HomeMy WebLinkAboutXR2023-0166 - Permitsa Wpo�r City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XR2U23-0166
off. Community Development Department - Building Division X R z 0 2 3 0 1 s 6
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-0164
�* n Permit Counter Phone: (949) 644-3288 Issued Date : 02/22/2023
Inspection Requests Phone: (949) 644-3255 Inspection Area : 5
cq{,rFoaT'�P newponbeachca.gov/inspections
Combination Type - PLUM
Work Class - Demolition
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 : 419 GOLDENROD AVE Legal Desc : A TRCORONA DEL MAR BLK 333 LOT 19
Description: DEMO DUPLEX/GARAGE 2941 sf. 4 BEDROOMS. SEWER CAP INCLUDED
Owner: 419 GOLDENROD LLC
Address : 419 GOLDENROD AV
CDM, CA 92625
Phone:
Applicant:
BRAD HOMER
Address :
1110 VALLECITO RD
CARPINTERIA, CA 93013
Phone :
(480) 220-8300
Owner/Builder
: BRAD HOMER
Address :
1110 VALLECITO RD
CARPINTERIA, CA 93013
Phone:
(480)220-8300
Code Edition : 2022
Type of Construction : V-B
Occupancy Groups: U,R-4
Bldg Height:
Contractor :
Architect
Address :
Address
Phone:
Phone:
Con State Lie :
State Lie
Lie Expire
Bus Lie :
Engineer:
Bus Lie Expire :
Address
Workers' Compensation Insurance
Phone:
Carrier :
Policy No :
Designer
W. C. Expire:
Address
Phone:
Fire Sprinklers :
Fire Hazard Zone
No of Units :
No of Stories
MARK TEALE
2900 BRISTOL ST BLDG A203 COSTA
MESA, CA 92626
(949)975-0123
NO Construction Valuation : $11,000.00
NO Added/New/TI sq. ft. Bldg : 0
2 Alteration sq. ft. Bldg :
3 Added/New sq. ft. Garage: 0
TOTAL sq. ft. : 0
Building Setbacks : Front: 15, Side: 3, Side: 3, Rear: 5 t
Flood Zone : X CSC+
Use Zone : R-2 - Two -Unit Residential _ti\ NO
\301\v PROCESSED BY:
SPECIAL CONDITIONS: JD;C,)FN'i()'TOIi/kUL,GEBRIS'
w rP r"
I hereby affirm under penalty of perjury that t am exempt from the Contractors' State License Law for the Resents) indicated below by the chedkmark(s) I have placed next to the applicable €terl
Section 7031.5. easiness and Professions Coda: Any city or county that requires a permit to construct. alter . improve, demol6sh, or repair any structure, prior to its issuance, also requires the applicant for
to permit to file a signed statement that he or she is licensed pursuant to the provisions of the ContractorsState License Law (Chapter S (commencing With Section 7000) of Division 3 of the Business cad
professions 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 iar a permit subjects the applicant to a civil penalty of
of more than five hundred dollars ($500).
1 I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) 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 toan owner of property who, through employees' arpersonal effort, builds or improves the property, provided that the
riprovements 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 builtor
nproved for the purpose of sale).
lI, as owner of the properly, am exclusively contracting with licensed Cony 'iD s construct the project (Section 7044, Business and Professions Cods: The Contractors' State License Law does not
tip to an owner of properly who builds or improves thereon, and who con cis or the projects with a licensed Contractor pursuant to the Contractors' State License Law).
1 m exempt from licensors under the Contractors' State Ucense or Ih foil
reason:
y m signature below I acknowledge that, excep9ep;
de ce it which I must have resided for at least one year prior to completion of the improvements Covered by this permit, I cannot legal],
structure that I have built as an owner-buildn true d in its entirety by ilegnsgd contractors. understand that a copy of the applicable law, Section 7044 of the Business and
'rofassions Code, is available upon request whenor at The following Web siteihttp:f/www.leginfo.ga.gov(calow,html.
ignature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATI
hereby affirm under penalty of penury that I am lon of Chapter g (commencing with Section 7000) of Division 3 of the Business and Professions Cade, and my license is In full force
rid effect. License Class o Date Contractor Signature,
COMPENSATION DECLARATION
ARNING: FAILURE TO SECURE WORMERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100.000). IN ADDITION TO THE
DST OF COMPENSATION: DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
3 I have and will 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 Of
arformance of the work 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 and policy number are:
Policy Number
to of Agent
Date
certify that, in the performance of OR
or ft which this permit is Issued, 1 shall not employ any person In any manner seas to become subject to the workers' compensation laws of California, and ogre
t, it I should become lest o worker " ompensatian provisions of Section 3700 of the Labor Code; tshall forthwith comply with those provisions.
nature of Appilcato � Bata 2 • 2 2 - 2J ?-7
CLARATION REGA I N C". ON LENDING AGENCY
neby affirm under penalty of pert .that there is a construction tending agency for the performance of the work for which this permit is Issued (Section 3007, Gil, Code).
rears Name Lenders Address
my signature below, I certify act) of the following:
I am the property owner or authorized i0 act on the. property owner's half,
i have read this application and the iniormalian I have rovidetl' car af.
I agree to comply with all applicable city and co ordin and at laws relating to building construction.
1 authorize representatives of this city Or ao ' or th cva-i fled property for inspection purposes. \ ��
nature of Prooenv Owner or Authorized Aaent Proaertv Owner's or Authorized Aoent's Name ii,.,.. - Date L "j t' z, zN
ACTION I DATE I BY ✓ FCLARA I0RFOF`W)MPUANCE WITH CODE OF FEDERAL FOR OrnCE USE ONLY
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