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HomeMy WebLinkAboutXR2022-2790 - PermitsEWPok City of Newport Beach Community Development Department - Building Division >?, y 100 Civic Center Drive, Newport Beach, CA 92660 v ie-..�,.= Permit Counter Phoney (949) 644-3288 - Inspection Requests Phone: (949) 644-3255 newportbeachca.gov/inspections Combination Type - SFP ELEC Work Class - Alteration COMB Permit: XR2022-2790 X R 0������������������������������������� II Plan Check No : PC2022-2649 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 : 410 TUSTIN AVE Legal Desc : A TR FIRST ADD TO NEWPORT HEIGHTS BILK 26 LOT 3 Description: SFR 400 SF ADU. ENCL OPENING, CREATE SOUND WALL Owner: GARY MASON Address: 410 MONARCH BAY DR DANA POINT, CA Phone : (949) 295-4569 Applicant: GARY MASON Address : 410 MONARCH BAY DR DANA POINT, CA Phone : (949) 295-4569 Owner/Builder : GARY MASON Address: 410 MONARCH BAY DR DANA POINT, CA Phone : (949) 295-4569 Contractor Address : Phone: Con State Lic Lic Expire Bus Lic : Bus Lic Expire Workers' Compensation Insurance Carrier : Policy No W. C. Expire: Architect Address Phone: State Lic Engineer: HAIGHTCHRISTOPHER Address : 1401 DOVE ST#240 NEWPORT BEACH, CA 92663 Phone : (949) 623-9957 Designer: CCIDC Address Phone : (714) 200-6789 Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $5,000.00 Type of Construction : V-B Fire Hazard Zone : NO AddedlNew/Tl sq. ft. Bldg : 0 Occupancy Groups : U,R-3 No of Units : 1 Alteration sq. ft. Bldg : 40n Bldg Height : No of Stories : 2 Added/New sq. ft. Garage : 0 TOTAL sq. ft. 0 Building Setbacks : Front: 20, Side: 4, Side: 4, Rear: 5 Flood Zone : X Use Zone : R-1 - Single -Unit Residential PROCESSED BY: 0_5 SPECIAL CONDITIONS: 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, after, 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 n t more than five hundred dollars ($500). I, 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 not intended or offered for sale (Section 7044, usiness 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 built or improved for the purpose of sale). ❑ 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 improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 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 legall, sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 f the usiness and Professions Code, is available upon request when this appljfatinlais�IlLeiBed At the following Web site:http:ftwww.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent / J�%� Date LICENSED CONTRACTOR'S DECLARATIO I hereby affirm under penalty of perjury that I am licensed under provisions 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 COMPENSATION DECLARATION ING: 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 ($100,000), IN ADDITION TO THE 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 370G of the Labor Code, for formance 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 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 California, and al t, if I should become subject to t'hh y/W/��s' c p fisalion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant �i:%iy/ Date �/J ►. _ ___ CLARATION REG :O CTION NDING AGENCY ereby affirm under penalty 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). Iders Name _ Lenders Address _ my signature beh:v, I c^_-tify to each of the following: Pm the property owner or authorized to act on the property owner's behalf. have road this crpSCz'ion and the information I have provided is correct. 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