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Home My WebLink AboutXR2023-1634 - Permits.r�EwaoRT City of Newport Beach 111111p111111111111111111p1111111111111111111p11111111 jj COMB Permit : XR2O23-1634 '` ' _ Community Development Department - Building Division X R 2 0 2 3 1 6 3 4 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2022-3192 Permit Counter Phone: (949) 718-1888 Issued Date P S newportbeachca.gov/civic Inspection Area : 5 o;,;>�' Combination Type - 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 : 419 GOLDENROD AVE Legal Desc : A TR CORONA DEL MAR BLK 333 LOT 19 Description: SITE WALLS, 610" LF X 2'-3' H, 28 LF X 3'3" H, GAS TO TO FIREPIT Owner: 419 GOLDENROD LLC Address : 419 GOLDENROD AV CDM, CA 92625 Phone Applicant: MARK TEALE Address : 2900 BRISTOL ST BLDG A203 COSTA MESA, CA 92626 Phone : (949) 975-0123 Owner/Builder : Address : Contractor: RBU INVESTMENTS LLC Address : 1110 VALLECITO ROAD CARPINTERIA CA 93013, CA 93013 Phone: (805)881-8912 Con State Lic : 1020655 Lic Expire : 11/30/2024 Bus Lic : BT30072726 Bus Lic Expire : 08/31/2023 Workers' Compensation Insurance Carrier : Policy No: EXEMPT W. C. Expire: s Architect : MARK TEALE Address : 2900 BRISTOL ST BLDG A203 COSTA MESA, CA 92626 Phone: (949)975-0123 State Lic Engineer: DEIHIMIAMIR Address : 4400 CAMPUS DR NEWPORT BEACH, CA 92660 Phone: (949)752-1612 Designer: Address Phone: Phone Code Edition : 201q Fire Sprinklers : NO Construction Valuation : $5,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/Ti sq. ft. Bldg : 0 Occupancy Groups : U No of Units : 0 Alteration sq. ft. Bldg : Bldg Height : No of Stories : 0 Added/New sq. ft. Garage : 0 TOTAL sq. ft. 0 Building Setbacks : Front: 15, Side: 3, Side: 3, Rear: 5 Flood Zone : X Use Zone: R-2 - Two -Unit Residential PROCESSED BY: a0 SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the reasGri indicated below by the checkmark(s) I have placed next to the applicableitem(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 ie permit to rile 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 'rofessions Code) or that he or she is exempt from licensors 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 of more than five hundred dollars ($500), 7 I, as owner of the property, or my empiayees with wages as their sole compensation, will de (_) all of or U portions of the work; and the structure is not intended or offered for sale (Section 7044, iusiness 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 nprovements 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 nproved 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 ply 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 lcensure under the Contractors' State License Law for the following reason: ly my signature below I acknowledge that, except for my personal residence in which I most have resided for at least one year prior to Completion of the Improvements covered by this. mit, I.cannot legally ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensedconiractors. I understand that a copy of theapplicable law, Section 7044 of usiness and 'rofessions Code, is available upon request when this application is submitted orat the following Web site:http:llwww.leginfo.ca.govicslaw.htmi. Ilgnature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sec ile Jo 0) of EAI%on 3 of the Busine and Prof my license is In full force nd effect. License Class License No D Contra Signature �+ VORKERS' COMPENSATION DECLARATION L EARNING; FAILURE TO SECURE WORNERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRWINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T US D LLARS ($1IMA00), IN ADDITION TO THE DST OF CeMPENSAI IUN;o/MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under pen ally of perjury one of the following declarations: 11 have and 011 maintain a certificate of consent to seif-insure for workers' compensation, Issued by the Director of Industrial Relations as provided for by Section 3700 of the labor Code, for th erformance of the work for which this permit Is issued. Policy No. JI ha%a 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' compansatio ns'Iran^e carrier c-j F�'icy number are: ::3rrie- olicy Number Expiration Date 1 gent _ _ _ _ Phone H CiF4, that, in the perform noo of th ich 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 agre .ha., d I saould be r sub'e � to orket mpensation provisions of Section 3700. of the Labor Code, I shall forthwith comply with those provisions. . — Signature of P,p�(iLa d DeCLARATION rtEGArtOIN C TION LENDING AGENCY hereby affirm urdsr nnnalty p - t at there is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil Code). _enders Name LendersAddress 3y my signature below, I ce..'. ach of the following: I am the property owner or authorized to act on the property owner's ttew. I have read this application and the information I have provided is Cor . I agree to comply with all applicable city and coon ordinan San ate laws relating to building Construction. I authorize representatives of this city or to an r th. denlifled property for inspection purposes. Signature of Properly Owner AuthG en lint Pro Owner's or Authorized A a Name t L'-/uOGGi-2L - ACTION DATE 111 BY E NOFCOMPLIANCE. WITHCODEOF FEDERAL FOR OFFICE USE ONLY EG LATIONS PART 61 OF TITLE 40 AND AOMD RULE PERMIT EXPIRED PERMIT EXTENDED PERMfTFiNAL CERTIFICATE OF OCCUPANCy15SUED L-I ASRESTOS NOTIFICATION 15 NOT APPLICABLE TO PROPOSED DEMOLITION N .�A. ti y Fri � N fpd � 4 td GL H U ttl � O aU+ O L7 m O U y .0 N •iC �i p Z �. O p•� V bTy ro O '—' p N � O ❑ O N _ O b O U U U q ° O to w U a O .��y U ❑�❑ �'-' K' N N U b .'� � o 0 7 b f7- � p i-i ✓ p > � � fA ~ U Vl � � � Yy a v/i