The URL can be used to link to this page

Home My WebLink AboutXR2022-2426 - Permitse'�WPOR� City of Newport Beach Q @ 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 °9<iFORN`P newportbeachca.gov/inspections Combination Type - SFP ELEC MECH PLUM Work Class - Addition/Alteration 111111111111111111111111111111111111111111111111111111111jj COMB Permit - XR2022-2426 Plan Check No: Issued Date : 11/17/2022 Inspection Area : 3 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 : 376 VISTA BAYA Legal Desc : N TR 2609 BLK LOT 5 Description: DELTA 2 REVISION & ADD'L SCOPE: ADD 364 SF AND REMODEL 400 SF FOR (N) BEDROOM Owner: SAM & BRENTON LOVE Address : 376 VISTA BAYA NEWPORT BEACH, CA Phone Applicant: CZAJKOWSKI MACIEJ W. Address : 2702 HARBOR BLVD COSTA MESA, CA 92627 Phone: (714)928-6220 Owner/Builder : Address : Contractor: WELL DONE BUILDING & DESIGN Address : 8576 HAMILTON AVE HUNTINGTON BEACH, CA 92647 Phone: (714)421-8853 Con State Lie : 1040701 Lie Expire : 06130/2024 Bus Lie: ST30074930 Bus Lie Expire : 04/30/2023 Workers' Compensation Insurance Carrier: STATE COMPENSATION INSURANCE FUND Policy No: 9324846 W. C. Expire : 9/24/2022 Architect Address Phone: State Lie Engineer: CZAJKOWSKI MACIEJ W. Address: 2702 HARBOR BLVD COSTA MESA, CA 92627 Phone: (714)928-6220 Designer: Address : Phone: Phone Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $15(066.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/Ti sq. ft. Bldg : 364, , "" Occupancy Groups : R-3 No of Units : 1 Alteration sq. ft. Bldg : 400 ;' Bldg Height: No of Stories : 1 Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 364 Building Setbacks : Front: 20, Side: 5, Side: 5, Rear: 20 ; Flood Zone : X Use Zone : R-1-7200-SiSingle-Unit Residential (7200 indicates minimum lot area) PROCESSED BY: .Jv SPECIAL CONDITIONS: rev2022-1599 OWNER -BUILDER DECLARATION I hereby affirm under penally 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 Rem(s) (Section 7031.5. Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolishr or repair any structure, prior to its issuance, also requires the applicant for the permit to Ito a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State 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 fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500), ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L)all of or U 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' ar 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). ❑ 1, as owner of the property, am exclusively contracting with licensed Contractors to constructthe project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ I am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below 1 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 legal, sell a structure that I have built as an owrior-buildar if it has not boon constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of tho Business and Professions Code, Is available upon request when flits application is submitted or at the following Web site: http:li"v v.leginfo.ca.gov/calaw.html, Signature of Property Owner or Authorized Agent _ Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 I l"'f �of Df iti 3of the Business and Professions Code, a^lieens`e -ls to full force and effect. License Class License No Date Contractor Signature / WORKERS' COMPENSATION DECLARATION rVARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS fS100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain B 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, forth payformance, 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' rance carrier and policy number are: Policy Number of Agent Date I certify 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 Califomia, and tat, if I should become subject to a workers' Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply With those provisions. ignature of Applicant ___,.— _ Date_ I( -t ZZ" ECLARATEON Rr';agD,NG CO. CTION LENDING AGENCY hereby affirm under penalty of perjury that there is a canstruction lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil Code). eooer'u ,vame Lenders Address y my signature below, I renify to each of the following: I orn tl.e 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 igren, to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize re,resentatives of this city or county to egter the ahnve.identifie6,property for inspection purposes. ianalure. of Proorirty Owner or Authorized Aaent / - �P7inl Prooertv Owner's or Authorized Aaeri Name 1 A 1("A FS(A,.kAA Date yt l BY MIf REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PER,PAITEXTENDED I� QMD TOS CERTIFICATE OF _ �'V� PROPOSED DEMOLITt FICpTION I5 N0' L£ TO OCCUPANCY ISSUED \ I SIGNATUREr FOR OFFICE USE ONLY