA
Phone:
(949)630-8991
Owner/Builder : Adam Holiday
Address : 1936 GALAXY DR
NEWPORT BEACH, CA
Phone: (949)630-8991
Contractor
Address :
Phone :
Con State Lie
Lie Expire
Bus Lie :
Bus Lie Expire
Workers' Compensation Insurance
Carrier :
Policy No:
W. C. Expire:
Architect
Address
Phone:
State Lie
Engineer:
Address
Phone:
Designer:
Address
Phone:
Code Edition :
2019
Fire Sprinklers :
NO
Construction Valuation :
Type of Construction :
V-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg
Occupancy Groups :
U,R-3
No of Units :
0
Alteration sq. ft. Bldg :
Bldg Height:
No of Stories :
1
Added/New sq. ft. Garage:
TOTAL sq. ft. Bldg:
Building Setbacks :
Front: 10,
Side: 6, Side: 6, Rear: 6
Flood Zone :
X
Use Zone :
R-1-6000
- Single -Unit Residential (6000 indicates minimum
lot area)
PROCESSED BY:
SPECIAL CONDITIONS:
v
$49,000.00
0
0
OWNER -BUILDER DECLARATION
t hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable items) .
:clion 7031.5, Business and Professions Code: Any city or county that requires a permlt to construct, alter, improve, dernolish, or repair any structure, prior to its issuance, also requires the applicant for
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
rfessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant forat 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 (_) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
siness 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).
1, as owner of the property, am exclusively contracting with licensed Contractors to consWctthe project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
� 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).
am exempt from licensure under the Contractors' State License Law for the following reason
my signature below I acknowledge that, except for my personal residence iJodn'
ch I at have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legalll
a structure that I have built as an owner -builder if it has not been co eructits . n rely by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
rfessions Code, is avai'abie upon request when this application i 5 ilte t wing Web site:http:/I w .leginfo.ca.gov/calaw.btml, X �� — 3 2 2
nature of Proprrry Uwi ter or Authorized Agent -1 __ —_ — Date
TENSED CONTRACTOR'S DECLARATION _ _ '-� �—
;reby a'lirm un ler penalty of perjury that I am licensed under provisions of Chapter 9 ( Ommencfog With Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force
t. effert. License Class License No Date Contractor Signature
)RM.ERS' COMPENSATION DECLARATION
i1'INGt TAILURE T7 SECUR-, WOR%ERS' COMPENSATION COVERAGE Is UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS tE1DgOtl01, IN ADDITION To THE
,T lF CCMPENSATIUI., J—MACES AS PROVIDED FOR IN SECTION 370E OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
Ireby affirm under pe„alty of perjury one of the fallowing declarations:
I. hev� 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
formanne of the work for which this permit is issued. Policy No.
have and will mon tao 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
e2nr:e carrier and policy number are:
Policy Number
of Agent
Date
certify that, in the performance 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 California, 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.
0
Date _
CLARATGN REGARDING CONSTRUCTION (_.ENDING AGENCY
Ireby 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).
Ides s Name Lenders Address
my signature below, I certify 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 provide a err Oct.
I agree to comply with all applicable Orly and county ordinan s I I. la s relating to building construction.
1 authorize representatives of this city or county to enleh Ov -I e ifi roperty for inspection purposes.
Si nature of Property Owner or Authorized Agent f— Print Property Owner's or Authorized Agent's Name Dale 'U'
ACTION DATE. BY DECLARATION OF MMPLI CE WITH CODE OF FEDERAL FOR OFFICE USE ONLY /
j REGULATION5 PART 61 DF TITLE 40 AND AQMD ROI.F.
1403
PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTI FICATION TO
PERMLTCANCFLL£D
CPA
PERmtiT EXTENDED
_ G - �3 j- ---- - ,�5
OCCUPANCYISSUED e / ? SIGNATURE,
O5 NOTIFICAr1 NOT A�PLit .1
CERTIFICATE OF POSED DEMOLffIO