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Home My WebLink AboutXR2022-3002 - Permits�r£ POa City of Newport Beach p @ Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 0 Z Permit Counter Phone: (949) 644-3288 m Inspection Requests Phone: (949) 644-3255 CgLlxOr+N�P newportbeachca.govlinspections Combination Type - SFP Work Class - Alteration IIIIIIIIIIIIII II11IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XR2022-3002 Plan Check No : PC2022-2860 Issued Date : 11/15/2022 Inspection Area : 6 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 : 17 CAMBRIA DR Description: SFR ADD GABLE ROOF OVER (E) ENTRY. Owner: ENGLER GREGORY L TR Address :. 2275 BLACKHEATH TRCE ALPHARETTA, GA 30005 Phone: JNCUSTOM .HOMES . � _ Architect: JUSTIN JOHNSTON )RATE PLAZA, STE 150 rAddress : 151 KALMUS DR, G-1 COSTA MESA, CA F BEACH, CA 92660 92626 1800 Phone: (714)754-4040 State Lie : C038829 uc. cxp)re: -Urrp v4Uw Applicant: PATTERSON CUSTOM HOMES Bus Lie: BT02110534 Address: 15 CORPORATE PLAZA, STE 150 Bus Lie Expire : 09/30/2023 NEWPORT BEACH, CA 92660 Phone: (949) 723-1800 Workers' Compensation Insurance Carried: STATE FUND Owner/Builder: Policy No: 9065406 Address : W. C. Expire : 8/1/2023 - Phone: Code Edition : 2019 Fire Sprinklers : YES Type of Construction : V-B Fire Hazard Zone :' NO Occupancy Groups : U,R-3 No of Units : 1 Bldg Height: No of Stories : 1 Building Setbacks : Front: 6, Side: 5, Side: 5, Rear: 46-45 Flood Zone: X Use Zone : PC -(Harbor View Hills PROCESSED BY: Is's SPECIAL CONDITIONS: MANSHADIFARHAD 1800 E 16TH ST UNIT B SANTA ANA, CA 92701 (714)835-2800 Designer: Address `Construction Valuation : Added/New/TI sq. ft. Bldg Alteration sq. ft. Bldg : Added/New sq. ft. Garage TOTAL sq. ft. : $15,000.00 0 225 0 0 pa. p� p I hereby affirm under penalty of perjury that] am exempt from the Contractors' State License Law for the reasen(s) indicated below by the checkmark(s) i have placed next to the applicable item(s) 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 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 Econsure 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 lot 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 (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, - lusiness 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 mproved 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 1 ly 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). I am exempt from licensure under the Contractors' State License Law for the following reason: ly 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 legal], ;ell a structure that I have built as an Gamer -budder 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 irafessions Code, is available upon request when this application Is submitted or at the fallowing Web site:httpJivww_leginfo.ce..gov/calaw.htmi. Signature of Property Owner or Authorized Agent _ Date JCENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that. I am licensed under provisions of Chapter 9 (commencing with Section 7000) 10 3 of the Business and Professions Code, ar Icense is in full force and effect. License Class License No Date T Contractor Signature,,— NORKERS' COMPENSATION DECLARATION YARNING: FALtIRE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVUL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000I. IN ADDITION TO THE :DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR. CODE, INTEREST, AND ATTORNEY'S FEES. �d hereby affirm under penalty of perjury one of the following declarations: .1 have and will maintain a certificate of consent to seWinsure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th Hnformance of the work for which this permit is issued. Policy No. Q 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' compensatioi asurance carrier and policy number are: Policy Number Expiration Date of Agent Ell certify that, in the performance of the work for which 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 agra that, if I should become su�€c'[1/athowor ors Gom nation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 1 Signature of Applicant Date 7(n—z DECLARATION REGARDINGtONSTRUCTION EMOING AGENCY t hereby 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 Cade). Lender's Name Lenders Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the property ownee's behalf. i have rAJ nr:applieation and the Information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. •.I authorbe�rearf•.sentatives of this city or county to the a yeti tied property for inspection purposes. / Si nature ofPro a Owner or Authorized A of Print Property Owner's or Authorized Agent's Name N Date z •• ACMON • DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY • ' • REGULATIONS PART fit OF TITLE 40 AND AQMD RULE • • a •••••. 1403 16 • 7i A !ASBESTOS NOTIFICATION IS APPLICABLE TO �•� L ROPOSEDDEMOTfIOAt