HomeMy WebLinkAboutXR2022-3127 - Permits�E,WPO�T City of Newport Beach �� IIIIII IIIIIIIIIII II IIIIIIIIIIIIII IIIIIIIIII ��
Community Development Department- Building Division X R 2 0 2 2 3 1 2 7
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
e9 N P Inspection Requests Phone: (949) 644-3255
newportbeachca.gov/inspections
Combination Type - SFP ELEC PLUM
Work Class - Other
COMB Permit : XR2O22-3127
Plan Check No: PC2022-2989
Issued Date : 12/01/2022
Inspection Area : 4
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 : 1844 PORT CHARLES PL
Legal Desc : N TR 6622 BLK'LOT 3
Description: SFR - INSTALL EXTERIOR FIREPLACE
Owner: LOS VALLECITOS INVESTORS LLC
Contractor;' JEREMY GRISSINGER
Architect
Address : 197 EMERALD BAY
Address : 11912 ARROYO AV
Address
LAGUNA BEACH, CA 92651
SANTA ANA, CA 92705
Phone : .,
Phone :' (949)922-5755
Phone
Con State Lic : 807874
State Lic
Lic Expire : 05/31/2024
Applicant : JEREMY GRISSINGER
Bus Lic: BT30043274
Engineer: °
Address: 11912 ARROYO AV
Bus Lic Expire: 05/31/2023 `.
Address: m°°°°°
SANTA ANA, CA 92705
°, °
d ° • <,
Phone: (949) 922-5755
Workers' Compensation Insurance
Phone:
Carrier.•
4
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Owner/Builder:
Policy No: NONE
Designer:
Address :
W. C. Expire:
Address
Phone:
Phone:
°
Code Edition ; 2019
Fire Sprinklers : YES
Construction Valuation : $7,00GA0
Type of Construction : V-B
Fire Hazard Zone i NO
Added/New/TI sq. ft. Bldg : 0 m ° • _ °
°
Occupancy Groups : U
No of Units : 1
Alteration sq. ft. Bldg
«9S^'
Bldg Height:
No of Stories : 2
Added/New sq. ft. Garage: 0
-
TOTAL sq. ft. 0
Building Setbacks : Front: 20, Side: 5, Side: 5, Rear: 10
Flood Zone : X
Use Zone: PC - Harbor View Hills
PROCESSED BY:
SPECIAL CONDITIONS:
�N E CT
however, the building or Im
;ling with licensed Contract
thereon, and who contracts
when
M
reason:
1 have placed next to the applicable Items
a to its issuance. also recuires the aDDROZ
eas and Professions Code: The ContractorsState License taw does net
aantto the Contractors' State License Law),.
affirm under penalty of pequryfhat I am licensed under provisions of Chapter 9 (commencing with Section 7000): f -VI ;of the Sustness'aand Prof Ion' od a y1lcense is in full force'
t. License Class License No Dat Contractor Signature
RS' COMPENSATION DECLARAT[ON
FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,. AND. SHALL SUBJECT. AN. EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED T SAND DOLLARS ($100,000), IN ADDITION TO THE.
OMPENSATION, DAMAGES AS PROVIDES FOR IN SECTION 070E OF THE LABOR CODE; INTEREST, AND ATTORNEY'S. FEES,
i(nrm underpenalty. of perjury one of the following declarations:
and will.maintein 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 its
ice ofthWo4KCar which this permit isIssued, Policy No.
ind will mail tafn wcrkars' 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' compensation
carder.: apd poily number are:
Policy Number:. expiration Date
&Want .... .Phoneit.
a of Applicant
ATION REG, IN CTfO,
*ffirm yu ar a?3�jalty of perfu that thee
Name
Instate below, Fcerhfy to each of the fc
the property oviner or authorized to act
a read this application and the informal
as to comply with all appticable city_anc
horiYa representatives of this city at tot
a of Property Owner or AuthorizedAgeY
DATE I BY
I shall not employ sny person in any manner so: as to become subject to the workers' compensation laws Of.Caffomia, and We
cticn 3700 of the Labor Coda,' I shall forthwith comply with those provisions.
pates
Iney for the performance of the work for which this permit. is issued (Section 3097, civil Code),
I nnrfer'c Add...
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