HomeMy WebLinkAboutX2022-0410 - PermitsaEWPORr City of Newport Beach II IIIIII IIII IIIIII IIIIIII IIIIIIIIIIIIIII II III III COMB Permit : X2022-041 U
Community Development Department -Building Division X 2 0 2 2 0 4 1 0
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: 0363-2022
3 Nb T Permit Counter Phone: (949) 718-1888 Issued Date: 0811912022
o.newportbeachca.gov/civic
Final Date: 10/23/2024
�GI F00.��P Combination Type - GRAD Permit Status: Final
Work Class - Other 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 : 2309 SANTIAGO DR Legal Desc : P BK 108 PG 43 PAR 1 PM 108-43 PAR 1 & 2 AND NEWPORT HEIGHTS FOR OF
Description: SFR TEMP. SHORING @ TENNIS COURT, WITH INCREASED GRADING CUT/FILL
owner, PPPPPATRiCK TFNORF Centrant r A.rrhotpGt: DAVID a SMITH
Address: 960 W 16TH ST Address : Address: 324 LOMA TERRACE LAGUNA BEACH, CA
COSTA MESA, CA 92627 92651
Phone: (949) 903-1426 Phone: Phone : (949) 433-6020
Con State Lic: State Lic : C018181
Applicant:
DAVID B SMITH
Address:
324 LOMA TERRACE
LAGUNA BEACH, CA 92651
Phone:
(949) 433-6020
Owner/Builder: PATRICKTENORE
Address:
960 W 16TH ST
COSTA MESA, CA 92627
Phone:
(949)903-1426
Lic Expire:
Bus Lic:
Bus Lic Expire:
Workers' Compensation Insurance
Carrier :
Policy No:
W. C. Expire:
Engineer: TUCHSCHER JAMES TODD
Address: 5318 E. 2ND ST STE 539
LONG BEACH, CA 90803
Phone : (310) 613-9980
Designer:
Address :
Phone:
Code Edition:
2019
Fire Sprinklers :
NO
Construction Valuation :
$0.00
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 :
0
Bldg Height:
No of Stories :
0
Add/New sq. ft. Garage:
0
TOTAL sq. ft.:
0
Building Setbacks :
Front:
15, Side: 10, Side: 10, Rear: 10
Flood Zone :
X
Use Zone:
R-1-10000 - Single -Unit Residential (10000 indicates minimum
lot area)
PROCESSED BY
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penally 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 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 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).
111. as owner of the property, or my employees with wages as their sole compensation, will do U all of or U 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 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' Stale 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 1 must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legalll
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://www.leginfo.ca.gov/calaw.htmi.
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 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
WARNING: 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 15100,0001, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
111 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
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'
rance carrier and policy number are:
Policy Number Expiration Date
of Agent Phone If
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
, if I should become subject to the workers' Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
signature of Applicant Dale_ _
IECLARATION REGARDING CONSTRUCTION LENDING AGENCY
hereby 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).
enders Name Lenders Address
ly my signature below, 1 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 application and the information I have provided Is correct,
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of this city or county to enter the above -Identified property for inspection purposes.
',ionature of Prooertv Owner or Authorized Anent Print Property Owners or Authorized Aaent's Name
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RUI F
PERMIT EXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLEO
UEPA
PERMIT EXTENDED
LIAQMD
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY ISSUED
(Q- 23 -24
U ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION
SIGNATURE:
Date