HomeMy WebLinkAboutF2022-0553 - Permits�t�EWIPORT City of Newport Beach IIIII I IIIIII IIIII I II IIIII IIII III IIIIIII II
Community Development Department- Building Division F 2 0 2 2 - 0 5 5 3
;i 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
q[.irOFN newportbeachca.gov/inspections
Combination Type - SFP
Work Class - Alteration
COMB Permit: F2022-0553
Plan Check No : PC2022-2684
Issued Date : 02/01/2023
Inspection Area : 2
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: 836 HARBOR ISLAND DR
Legal Desc : N TR 3867 BLK LOT 2
Description: SFR FIRE SPRINKLERS (X2022-0810) 28 HEADS
Owner: LINDA BAKER
Contractor: GARDNER JACK JR
Architect
Address : 29 SPRINGWOOD #49
Address : 3772 SIERRA AVENUE
Address
IRVINE, CA 92604
NORCO, CA 92860
Phone :
Phone: (951) 212-9408
Phone
Con State Lie : 470911
State Lie
Lie Expire : 06/30/2024
Applicant: GARDNER JACK JR
Bus Lie : BT30072167
Engineer: • ,
Address : 3772 SIERRA AVENUE
Bus Lie Expire : 02/29/2024
Address
NORCO, CA 92860
Phone: (951) 212-9408
Workers' Compensation Insurance
Phone:
Carrier: NO EMPLOYEES
-
Owner/Builder :
Policy No: EXEMPT
Designer: GARDNER JACK JR
Address :
W. C. Expire:
Address: 3772 SIERRA AVENUE',
NORCO, CA 92860
Phone:
Phone: (951)212-9408
Code Edition : 2019
Fire Sprinklers : YES
Construction Valuation : $12,000.00
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/Ti sq. ft. Bldg : 0
Occupancy Groups :
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: 10, Front: 18, Side: 4, Side: 4
Flood Zone : AE, 8 FT; X
Use Zone : R-1 - Single -Unit Residential
PROCESSED BY
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the resson(s) indicated below by the cheokinark(s) I have placed next to the applicable items)
(Section 7031.5, 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
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 licensors and the basis for the alleged exemption. Anyviolation of Section 7031,5 by any applicant for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500).
M 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not Intended or offered for sale (Section 7044,
Business and Professions code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I am exempt from kcensure under the Contractors' State License Law for the following reason: _.
By my signature below I acknowledge that, except for my personal residence in which I must have resided For atleast one year prior to completion of the improvements covered by this permit, I cannot legail
sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors.) understand that a copy of the. applicable law, Section 7044 of the Business and
Professions Code„ is available upon request when this application Is submitted or at the following Web site:http:IiWww.Ieginfo.ca.govlcalaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 00 ) of ivi ion 3 of the Business and Pros ode a IlceriS - h full force
and effect. License Class License. No Date e / 2$ Contractor Signature
WORKERS' COMPFN3ATION DECLARATION
WHINING: F- LURE TO SECURE WORXERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SU84ECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED 41AND DOLLARS t5100,000j, IN ADDITION TO THE
CO-1 OF COMPENSATION, IWAOES AS PROVIDED FOR 7N SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I hereby affirm under penalty of perjury one of the following declarations:
0 1 har_- 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
erfcrmaace of the work fer which this permit is issued. Policy No.
i 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` compensatio
tnscralcc carrier Is)J pd;c,' number are!
Cal ria Policy Number Expiration Date
Nalaa o: Agent _ _ _ Phone #
[If certify filet. in thJ performance of the work for which this permit is issued, I shall not employ any person in any' manner $o a$ to become subject to the workers' compensation laws of California., and ogre
thai. ,f I sur aid become subject to the orkers' Corr Ion provVon of Section 3700 of the Labor Code, I shall forthwith comply Wth those provisions. -'t
DECLARATION
Applicant G�%`�� Dat la//�fJ�!
DE:Ci,ARATtON REGA IhtG 00 RUCTIO LENDING AGENO
I hereby affirm and Iry that there is a construction trig agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lenders Name Lender's Address
By my signature beKw, 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 1 have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of this city or cou ty maTthe by 'Red p. p for inspection purposes. jj fi 11
Si nature of PropertyOwner or Authorized A ent Print Property Owner's or Authorized Agent's Nam t J 1 717
ACTION DATE BY I gfCLARATIbWOFCOMPUAZ$ll CODE OF FEDERAL FOR OFFICE USE ONLY
EGJLATIONS PART 51 OF&ILE40 AND AOMD RULE
1403
PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED 011PA
PERMITWENDED MD
PER,b}ITFINAL LOABESIOS NOTIFICATION 15 NOTAPPLICABL£ TO
CERTIFICATE OF i4-2y .Puri`--' PROPOSE D1;
OLITION
OCCUPANCY ISSUED SIGNATU r