HomeMy WebLinkAboutXR2023-0472 - PermitsCity of Newport Beach
. d Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
n Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
newportbeachca.gov/inspections
Combination Type -
Work Class - Other
X R 2 0 COMB Permit: XR2023-0472
Plan Check No: 0987-2021
Issued Date : 10/14/2021
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 : 1726 CANDLESTICK LN Legal Desc : N TR,3763 BLK,LOT 32..
Description: SFR DETACHED PERGOLA 260 SF & MASONRY FIREPLACE; GAS/ELEC TO BBC/FIRE PIT **RENEW EXPIRED PERMIT**
Owner: HILARY SHALLA
Contractor: ADAMSON MARK.
Architect
Address : 1726 CANDLESTICK LN
Address : 104 OKRA
Address:
NEWPORT BEACH, CA 92660-
IRVINE, CA,.92618
Phone: (949)331-5327
Phone:. (7.14)376-6301
Phone:
Con State Lic: 7i 590874
State Lic
Lic Expire : -.I 02/29/2024
Applicant; ADAMSON MARK
Bus Lic : ' BT30057889
Engineer: RAHMAN MOKSUDUR
Address : 104 OKRA
Bus Lic Expire : 01/31/2024
Address : 13611 12TH ST, STE B
IRVINE, CA 92618
CHINO, CA 91710
Phone: (714) 376-6301
Workers' Compensation Insurance
Phone: (213) 400-8078
Carrier: STATE COMPENSATION INSURANCE FUND
Owner/Builder :
Policy No,-,. 9225662
Designer:
Address :
' W. Ct'Expire : 2/2/2024
Address
Phone:
Phone:
Code Edition : 2019
Fire Sprinklers i NO
Construction Valuation
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
t� m
Building Setbacks : Front: 20, Side: 6, Side: 6, Rear: 6
Flood Zone: X
Use Zone: R-1-6000 - Single -Unit Residential
(6000 indicates minimum lot area)
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PROCESSED BY:
SPECIAL CONDITIONS:
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Ii therebyafifirmunder penalty ofpenurythat lame
Improved for the purpose of sale).
❑ I, as owner of the property, am exclusively con-
a ply to an owner of property who builds or Improv
I am exempt from tieensure under the Contract
tractors' Sta
Caw)_
liehnt fn !
that the
built or
QRKERS' COMPENSATION DECLARAT[ON V y_ ' ' / V
WARNING: FAILURE TO SECURE WORKERS'. COMPENSATION COVERAGE IS UNLAWU4y.AND SHALL SUBJECT AN EMPLOYER TO CRMUVAL PENALTIES.A 4D CIVIL FINES UP TO ONE HUNDRED T USAND DOLLARS ISI00,000j, 1N ADDITION TO THE
COST OF. COMPENSATION;: DAMAGES AS: PROVIDED. FOR: IN SECTION 37" OF THE LABOR OOM INTEREST. AND ATTORNEYS FEES.
I hereby aifrrm under penalty of perjury one of the following declarations;:
I have and will maintain a certificate of consent to selr unsure for workers' compensation, Issued by the Director of Industrial Relations as provided for by Section 3700. of the Labor Coda, for In
e Orman€e of the work for which Ibis permit is issued. Policy No.
I �ve and will maintain workers' compensation insurance,: as required by Section 3700 of the Labor Code; for the performance of the work for which this permR is issued. Any workers`:compenatiol
insurance carder and policy number aw. - ..
Carrier PolicyNumber --Expiration Date
Name ofAgeni. Phone#
I certify that, in the rfo ance of t e work f r which this permit is issue not employ any person In any manner so as to become subject to the workers' om nation laws of California, and agre
that, if l should trecome k ject to'the workers" mpansation pro of Section n 3700'of the Labor Code, I shall forthwith comply with those provisions. _ f _ I _
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