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HomeMy WebLinkAboutX2022-1487 - Permitso��,eWpogr City of Newport Beach Community Development Department- Building Division > 100 Civic Center Drive, Newport Beach, CA 92660 �� ' ? Permit Counter Phone: (949) 644-3288 tea., Inspection Requests Phone: (949) 644-3255 ogrRN`r. newportbeachca.gov/inspections Combination Type - SFP ELEC MECH PLUM Work Class - Addition/Alteration COMB Permit : X2022-1487 X 2 0 2 2������������������������������������� Plan Check No : 1371-2022 Issued Date : 11108/2022 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 : 1736 ANTIGUA WAY Description: SFR ADD 206 SF, REMODEL 3,054 SF Owner: JASON DOWNING Address : 1736 ANTIGUA WAY NEWPORT BEACH, CA 92660 Phone: Applicant: DAHL JEFFREY ALAN Address : 1102 MAIN ST HUNTINGTON BEACH, CA 92648 Phone: (714)847-8480 Owner/Builder : Address : Legal Desc : N TR 4224 BLK LOT 284 Contractor: GPE BUILDER'S Address : 404 E 16TH STREET COSTA MESA, CA 92627 Phone: (949)691-8020 Con State Lie : 1061982 Lie Expire : 01/31/2024 Bus Lie : BT30072992 Bus Lie Expire : 09/30/2023 Workers' Compensation Insurance Carrier: NO EMPLOYEES Policy No: EXEMPT W. C. Expire: Architect : DAHL JEFFREY ALAN Address : 1102 MAIN ST HUNTINGTON BEACH, CA 92648 Phone: (714)847-8480 State Lie Engineer: BAYANI-RAD PADRA Address : 15901 HAWTHORNE BLVD #220 LAWNDALE, CA 90260 Phone : (910) 793-8410 Designer Address Phone: Phone: Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $385,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/Ti sq. ft. Bldg : 206 Occupancy Groups : U,R-3 No of Units : 1 Alteration sq. ft. Bldg : 3,054 Bldg Height: No of Stories : 1 Added/New sq. ft. Garage: 0 TOTAL sq. ft. 206 Building Setbacks : Zone Front: 6, Front: 12, Side: 6, Rear: 6 X Flood : L Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area) ® PROCESSED BY: NC11 . I ` _ _ - SPECIAL CONDITIONS: ROBERTS WASTE TO HAUL DEBRIS I hereby affirm under penally of perjury that I are 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 703f.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 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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 0 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) 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' or personal effort, builds or improves the property, provided that the Improvements 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 bullt or Improved for the purpose of sale). 0 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 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 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 legally sell a structure that I have built as an owner-buildor if it has not been Constructor] in its entirety by licensed contractors. I understand that a copy of the applicable few, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site:htip:liwww.leginfo.ca.govlcalaw.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 70 0) of Division 3 of the Business and Profe at ode. and my license is In full force and effect License Class License No D %. 2 Z Contractor Signature WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS 15100,000), 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 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 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' Compensa Trance carrier and policy number are: Policy Number of Agent Date -ify 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 California, and I should become subject t"e workef5' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 411nature of Applicant_ _. __ ____, _ D e r);Ct.ARA7ION REGAL 3 CONSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit Is issued (Sedon 3097, Civil Code). rnder's Name Lender's Address Iy my signature below, I certify to each of the following: I ant 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 ordinances and state laws relating to building consmctlon. I authorize representatives of this city or coury(y to enlePtp�abov_, _Tfrfied property for inspection purposes. Date iJ-L'^ZZ ACTION DATE BY ` i DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE 4D AND AQNID RULE 1403 FOR OFFICE USE ONLY I W PERMIT EXPIRED I LJ I SUBMITTED A5RESTOS NOTIFICATION TO PERMITCANCELLED PERM T EXTENDED 16MD PCRMIT FIAIAi l,� ❑ASBESTOS NOT ]FICA ICON I5 NOT APPLICABLE To CERTfFfCATC OF (,�/,9/q L PRO905E0O MOLT N OCCUPANCY ISSUED SIGNATU N 0 N N N LO O) Co 00 LO co N O UO C) M Co CO z�(o 03� a) Z —o Aco LJ �_ U H x U A Co N d O N O > C a� U U U O O Y U � # L W. 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