HomeMy WebLinkAboutXR2023-0337 - Permits�EWPOT City of Newport Beach IIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIII�IIII�I II
q� d Community Development Department- Building Division COMB Permit : XR2023-0337
F fyk 100 Civic Center Drive, Newport Beach, CA 92660 X R 2 0 2 3 0 3 3 7
Permit Counter Phone: (949) 644-3288 Plan Check No
Inspection Requests Phone: (949) 644-3255
Issued Date : 02/06/2023
°qr oaN`P newporibeachca.gov/inspections Inspection Area
Combination Type - MFP
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 : 512 BAY AVE W Legal Desc : A TR.EAST NEWPORT.BLK A BLK LOT 123
Description: MFR - T/O COMP. INSTALL 30# FELT. INSTALL 12 SQ COMP SHINGLE
Address:
4331vES PATRICIA CA ALINA DR 1���O`SS
ContractAddressor
NEWPORT+ E,Apt 'CA 92663
Phone:
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Phone:
Con State Lie
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Applicant: JUAN BECERRIL ('�E'"�
Lie Expire
Bus Lie
Address
: 820 CENTE
''lA92627
Bus Lie Expire
COSTA
Phone :
(949) 27 -3739
Workers' Compensation Insurance
Carrier :
Owner/Builder : JONES PATRICIA L TR Policy No
Address : 431 CATALINA DR W. C. Expire:
NEWPORT BEACH, CA 92663
Phone:
Code Edition :
2022
Fire Sprinklers :
NO
Type of Construction :
V-B
Fire Hazard Zone :
NO
Occupancy Groups :
U,R-3
No of Units :
2
Bldg Height :
No of Stories:
2
Building Setbacks:
Flood Zone :
X
Use Zone :
R-1 - Single -Unit Residential
PROCESSED BY:
SPECIAL CONDITIONS:
Architect
Address
Phone :
State Lie:
Engineer:
Address:
Phone:
Designer:
Address
Phone:
Construction Valuation : $12,000.00
Added/New/TI sq. ft. Bldg : 0
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage: 0
TOTAL sq. ft. : 0
INSPIll
ECTOR
I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the reason($) indicated
;action 7031.5. Business and Profession$ Code: Any city or county that requires a permit to construct, alter, improve, demoltsl
a permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law
rofessians Code) ar that he or she Is exempt from ticensure and the bash for the alleged exemption. Any violation of Section 7
at more than five hundred dollars ($540)
1 1, as owner of the property, or my employees with wages as their sole compensation., will do L) all of or L) portions of the v
usiness and Professions Cade: The Contractors' State License Law does not apply to an owner of property who, through Sure
iprovements are not intended or offered for sale. if, however, the building or improvement is sold within one year of complete
;proved for the purpose of sale).
1'.1, as owner of the property, am exclusively contractingwith licensed Contractors to construct. the project (Section 7044, Bus
ly o an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pur
Ti a exempt from licensee under the Contractors' State License Law for the following reason:
y my ignature below P acknowledge that, except for my personal residence in which I must have resided toner least Ono year
ll a ructure that I have built as an owner -builder if it has not boon eonstru n Tory by licensed contractors. I undari
ro ssions Code, is available upon request who.;Ilcens
s app6Catio .. ad or a otlowing Web site;http:// wW.Ieg!OfG.cl
:ignature of Property Owner or Authorized Agent .ICENSED CONTRACTOR'S DECLARATIhereby affirm under penalty of perjury that I am r provisions of Chapter 9 (Commencing with Section 7000) of Dh
nd effect. License Class License No Date
VORKERS' COMPENSATION DECLARATION
rARNINW FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL: AND SHALL SULVECT AN EMPLOYER TO CRIMINAL PENALTIES
DST OF COMPENSATION: DAMAGES AS PROVIDED FOR IN SECTION JTQE OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the fallowing declarations:
3 t have and will maintain a certificate of consent to self -Insure for workers' compensation, Issued by the Director of Ini
erformance of the work for which this permit is issued. Policy No,
-11 have :and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perfol
isurance carrier and policy number are:
farrier _ Policy Number
of Agent
tltlfy that, in the performance
should become subject to
rw by the checl rnark(s) I have placed next to the applicable Items)
repair any structure, prior to its issuance, also requires the appficant for
pter 9 (commencing with Section 7000) of Division 3 of the Business Lind
,5 by any applicant for a permit subjects the applicant to a civil panatty of
k, and the structure is not intended or offered for sale (Section 70",
nes' or personal effort, builds or improves the property, provident that the
the Owner -Builder will have the burden of proving that it was not built or
and Professions Code; The ContractorsStale License Law does not
to the Contractors' State License Law).
to completion or the improvemenLS coveteu uy inis pis,,,, t, I
that a copy of the applicable taw, Section 7044 of thl Business and
3of the Business and Professions
Contractor Signature
my license Is In full force
CIVIL. FINE$ UP' TO ONE HUNDRED THOUSAND DOLLARS (E100,000)., IN ADDITION TO
Relations as provided for by Section 3700 of the Labor Coda, for
of the work for which this permit is issued. My workers'
Date
work for which this permit I$ issued. I shall netemploy any person in any manner so as to become subject to the workers' compensation taws of Cailfomia, and agre
�kars' Cotertasatlotlpt52visions Of SechOn 3700 of the Labor Cade, 1 shall forthwith comply with those provisions.
Mature of Applicant
GI.AiRATiON REGARD �CO ... ON LENDING AGENCY
baby affirm under penally erjury That there is a construction lending agency for the performance of the work for which
Ider's Name Lenders Address
my signature below, I certify to each of the following.
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 ordi ces and state laws relating to building eonstntchom
I authorize representatives of this city or county to ante above-jdeTR Perry for inspection purposes.
ACTION DATF BY (, PEA-R{iA" OFCOMPUANCE WITH CODE OF FEDERAL FOROFFICE
I E15ULATIONS PART 61 OFT;TLE40 AND AQMD RULE
PERMIT EXTENDED
PERMIT FINAi
CERTIFICATE OF
OCCUPANCYISSUER
1403
I5UBMITTED
TO
ASBESTOS NOTIFICATION 15 NUTAP BLE TO
D&t*�
permit is issued (Section3097, Civil Code).
Ly