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HomeMy WebLinkAboutXR2023-0013 - Permits�EwPoRr City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XR2023-0013 C�. Community Development Department- Building Division X R 2 0 2 3 0 0 1 3 �'. 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2023-0017 Permit Counter Phone: (949) 644-3288 Issued Date : 0310812023 Inspection Requests Phone: (949) 644-3255 Inspection Area : 5 c9</F00.N\P newportbeachca.gov/inspections Combination Type - ELEC 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 : 30 WHARFSIDE DR Legal Desc : N TR 15850 BLK LOT 35 Description: SFR FREESTANDING SOLID PATIO COVER W/ ELEC 208 SF Owner: MANLEY MICHELLE LYN TR MLM LIVING TR Address : 30 WHARFSIDE DR NEWPORT COAST, CA 92657 Phone Applicant: HUNTER ELLISON Address: 24564 VIA RAZA LAKE FOREST, CA 92630 Phone: (949)315-1511 Owner/Builder : Address : Phone Code Edition : Type of Construction Occupancy Groups: Bldg Height : Building Setbacks Flood Zone Use Zone : PROCESSED BY: Contractor : TESERRA Address : P O BOX 1280 COACHELLA, CA 92236 Phone: (760)398-9222 Con State Lie : 656128 Lic Expire: 10/31/2024 Bus Lic : BT3007B953 Bus Lic Expire : 06/30/2023 Workers' Compensation Insurance Carrier: STARSTONE NATIONAL INS CO Policy No : T10230999 W. C. Expire : 1/1/2024 2022 Fire Sprinklers : V-B Fire Hazard Zone U No of Units : No of Stories PC - Newport Coast SPECIAL CONDITIONS: Ia 'ti o,.. a--`Z.% Architect Address Phone : State Lie Engineer: NIKJOO SHAHRAM Address : 6011 E BRIGHTON LANE ANAHEIM, CA 92807 Phone: (714)777-7200 Designer Address Phone: NO Construction Valuation : NO Added/New/TI sq. ft. Bldg 0 Alteration sq. ft. Bldg : 0 Added/New sq. ft. Garage TOTAL sq. ft. : $13,000.00 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 reasons) indicated below by the checkmark(s) I have placed next to the applcable 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 applicantfor 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). ❑ 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).. 71 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 improvesthereon, and who contracts for the projects witha licensed Contractor pursuant to the Contractors' State License Law), © 1 am exempt from licensure under the Contractors' Stale 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 -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:Iiwwwaeglnfo.ca.govlcalaw.html. Signature of Property Owner Or Authorized Agent _ _ Date _ LICENSED CONTRACTOR'S DECLARATION r I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 ' Isidn 3 off the Business and Professioy>g , and r�ty license is In full force and effect. License Class License. No Date G. Contractor Signature, f %l0 WORKERS' COMPENSATION DECLARATION NARNING: 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 (Sf00,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST; ANO A17ORNEY'S FEES, hereby affirm under penalty of perjury one of the following declarations: 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 mince of the work for which this permit is issued. Policy No, 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` carrier and policy number are: Policy Number Expiration Date of Agent Phone #_ certify that, inthe 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' compen ation laws of California, and agree t, if I should become subje t h r is' co ensaGen provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant Oa Ci_ARATfON REGA p G�CO uC1 N I.END3 G AGENCY areby 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 309 Civil Code). tder's Name Lender's Address my signature below, I certify to each of ilia following: I am the property owner or authorized to act on the property owner's behalf. I have read this application andthe information I have provided is correct. I agree to comply with all applicable city and county or non s and state laws relating to building. construction, I authorize representatives of this city Or county t e abovF..id ntiflad property for inspection purposes�/I j5 nature of Property Owner or Authorized Apeatt.i/ ��c!�� Print Property Owner's or Authorized Aoem's Name i Date ✓ `E, ACTION DATE. BY I DECLARATIONOF COMPLIANCE WITH CODE OF PEDERAL { REGULATIONS PART SS OF TITLE 40 AND AOPAD RULE 1403 FOR orriCE USE ONLY PERMIT EXPIRED _ i—C] 1 SJRMITi €G AS BESTOS Nom FICATION TO PERIMITCANCELLED I PERMIT EXTENDED t�-1TA'F I r �e4MD PCRiLI±T FINAL �� 1 ASBESTOS NOTIFICATION 15 NOT APPLICABLE To CERTIFICATE OF 'p` PRO"I''tUVSMOLITION OCCUPANCYI$5UED S-GNATURr;.