HomeMy WebLinkAboutXR2022-2387 - Permits�EWPO�,T City of Newport Beach
`� Community Development Department- Building Division II IIII I I II I II I III III I I II
p 100 Civic Center Drive, Newport Beach, CA 92660
U} Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
cg4coaH`r newportbeachca.gov/inspections
Combination Type - SFP ELEC PLUM
Work Class - Alteration
II COMB Permit:XR2022-2387
Plan Check No
Issued Date : 0910212022
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 : 4726 CORTLAND DR
Legal Desc : N TR 3519 BILK LOT 21
Description: SFR REMODEL TO KITCHEN AND (2) BATHS
300 SF
Owner: EDWARD F AND MARY K HICKEY
Contractor :
Architect
Address : 4726 CORTLAND DR CORONA DEL MAR, CA
Address :
Address
92625
Phone:
Phone:
Phone:
Con State Lie :
State Lie
Applicant: EDWARD F AND MARY K HICKEY
Lie Expire
Address : 4726 CORTLAND DR CORONA DEL MAR, CA
Bus Lie :
Engineer
92625
Phone:
Bus Lie Expire :
Address
Workers' Compensation Insurance
Phone
Owner/Builder : EDWARD F AND MARY K HICKEY
Carrier:
Address: 4726 CORTLAND DR CORONA DEL MAR, CA
Policy No:
Designer
92625
Phone :
W. C. Expire:
Address
Phone:
Code Edition : 2019
Fire Sprinklers : NO
Construction Valuation : $40,00A00,
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/Ti sq. ft. Bldg : 0 „
Occupancy Groups : U,R-3
No of Units : 1
Alteration sq. ft. Bldg : 300 ,
Bldg Height :
No of Stories : 1
Added/New sq. ft. Garage: 0
Building Setbacks : Front: 15, Side: 6, Side: 6, Rear: 6
Flood Zone: X
Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area)
y�PROCESSED BY: C
i10L_CTOR
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty 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 items)
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
ie permit to file a signed statement that he or sho 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
'rofessions 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
of more than five hundred dollars ($500).
1 I, as owner of the property, or my employees with wages as their sole compensation, *11 do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusinass 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
nprovements 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 built or
np%4ved for the purpose of sate).
Er I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
1 I all exempt from licensors under the Contractors' State License Law for the following reason
ly my signature below I 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],
ell a structure that I have builtasan owner -builder if it has not been constructed in its entirely by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
'rofessions Code Is available upon request whgggn this application is submitted or at the following Web site:http:llwww.leginfo.ca.govlcalaw.html,.
signature of Property Owner or Authorized Ag%n 2 /,1 i /�� __ Di 0
JCENSED CONTRACTOR'S DECLA'.RAT '-"'r"-"'m��""'7�� —`—
hereby affirm under penalty of perjury that I am licensed under provisions of Cha er 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force
nd effect. License Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
'ARNING: 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 (11700,000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of par}ury one of the following declarations:
I I have and W 1 Ili 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 lh
3rforma:ice of the work for which this permit is issued. Policy No..
have and will mewtain 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
of Agent
Date
certify that. in '.he ps.formanoe 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 California, and
r, it I should become rubject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applearrl __ Date
C_AFtATION R-_GA,YDING CDNSTRUCTIGN LENDING AGENCY
areby affirm unds- peraity of perjury that there is a construction lending agency for the performance of the work for which this. permit is issued (Section 3097, Civil Code),
mei's game Lender's Address
.Ty signature L,etmv, I', certify to each of the following:
I am lire 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.
€ agree to comply with all applicable city and county, ordinances and state laws relating to building construction.
I authorize representatives of this city or county t enter the aboyo-identified property for inspection purposes. _ „ , ri 7 i
of Property Owner or Authorized Agenl`t J//"IG _Ilii_ Print Property Owner's or Authorized AD
ACTION ( DATE ( BY ° LOAMr;PART OF TITLE AD R
roF coi NITH CODEOFF FEDERAL FOR OFFICE USE ONLY
RE
PERMIT EXPIRED
pERMi7- Ei.t ED
PERMIT EXTENDED
CERTIFICATE OF
OCCUPANCY ISSUED
TO
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