HomeMy WebLinkAboutXR2023-0984 - Permits�AtiWPok City of Newport Beach
Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
U Inspection Requests Phone: (949) 644-3255
newportbeachca.gov/inspections
Combination Type -
Work Class - Alteration
jjiI��III��1111111111111111111111111111111111111111111111 COMB Permit : XR2023-0984
Plan Check No:
Issued Date: 04/17/2023
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 : 322 CORAL AVE
Description
: SFR BATHROOM RETILE
Owner:
HAVIKEN MICHAEL R TR M R
Address :
35 RISA ST
RANCHO MISSION VIEJO, CA 92694
Phone:
(949)632-2888
Applicant: HAVIKEN MICHAEL R TR MR
Address : 35 RISA ST
RANCHO MISSION VIEJO, CA 92694
Phone : (949) 632-2888
Owner/Builder: HAVIKEN MICHAEL R TR M R
Address : 35 RISA ST
RANCHO MISSION VIEJO, CA 92694
Phone : (949) 632-2888
Legal Desc : A TR BALBOA ISLAND SEC 3 BLK 16 LOT 12
Contractor
Address :
Phone:
Con State Lic
Lic Expire
Bus Lic:
Bus Lic Expire:
Workers' Compensation Insurance
Carrier :
Policy No:
W. C. Expire:
Architect
Address
Phone:
State Lic
Engineer:
Address
Phone:
Designer:
Address
Phone:
Code Edition:
2022
Fire Sprinklers : NO
Construction Valuation :
Type of Construction :
V-B
Fire Hazard Zone : NO
Added/New/TI sq. ft. Bldg:
Occupancy Groups :
U,R-3
No of Units : 1
Alteration sq. ft. Bldg :
Bldg Height :
No of Stories : 2
Added/New sq. ft. Garage:
TOTAL sq. ft.
Building Setbacks:
Front: 8, Side: 3, Side: 3, Rear: 5
Flood Zone :
Use Zone:
X; AO 1
R-BI- Two -Unit Residential, Balboa
Island
e3 tl f�'r
Iv a CONSTRUCTION ION NOSE
PROCESSED BY:
SPECIAL CONDITIONS: t—% a- ON THE WEEKEND
t%
$3,800.00
0
0
0
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 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
in 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
Irofessions 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
of more than five hundred dollars ($500).
1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of of L) portions of the work; and the structure is not intended or offered for sale (Section 7044,
tusiness and Professions Code: The Contractors' State License Law (Ines not apply to an owner of property who, through empoyees' ar personal effort, builds or improves the property, provided that the
nprovements 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
npraved 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
poly 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).
1 am exempt from licensure under the Contractors' State License Law for the following reason: __
ty 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,
all a structure that I have built as an owner -builder if it has not boon constructed in its en ' ty by licensed Contractors. I understand that a copy of theapplicable law, Section 7044 o€ th usin s and
'rofessions Code, is available upon request when thi a le s or olloWing Web site:http://www.leginfo.ca.govicalaw.html.
lignature 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 7000) of Division 3of the Business and Professions Code, and my license is in full force
rid effect. License (,lass License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
'P i'SaJ: FAILURE TO SSCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS t410(1,000), IN AO on ION TO THE
DST OF COMPENSATIlr', ] .MAGES AS PROVIDED FOR IN SECTION 070E OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES.
h.:reby affirm under penally of perjury one of the following declarations:
I I have and wit, malrwin 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
Rnarmarca of the work ;or which this permit is issued. Policy No.. _
JI have :and wil' msmtain 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
nsurance carrier dud policy number are:
carrier_ Policy Number Expiration Date
Veme of Agent _ Phone #
-11 ceriLT, 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 agre
hat, if I should berore subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant Date____
)ECLARATION REGARDING CONSTRUCTION LENDING AGENCY
hereby affirm under penally of perjurythat there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
_pnder's Name Lender's Address
3y my signature below, I certify to each of the following: m
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 correct.
I agree to comply with all applicable city and county ordinances and slat laws relating to building construction. Y
I authorize representatives of this city or cou ty a ifl p ' s ction purposes.
Signature of Property Owner or Authorized Agent - Print Pra art Owner's or Authorized A enCs Nam Data
ACTION DATE By DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
i REGULATIONS PART 61 OF TITLE 40 AND AQI RULE
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXFENOED
CERTIFICATE Of
OCCUPANCY ISSUED
TO
NOTIFICATION 15 NOT APPUCAUV 'TO
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