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Home My WebLink AboutXC2022-2064 - Permitsk�EWPORT City of Newport Beach e Community Development Department- Building Division, n100 Civic Center Drive, Newport Beach, CA 92660 = Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 c,(�F00.N�P newportbeachca.gov/inspections Combination Type - ELEC Work Class - Other iiiiiiiii4 II COMB Permit : XC2022-2064 Plan Check No: PC2022-2877 Issued Date : 03/24/2023 Inspection Area : 6 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 : 21474 VISTA RIDGE RD, (CS) Description: COMM CELL SITE "VERIZON" Owner: IRVINE CO Address : 111 INNOVATION IRVINE, CA 92618 Phone: (949) 608-9659 Applicant : Garrett Holland Address: 3471 Via Lido, Suite 202 Via Lido Newport Beach, CA 92663 Phone : (949) 633-6576 Owner/Builder : Address : Phone Legal Desc : Contractor: ERISSON INC DBA E US INC Address : 6300 LEGACY DR PLANO TX 75024, CA Phone : (469) 266-7025 Con State Lic : 698896 Lic Expire : 11/30/2024 Bus Lic: BT30052827 Bus Lic Expire : 10/31/2023 Workers' Compensation Insurance Carrier: ACE AMERICAN Policy No: WLRC50734936 W. C. Expire: 11/1/2023 Code Edition : 2019 Fire Sprinklers : Type of Construction : Fire Hazard Zone Occupancy Groups : U No of Units : Bldg Height: No of Stories Building Setbacks : Flood Zone : X Use Zone : PC - Newport Coast PROCESSED BY: 9!5 Architect : FULSANG ARCHITECTURE Address : 3471 VIA LIDO STE 202 NEWPORT BEACH, CA 92663 Phone : (949) 838-4139 State Lic: C030715 Engineer; POOLE RICHARD Address : 3400 VIA OPORTO #202 NEWPORT BEACH, CA 92663 Phone : (949) 633-5809 Designer: Address : Phone: NO Construction Valuation : YES Added/New/TI sq. ft. Bldg 0 Alteration sq. ft. Bldg : Added/New sq. ft. Garage TOTAL sq. ft. : SPECIAL CONDITIONS: FIRE HAZARD SEVERITY ZONE; LANDSLIDE ZONE; IRWD $29,500.00 0 0 0 OWNER. -BUILDER DECLARATION I hereby affirm under penalty of perjury that i am exempt from the Contractors' State License Law for the resson(s) indicated below by the checkmark(s) I have placednext to the applicable item(s) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter. improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a. signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or drat he or she is exempt from licensors and the basis far the alleged exemption. Any violation of Section 7031.6 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($.500).. ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) 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 built or improved for the purpose of sale).. El 1, 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). ❑ 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 constructed in its entiroty by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code,. is available upon request when this application is Submitted or at the following Web site:http:liwww.ieginfo.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 of Div' ion 3 of the Business and Profe Co of Kli all is Infull force and effect License Class License. No Date 202 Contractor Signature WORKERS' COMPENSATION DECLARATION MARNING: 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 (S15 J ), tN ADDITION TO THE COST OF COMPENSATION,DAMAOFS AS PROVIDED FOR IN SECTION ling OF THE LABOR CODE, INTEREST, AND ATTORNEY-3 FEES. Inhereby affirm under penalty of perjuryone of the following declarations: u 1 have and will maintain a certificate of consent to selNnsure for workers' compensation, Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th performance 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' ranee carrier and policy number arc: Policy Number Date ie of Agent Phone $ 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 agree If I should become;W* ` h`e workers' compensation proves ens of Section 3700 of the Labor Code I shall forthwith comply w4lh those provisions. /�y nature of Applicant �� 5`�,� Date V � ! 20 2 3_ V AOI1TEItAI OCf�AOA..I AII+ /^l�i1CT01}PTI!'\61 CRIl1Rif+ Af]CAIfV / ani affirm under penalty of perjury that t >f ere is a construction fendi g !gene for the performance of the work for which this permit is Issued (Section 3097, Civil Code). tder s Name Lender's Address _ 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 a2rl:cation and the information I have provided is correct. I agree to comp vvli all applicable city and comity ordinances and state taws relating to building. construction. I rc`.rc-ize rep-esen'atives of this city or countyAc-Iffte he abovill-derilifirIcLtI perry for inspection purposes. N C(1 / /I, :nature of ProDcr! OY ner or Authorized Aoe�nt 4r ( Print Prooery Owner's or Authorized Aoeot's Name ill �J(�i 6t( Date FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AOtAD RULE 1403 _ PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CF YCELLED CPA PERMIT EXTENDED QMp P[dYr,TFhiAL jj SBLSTCIS NOTI FICA [ION 15 NOT APPLICABLE 70 OF I•-,-1'i-�1 � � ROPOSE0I LA ION PANCYISSUEn _ OCCUPANCY OCCU SIGNATURE:_,