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Home My WebLink AboutXR2023-1399 - PermitsEWPo City of Newport Beach ��IIIl11111111111111111111111111111111111111111111111111111 COMB Permit : XR2O23-1399 X Community Development Department- Building Division R 2 0 2 3 1 3 9 9piyn Check No : PC2023-1273 lo0 Civic Center Drive, Newport Beach, CA 92660 Issued Date : 0612012023 Z. Permit Counter Phone: (949) 718-188B Inspection Area : 2 newportbeachca.gov/civic Cq(./rnp��P Combination Type - ELEC PLUM Work Class - Other 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 : 2001 CHUBASCO DR Legal Desc : N TR 2813 BLK LOT 5 Description: SFR DEMO (E) POOL "METHOD B", INSTALL GAS & WATERLINE FOR BBQ ISLAND AND SINK Owner: ROBIN WOODHALL Address : 2001 CHUBASCO DR NEWPORT BEACH, CA 92625 Phone: Applicant : Josafat Monroy Address : 451 East Adams St Santa Ana, CA 92707 Phone: (714)623-8324 Owner/Builder : Address : Phone Contractor: JOSAFAT POOLS Address : SANTA AANA AVAE, CA 92707 Phone: (714) 623-8324 Con State Lic : 1026428 Lic Expire : 05/31/2025 Bus Lic: BT30081697 Bus Lic Expire : 05/31/2024 Workers' Compensation Insurance Carrier : Policy No: EXEMPT W. C. Expire: Architect Address Phone: State Lic Engineer : LACHER TODD Address : 1201 N TUSTIN AVE ANAHEIM, CA 92807 Phone : (714) 630-6100 Designer: Address Phone: NO Construction Valuation : Code Edition : 2022 Fire Sprinklers : Fire Hazard Zone : NO Added/New/Tl sq. ft. Bldg Type of Construction : V-B No of Units : 0 Alteration sq. ft. Bldg: Occupancy Groups : U No of Stories: 0 Added/New sq. ft. Garage Bldg Height : TOTAL sq. ft. Building Setbacks : Front: 10, Side: 4, Side: 4, Rear: 10 Flood Zone : X R-1 - Single -Unit Residential Use Zone : PROCESSED BY: SPECIAL CONDITIONS: $5,000.00 0 0 0 I hereby affirm under penalty of perjury that t am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 70314 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 rile a signed statement that he or she is licensed pursuant to the provistons of the Contractors' State License Caw (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). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work; and the structure is not Intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' Slate License Law does not apply to an owner of properly who, through employees' or personal effort, builds or improves the properly, 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 ra�rply 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). t-..i I am exempt from licensure under the Contractors' Stale License Law for the fallowing 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 sell a structuro 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 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site:http:Iiwww.ieginfo.ca.govicalaw.html. Signature, of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION _ Date I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 of vision 3 of the Business and Pro ions C , and my license is In full force and effect. License Class License. No Date NORKERS' COMPENSATION DECLARATION Contractor Signature G -Zp_2 3 NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRWUNAL PENALTIES AND CIVIL FINES UP TO' ONE HUNDRED THOUSAND DOLLARS I15100,000). IN ADDffION TO THE ?mrr OF COMPENSATION; OAMAOES AS PROVIDED FOR IN SECTION 7706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjuryone of the following declarations: _ 3 1 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 IN lerformance of the work for which this permit is issued. Policy No. :1I 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 jssued. My workers' compensation isurance, carder and policy number are: of Agent Policy Number Expiration Date PIT g one n 'Oertify that. in the erf0rmonce of the work for which this permit is issued. I shall not. employ any person do any manner so as to become subject to the work rs' ompansation laws of California, and agre I should becom subject to th rkers' compensatl provisions Of Section 3700 of the Labor Code; I shall forthwith GDmply with those provisions. A Signature Of Applicant I _ , DECLARATION REGA, CONSTRIJOTIO ENDING AGENCY Dat hereby affirm under penally of perjury that there is a construction lending agency for the performance of the work for which this penult Is issued (Section 3097 Clv I Code). Lender's Name Lenders Address By my signature below, I certify to each of the following: 1 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 applicablecity and c my ordinances and slate laws relating to building construction. I authorize representatives of this city or count o rite, the e-Identifled property for Inspection purposes. e ii nature of Pro en Owner or Authorized Agent Punt Pro ertOwner's or Authorized Agent's Name C:i.,4 C�1- o/LfJy �/teACTION ( -,LJ Gy' FATE. BY D ARATIONoF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE W4.V1It CERTIFICATE OF -%O%Z� BESTO5 N0T9FICATION IS OTAPPLICABLE TO OCCUPANCYISSUED P�-f-- PRO SEO OLfTO _I—_-- ' st6Np rm