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HomeMy WebLinkAboutXR2023-2504 - Permits2gvrvo�r City of Newport Beach II IIIIIIIIIIII IIII IIIII IIIIIIIIIIIII IIIIIII II COMB Permit : XR2023-2504 Community Development Department- Building Division X R 2 0 2 3 2 5 0 4 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : 0354-2021 D h i Permt Counter Pone: 949 718-1888 U > z ( ) Issued Date : 09/07/2023 � newportbeachca.gov/civic Final Date: C,4Fp0.N�P Combination Type - Permit Status: Issued Work Class - Other Inspection Area : a 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: 1912 KEWAMEE DR Legal Desc : N TR 2813 BLK LOT 35 Description: SFR BLOCK WALL 6' HIGH X 70 LF ON P/L *MARKERS ON SITE* Owner: EZ PROPERTIES LLC Contractor : i P 3 CUS I OM HOMES INC Architect Address : 175 MONARCH BAY DR Address : 1232 STARLIT DR Address DANA POINT, CA 92629 LAGUNA BEACH, CA 92651 Phone: (702)340-9238 Phone: (949)813-3797 Phone: Con State Lie : 907971 State Lie Lie Expire: 12/31/2023 Applicant: J P 3 CUSTOM HOMES INC Bus Lie : BT30082241 Engineer Address : 1232 STARLIT DR Bus Lie Expire : 07/31/2024 Address LAGUNA BEACH, CA 92651 Phone: (949)813-3797 Owner/Builder : Address : Phone Workers' Compensation Insurance Carrier: EXEMPT- NO EMPLOYEES Policy No: EXEMPT W. C. Expire: Phone : Designer Address Phone : Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $12,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/Ti sq. ft. Bldg : 0 Occupancy Groups : U No of Units: 0 Alteration sq. ft. Bldg : Bldg Height: No of Stories : 0 Added/New sq. ft. Garage : 0 TOTAL sq. ft.: 0 Building Setbacks : Front: 10, Side: 4, Side: 4, Rear: 10 Flood Zone : X Use Zone: R-1 - Single -Unit Residential PROCESSED BY: SPECIAL CONDITIONS OWNER -BUILDER DECLARATION 1 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 ftem(s) (Seclloti 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, dernoiish, 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 ContractorsState 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 licensure and the basis for the alleged exemption. Any violation 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). 0 I, as owner of the property, or my employees with wages as their sole compensation, will do C_) all of or (_) 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 properly who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. It, 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' Stale License Law does not El to an owner of property who huilds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law), 11 I am exempt from Ilceneure Driest the Contractors' Slate 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 at least one year prior to completion of the improvements covered by this permit, I cannot legall) soli a structure that I hsve built as ai ownor-builder if It has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is availablo upon request when this application is submitted or at the following Websita:http:llwww.laginfo.ca.govicalaw.html. Signature of Property OWneror Auth]rized Agent _ _ Date LICENSED CONTRACTOR'S nECLARATION I hereby affirm under penalty of parjury that I am licensed under provisions of Chapter 9 (commencing with Seclio 7 ) i i '� 3of the Business and P s i e, • d my license is in full force and effect. License Class License No Date Contractor Sign WORKERS' COMPENSATION DECLARATION ,NARNING: FAILURE TO SECURE WORAeRS' COMPENSATION COVERAGES UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE O OO LARS IS100.000i.IN AODITION TO THE COST OF COMPENSATION, DAMAGES AS PRO - Imo FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST• AND ATTORNEY'S FEES. hereby affirm uncle, penalty of perjury one of the following declarations: ,,,,) I have and will maintain a celrti^ale of consent to self -insure for warkers compensation, issued by the Director of Industrial Relations as provided for by Section'3700 of the Labor Code, for th )erformance of the work for which this permit is issued. Policy No. :11 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' compensatiol nsurance carrier and policy number are: ;artier Policy Number Expiration Date ,JL,rne of Agent Phone # t_R�aed$y that. in the perfor once of the work for which this permit is issued, I shall not employ any person is any manner sous to become subject to the woPFs'mppnsaii. - laws of California, and agre hat, if I shouldbecom su ct to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.iignalure of Applicant __, Q1>ECLARATION REGA N LENDING AGENCY hereby affirm underp * o perjury that ere is a construction lending agency for the performance of the work for which this permit is issued (Section 309ode). .endars Name Lender's Address ly my signature below, I certify to each of th following: I am the property owner or authorized to act on the properly owner's behalf, I have read this application and the into natJ ion I have provided is correct. INk I agree to comply with all applicable city and GOun4 ordinances and St a laws relating to building construction. ��11 I authorize representatives of this city o count e e - vde ified property for inspection purposes. y �y signature of Property Owner or Authorized A enl Print Pro e Owner's or Authorized A enf am ate " r ACTION DATE BY -.CLA --RATIO C MPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY i RF.GULATIO ART 1 OFTITLE40 AND AQMD RULE PERMITEXPIRED I I I U I SURMITTED ASBESTOS NOTIFICATION TO PERMIT EXTENDED I LJAQM_p _ _ _ .......... ..._____ __ _ . __ .. _....__ t'r PERiYNi FINAL I��O-j�z3 �Av IU ASBESTOSNOI`9 CATION IS NOT APPLICABLE TO CERTIFICATE Of PROPOSED DEMOLI ON OCCUPANCY ISSUED CM5 SIGNATURE: