HomeMy WebLinkAboutXR2023-1207 - Permitsa£�Po�r City of Newport Beach III III I IIII II I IIII IIIIII IIII IIIII III II COMB Permit : XR2023-1207
p� d Community Development Department- Building Division X R 2 0 2 3 1 2 0 7
t}- 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No:
z Permit Counter Phone: (949) 718-1888
newportbeachca.gov/civic Issued r$/0912023
e
Inspection on Area : 6
�4[/coRN�P Combination Type - SFP
Work Class - Other
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: 421 MARGUERITE AVE Legal Desc : A TR CORONA DEL MAR BILK 438 LOT 15
Description: SFR KITCHEN AND BATHROOM REMODEL 230 SF AND WINDOW CHANGEOUT (NO CHANGE TO HEADER)*CITY STANDARD* 121-3229 *RENEW EXPIRED
PERMIT*
Owner: JOHN CLAREY
Contractor :
Architect:
Address : 421 MARGUERITE AVE
Address :
Address
NEWPORT BEACH, CA 92625
Phone : (949) 933-1529
Phone:
Phone:
Can State Lie :
State Lie
Lie Expire :
C)
Applicant : JOHN CLAREY
Bus Lie :
Engineer
Address : 421 MARGUERITE AVE
Bus Lie Expire :
Address
NEWPORT BEACH, CA 92625_
" ^
Phone: (949) 933-1529
Workers' Compensation
Insurance
Phone:
Carrier :
Owner/Builder: JOHN CLAREY
Policy No:
Designer: 'A -
Address: 421 MARGUERITE AVE
W. C. Expire :
Address : (r
NEWPORT BEACH, CA 92625
,T-p
Phone: (949) 933-1529
Phone
Code Edition : 2019
Fire Sprinklers :
NO
Construction Valuation
Type of Construction : V-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg : 0
Occupancy Groups : R-3
No of Units:
1
Alteration sq. ft. Bldg:
Bldg Height :
No of Stories :
1
Added/New sq. ft. Garage : 0
TOTAL sq. ft. 0
Building Setbacks : Front: 20, Side: 3, Side: 3, Rear: 5
Flood Zone : X
Use Zone : R-2 - Two -Unit Residential -
PROCESSED BY
SPECIAL CONDITIONS: O/B FORM ATTACHED
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law Tor the reason(s) indicated below by the checkmark(s) 1 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
the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Stale 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).
71 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,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' nr 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).
as owner of the property, am exclusively contracting with lie sed Contractors [o construct the project (Section 7044, Business and Professions Coder The Contractors' State License Law does not
apply to an owner of property who builds or improves. thereon; an who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law),
I am exempt from licensees under the Contractors' State Li .rise La I r the following reason
By my signature below I acknowledge that, except for my per n rest ce in whit I must have resided for at least one year prior to completion of the Improvements covered by this permit, I cannot legall;
sell a structure that I have built as an ownor-builder if I as n on c t Cie its entirety by licensed contractors. I understand that a copy of the applicable law. Section 70" of the Business and
Professions Code, is available upon request who th( appy n is It ollowing Web site:tittpaiwvay.laginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent oat& V....
LICENSED CONTRACTOR'S DECLARATIv/T\_
I hereby affirm under penalty of perjury that I am nfluense—Idde"prov,sions Ch ter 9 (commencing with Section 7000) of Division 3of the Business and Professions Code, and my licenseis in full force
a.nJ e:fet. Licence Class cense No Date Contractor Signature
COMPENSATION DECL.ARATIDN
MnANING: rAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($10 ,000), IN ADDITION TO T
CuST OF COMPENSAT'CN ^AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYa FEES.
hereby affirm unds- penalty of perjury one of the following declarations:
711 have and wil, ,nain-ain 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
performance of the for which this permit is issued. Policy No,
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'
ranee carrier a,rd oulicy number are:
le of Agent
comity that. in the performXAT/
e of the
, If I should become s/gbjewe
lature of Aoollcantt V
Policy Number Expiration Date
this permit is issued. I shall not employ anyperson in any manner so as to become subject to the workers' compensation laws of California, and agre
if prov" ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ?
Dat i
NG AGENCY
hereby affirm under p6nalit�gf¢erjury that there is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097, C i1 Code).
ender's Name ]]// Lender's Address _-__—
ly my signature below, I Drily to each of the following:
I am the property owner or authorized to act on the fir,
I have read this application and the information I have
I agree to comply with all applicable city and county
I authorize representatives of this city or county to
signature of Property Owner or Authorized Age
ACTION I DATE I v
1403
PERMIT CANCELLED
PERMIT EMENDED
PERMIT C 3S /����
CERTfFICATE AFEC OF � 1"
OCCUPANCYISSUED
owner's behalf,
ad is correct.
es d state Laws relating to building construction. J G'/`J`ey/
ifor inspection purposes. I /
OF COMPLIANCE WITH CODE OF FEDERAL ( FOR OFFICE USE ONLY
PART GI OF TITLE 40 AND AQMD ROLE
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