HomeMy WebLinkAboutXR2022-2863 - PermitsaE Poa, City of Newport Beach 111111111111111111111111111111111111111111111111111111IIIil
0 "I Community Development Department- Building Division X R 2 0 2 2 2 8 6 3
y 100 Civic Center Drive, Newport Beach, CA 92660
' n Permit Counter Phone: (949) 644-3288
U o- Inspection Requests Phone: (949) 644-3255
cqG/Fnpl+�P newportbeachca.gov/inspections
Combination Type - SFP
Work Class - Alteration
COMB Permit : XR2O22-2863
Plan Check No
Issued Date :
Inspection Area : 5
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: 4733 CORTLAND DR
Legal Desc : N TR 3519 BLK LOT 6 TR 3519
LOT 6 ALL -EX SWLY 1 FT -
Description: SFR REMOVE AND REPLACE SIDING ON GARAGE
cdy
Owner: DAVID IGATA
Contractor:
Architect: C0
Address : 4733 CORTLAND DR
Address :
Address
CORONA DEL MAR, CA 92625
F
Phone : (949) 633-7772
Phone :
Phone:
Con State Lic :
State Lic
Lic Expire
4`
Applicant: DAVID IGATA
Bus Lic:
Engineer :
Address : 4733 CORTLAND DR
Bus Lic Expire :
Address : C)
CORONA DEL MAR, CA 92625
y
Phone : (949) 633-7772
Workers' Compensation Insurance
Phone
Carrier :
Owner/Builder: DAVID IGATA
Policy No:
Designer:
Address : 4733 CORTLAND DR
W. C. Expire:
Address
CORONA DEL MAR, CA 92625
Phone: (949) 633-7772
Phone
Code Edition : 2019
Fire Sprinklers : NO
Construction Valuation : $5,000.00
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/TI sq. ft. Bldg
Occupancy Groups : U
No of Units : 1
Alteration sq. ft. Bldg :
Bldg Height : -
No of Stories : 1
Added/New sq. ft. Garage: 0
TOTAL sq. ft. Bldg : 0
Building Setbacks : Front: 35, Side: 6, Side: 6, Rear: 6
Flood Zone : X
Use Zone : R-1-6000 - Single -Unit Residential (6000
indicates minimum lot area)
PROCESSED BY: (!N_ 4—
SPECIAL CONDITIONS: O/B FORM W/ X2022-1495
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 nextto the applicable item(sj
(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 ho 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 ficensure 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),
F1 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure is nor 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' or personal effort, builds or improves the property, provided that the
improvements are not Intended or offered for sale. If, however, the building of improvement Is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
roved for the purpose of sale)
_
Ms owner of [fie property, am exclusively contracting with licensed Contractors to construct the project (Secfion 7044, Business and Professions Code: The Contractors' Stale License Law does not
ra''pTply 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).
u I am exempt from licensure under the Contractors' State License Law for the following reason. ._ -----------
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at leas! one year prior to completion of the improvements covered by this permit, 1 cannot legal],
sell a structure that I have built as an ownor but or if, it has not' n cons c din it ntirety by licensed contractors. understand that a copy of the applicable law, Soctio OA4 of the Business and
Professions Code, is available upon request who l s a i i s i or g Web sita;http:(Iwvw.laginio ca.govlcalaw.html.
Signature of Property Owner or Authorized Agent _ __ Da,,,,,,_____
LICENSED CONTRACTOR'S DECLARATI
I hereby affirm under penalty of penury that I am I censed under pro , one of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force
and effect. License Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
NARNING: 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 (E100,0001, 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 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
ormance of the work for Which this parmlt 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' compensa
Trance carrier and policy number are:
Policy Number
of Agent
Date
.JI certify that in thWnafof
he work I whic his pe t is issued. I shall not. employ any person in any manner so as to become subject to the workers' compensation taws of California, and agre
iat, if I should becoworkers' m SLID visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applica_ _ _ _ Dated(_.
ECLARATION RERUC I A CY \`C
hereby affirm undet t is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097, m, ode).
ender's Name Lender's Address
y 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 coui y ordin as and st t re to building construction.
I authorize representatives of this city or rourRt(L e th giTov_e= p y for inspection purposes.
of Property Owner
ACTION
PERMIT EXPIRED
DATE. BY I� DECtARATI PLMCE W17H CODE OF FEDERAL FOR OrFICE USE ONLY
ftF.GULA71 IN. FIT at OF TITLE 40 AND AQMD RULE
PERMIT EXTENDED
PERMIT Fir 1A1
6
CERTIFICATE OF
OCCUPANCY ISSUED
140033
__I
ASEE5 05 OI IHCA IS NOT'
l� PRBPOSED -IV a