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Home My WebLink AboutXR2022-3053 - PermitsaEWPo T City of Newport Beach 1111111111111111111p1111111111111111p11111pIJI111p111 0 A Community Development Department - Building Division x R 2 0 2 2 3 0 5 3 100 Civic Center Drive, Newport9each, CA 92660 n Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 Cq</F00.N`P newportbeachca.gov/inspections Combination Type - SFP ELEC MECH PLUM Work Class - New COMB Permit: XR2022-3053 Plan Check No : PC2022-2923 Issued Date : 0310812023 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: 2012 TUSTIN AVE Legal Desc : A TR NEWPORT HEIGHTS BLK LOT 297 NEWPORT HEIGHTS LOT 297 ALL -EX SELY 520 FT & Description: NEW SFR W/ ATT GAR 3,803 SF / 437 SF; PATIO 176 SF Owner: LA21G LLC Contractor: T J C HOME BUILDERS LLC Architect : NIEMERSKI KENNETH Address : 26880 ALISO VIEJO PKWY STE100 Address : 26880 ALISO VIEJO PKWY #100 Address : 2031 ORCHARD DR #100 NEWPORT ALISO VIEJO, CA 92656 ALISO VIEJO, CA 92656 BEACH, CA 92660 Phone: (949)463-1328 Phone: (949)481-7026 Phone: (949)553-9100 ,,,, Con State Lie : 1025507 State Lie Lie Expire : 04/30/2023 Applicant: Thomas James Homes Bus Lie : BT30059037 Engineer : NGUYEN HUAN , Address : 26880 Aliso Viejo Pkwy #100 Bus Lie Expire : 05/31/2023 Address : 15 STUDEBAKER IRVINE, CA 92618 Phone: (949) 293-3018 Workers' Compensation Insurance Phone: (949) 752-1612 Carrier: TECHNOLOGY INSURANCE COMPANY Owner/Builder: Policy No: TWC4081048 Designer Address : W. C. Expire : 3/8/2023 Address Phone: Phone: •• Code Edition ; 2019 Fire Sprinklers : YES Construction Valuation : $750,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 3,803 Occupancy Groups : U,R-3 No of Units : 1 Alteration sq. ft. Bldg : Bldg Height: No of Stories : 2 Added/New sq. ft. Garage: 437 TOTAL sq. ft. : 4,240 Building Setbacks : Front: 20, Side: 4, Side: 4, Rear: 10 Flood Zone : X Use Zone : R-1 - Single -Unit Residential PROCESSED BY: SPECIAL CONDITIONS: CMSD OWNER -BUILDER DECLARATION I 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 iteri 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 applicantfor he 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 'rofessions 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 fora permit subjects the applicant to a civil penalty of Ict more than five hundred dollars ($500), 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, 3uslness 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 mprovements 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 moved for the purpose of sale). 1 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 Ipply 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). 1 am exempt from licensure under the Contractors' State License Law for the following reason: 3y my signature below I acknowledge that, except for my personal residence in which I must have residad Far at least one year prior to completion of the Improvements covered by this permit, I cannot iegafl% Tall a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. j understand that a copy of the applicable law. Section 7044 of the Business and 'rofessions Code., is available upon request when this application Is submitted or at the following Web site:http:fiwww.leginto.ca.gov/calaw,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 7 O i isiD of the Business and Prolesions d d-licen / ' 6 ull rC@— md effect. License Class License No Date Contractor Signature 1 PORKERS' COMPENSATION DECLARATION J - ;ARNING: FAILURE Tn SrCURE WOR%ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARS pit00(000), {ry p fr]ON TO THE :OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, Me ATTORNEYS FEES- LLrou, affirm ^near punalty of per}'ury one of the following declarations: {rare 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, forth erii'bmance of the work for which this permit is issued. Policy No. Ill ha.e and will m^i-Itain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perform anoe of the work for which this permit is issued. My workers' Compensatio. •sursr-e carrier and policy number are: 'a -re-_ _ Policy Number Expiration Date ri-r3. cf Agent _. Phone # aI (ertify that, in the oa, €ormance of the rk r which this permit' s ad, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agm lit, if I s iould become subject to e wo pens av' is f Section 3700 of the Labor Code, I shall forthwith comply with those provisions. f ti0nalure of Applicant --r� 0ateee� IECf,ARATIpN F.E:GtikD1NG C NST Lt G A E Y hereby affirm under penalty of perjury that there is a construction I g agency for the performance of the work for which this permit Is issued (Section 3097, Civil Code). anodes Name Lender's Address y 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 provided is�o} re��. I agree to comply with all applicable city and county orplulances t'a to ,re all g o buiillding. construction. �� y I authorize representatives of this Sty or county to Ent r EIg7b Id tifie e r ms ectlon ur + l{�,"`-�,0 9/;i nT/ ACTION PERMIT EXPIRED PERMIT CANCEttED PERMIT EJ,TfNDED PERMITFINAL 5-152N CERTIFICATE OF OCCUPANCOSSUED BY € DECLARATIONOF COMPLIANCE ±ITH IDE. OF FEDERAL I FOR OFFICE USE ONLY I REGULATIONS PART 61 OF TITLE AND AQMD RULE SUBMITTED ASBESTOS NOTIFICATION TO IS NOT IIn �Ewv°RT City of Newport Beach II IIII I I III II I IIII IIIIII II Permit: XR2022-3053 100 Civic Center Drive Plan Check: PC2022-2923 Newport Beach, CA 92660 c94 aaaN`P Certificate of Occupancy THIS CERTIFICATE ISSUED PURSUANT TO THE REQUIREMENTS OF SECTION 111 OF THE CITY OF NEWPORT BEACH ADMINISTRATIVE CODE ATTESTS THAT AT THE TIME OF ISSUANCE, THIS STRUCTURE WAS IN COMPLIANCE WITH THE VARIOUS ORDINANCES OF THE CITY OF NEWPORT BEACH REGULATING BUILDING CONSTRUCTION OR USE. Owner: LA21G LLC Address: 2012 TUSTIN AVE, NEWPORT BEACH, CA Tenant: Use Zone: RA - Single -Unit Residential Description of Work: NEW SFR W/ ATT GAR 3,803 SF / 437 SF; PATIO 176 SF Special Conditions: Chief Building Official: Tonee Thai, PE, CASp, CBO Signature: %6rt22 / 21, Code Year Edition: 2019 Number of Stories: 2 Construction Type: V-B Occupancy: U,R-3 Total Occupant Load: Fire Sprinklered: YES Date: 8/21/2024