HomeMy WebLinkAboutXR2022-3045 - Permits�EwPORT City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIiIlllll II COMB Permit : XR2022-3045
Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No :
Permit Counter Phone: (949) 644-3288 Issued Date : 11/1712022
u Inspection Requests Phone: (949) 644-3255 Inspection Area : 3
cqG/pppN�P newportbeachca.gov/inspections s w q ,rN,
Combination Type - SFP
Work Class - Alteration
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 BILK LOT 19
Description: DELTA 2 REVISION & ADD'L SCOPE: ROOF FRAMING PLAN, REMODEL BATHROOMS
Owner: HOLIDAY FAMILY REVOCABLE TRUST
Address : 1700 E OCEAN BLVD
NEWPORT BEACH, CA 92661
Phone :
Applicant: ADAM HOLIDAY / JULIE HOLIDAY
Address : 1700 E OCEAN BLVD
NEWPORT BEACH, CA 92661
Phone:
owner/Builder: ADAM HOLIDAY / JULIE HOLIDAY
Address: 1700 E OCEAN BLVD
NEWPORT BEACH, CA 92661
Phone:
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: CHEN YONGQING
Address: 11 DEERWOOD W
IRVINE, CA 92604
Phone: (949)466-6946
Designer:
Address :
Phone:
Code Edition :
2019
Fire Sprinklers :
NO
Construction Valuation :
$4,500.00
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 :
55
0
Bldg Height:
No of Stories :
1
Added/New sq. ft. Garage :
TOTAL sq. ft.
0
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)
o
,
PROCESSED BY:
/
SPECIAL CONDITIONS
I hereby affirm under penalty of perjury that I. am exempt from the Contractors' State License Law for the reasons) indicated below by the checkrnark(s) I have placed next to the applicable Iterr(s)
Ilion 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, altar, improve, demolish, 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
fessions Code) or that he or she is exempt from )!censure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of
Fthan five hundred. dollars ($500).
owner of the property, or my employees with wages as their sole compensation, will do U 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, file building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not builtor
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 not
ry 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),
LJ I am exempt from licensee under the Contractors' State License La
By my signature below I acknowledge that, except for my personal msid
sell a structure that I have built as an owner -builder if it has not been col
Professions Code, is available upon request when this application is sut
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perfury that I am licensed under p visiG
and effect. License Class License No
COMPENSATION DECLARATION
following reason
'hi ust have resided for at least one year prior to completion of the Improvements covered by this
i c 'rely by licensed contractors, understand that a copy of the applicable law, Section 7044_of t
t 11 g Web site.http:liwvnv.leginfo.ca.gov/calaw.html. [J )
Data
of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my
Date Contractor Signature
force
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SU84ECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS f$100,000j, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370E OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES -
hereby affirm under penalty of perjury one of the following declarations:
-11 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 Ih,
)erformance 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:
Policy Number
of Agent
Date
Certify that, inthe performance of t a wor or hick this permit is issued. I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
t, If I should become subject to th or Is' perlsaticn provisions of Section 3700 of the Labor Code, I shall forthwith comply w1h those provisions. >
nature of Applicant„ [
Dale
CLARATIGN REGARDING NS UCTION LENDING AGENCY
neby 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 the property owner's behalf.
I have read this application and the information i have pro ed is correct.
I agree to ccrnrl v th all applrcable city and cowTty Ordi noes ate laws relating to building construction.
I authorize representatives of this city or county to am e au -I property for inspection purposes.
ualura of Pro.i^.CI 0-iner or Authorized Agent Print Prooerty Owner's or Authorized Aoant's Names nFt
ACTIOT' ( DATE BY DECLAMATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AWAD RULE
1403
Fr4,`47EXTENDED
F .f iTTWAt
JFr6AFEOi — ; / Z4- Z'
QCCJrl/?�
OCrfrpANCyl55GEp Jj
I SUBMITTED
L,ajr5BEST05 NCTIFICATION
PROPOSED DEMOLITION ,
RE: