HomeMy WebLinkAboutXR2022-2454 - Permits�afwPo� City of Newport Beach I II I I I I I II I III i III II II o� @ Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
N� ? Permit Counter Phone: (949) 644-3288
ex Inspection Requests Phone: (949) 644-3255
c r newportbeachca.gov/inspections
Combination Type -
Work Class - Alteration
COMB Permit : XR2U22-2454
Plan Check No: PC2022-2296
Issued Date : 09/13/2022
Inspection Area : 1
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 : 215 32ND ST
Legal Desc : A TR LAKE TR BLK 132 LOT 17
Description: MFR INFILLING DOOR W/ DRYWALL
UR
Owner: THOMAS PRESTON
Contractor :
Architect
Address : 430 BROADWAY
Address :
Address
LAGUNA BEACH, CA 92651
Phone: (949)923-8943
Phone:
®()
Phone: •�`
Con State Lie:
���y
State Lie
Lie Expire :
,y
Applicant : THOMAS PRESTON
Bus Lie:
Engineer
Address : 430 BROADWAY
Bus Lie Expire :
Address
LAGUNA BEACH, CA 92651
Phone: (949) 923-8943
Workers' Compensation Insurance
Phone
Carrier
Owner/Builder : THOMAS PRESTON
Policy No:
Designer: THOMAS PRESTOr�
Address: 430 BROADWAY
W. C. Expire:
Address: 430 BROADWAY
LAGUNA BEACH, CA 92651
LAGUNA BEACr' A 92651
Phone : (949) 923-8943
Phone : (949) 923-894,3!
Code Edition : 2019
Fire Sprinklers : NO
Construction Valuation : $850.00
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/TI sq. ft. Bldg : D
Occupancy Groups : R-3
No of Units : 2
Alteration sq. ft. Bldg : - -_ -
Bldg Height :
No of Stories : 3
Added/New sq. ft. Garage : 0 -
Building Setbacks : Front: 10, Side: 3, Side: 3, Rear: 5
Flood Zone : X
Use Zone: R-2 - Two -Unit Residential
o J
PROCESSED BY:
SPECIAL CONDITIONS: OWNER/BUILDER ATTACHED
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 items)
Ilion 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
permit to file a signed statement that he or she is liconscd 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 licensors 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 ponalty of
more than five hundred dollars ($500).
.L as owner of the property, or my employees with wages as their sole compensation, will do II 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 owne Gf pr party who, through employees' or personal effort, builds or improves the property, provided that the
rovements 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
roved 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
ly to an owner of property who builds or Improves thereorA and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law),
J I am exempt from licensure Linder the Contractors'
,y my signature below I acknowledge that, exce t fo
all a structure that I have built as an owner -bull t s
'rl
rofessions Code, is available upon request who.
Ignahire of Property Owner or Authorized Agen
.ICENSED CONTRACTOR'S DECLARA
hereby affirm under penalty of perjury that I am can,
nd effect. License Class
Law for the
:h I must h e resided for at least one year prior to completion of the improvements covered by this permit, I. cannot
its antir by licensed Contractors. I understand that a copy of the applicable law, Sectioq 7¢r44 0€ Ihp Busi as and
ih Mowing Web site:hltpalwwv✓.leginfo.ca.gov/calaw.html. V �r C
isions of Chapter 9 (commencing with Section 7000) of Division 3of the Business and Professions Code, and my license is In full farce
No Date Contractor Signature
NORKERS' COMPENSATION DECLARATLN
YARNING: FAILURE TO SECURE WORKERS' COMPENSATIOme
D AGE 19 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,00061N ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR iN N0706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of theowing declarations:
1 have and wiff 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
)erformance of the work for 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' compensatiot
nsurance carrier and policy number are:
:arrler n Policy Number Expiration Date
dame of Agent Phone #
—11 certify that, in the performs a he k f"hthisci is is ued, I shall not employ any person in any manner so as tD become subject to the workers' compensaV laws f California, and agra
hat, if I should become ubj to th w- s' ion of S Ilion 3700 of the Labor Code, I shall forthwith comply with those provisions.
3lgnature of Applicant _ DataDECLARATION RFr,ARNI CON ONfe-ehy Pffirm under penalty D perj a t n lending agency for the performance of the work for which this permit Is Issued (Section 3097, Civil Co ).
_ender's Name Lender's Address
3v,ny signature below. I Cart ly to a t of the following:
I an, the pro party Owner r an
lot ed to act on "a property own 's behalf.
I have read IN-, aPEI'catio a d t information I hav fir ed con .ct.
I cgree to comply wnn all a or.,
city and co 8y f es d to aw eel in to huilding consiruclion.
! : rthorize representatives of this city or county t ar the b -I nt d op dy r inspection purposes.
i' :-,3',.-e of Pro art (owner or Authorized Agent Print Pro Property
Owner's or Authorized Agent's Na Da[e
.CLGK HATE BY DF RA I C P NCE 1NITti CODE OF FEDERAL FOR OFFICE ONLY
I � RE RA
RT51OF TITLE 40 AND AQMD RULE _T _ T a.. n/'.R, n
PfPVITEXPIREO Ld I S LA MITTED AS BESTCPS NOTI FICATION TO
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