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HomeMy WebLinkAboutXC2022-2040 - PermitsCity of Newport Beach �aErPoRr p 6� Community Development Department- Building Division F Fy. 100 Civic Center Drive, Newport Beach, CA 92660 u Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 °gciFORN`P newportbeachca.gov/inspections Combination Type - Work Class - Other X C 2 0 2 2 2 0 4 0COMB Permit : XC2022-2040 Plan Check No: PC2022-2735 Issued Date : 10/3112022 Inspection Area : 7 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 : 110 22ND ST Legal. Desc : A TR NEWPORT BEACH CITY BLK 21 LOT 11 Description: COMM TEMPORARY SHORING FOR (E) EXCAVATED AREA ONLY Owner: MCFADDEN PLACE LLC Contractor : D B A C INC Architect Address : 3334 E COAST HWY #418 Address : 101 SHIPYARD WAY #A ` Address CORONA DEL MAR, CA 92625 NEWPORT BEACH, ;CA 92663 Phone: Phone: (949)723-0147 Phone: Con State Lie : 637651 State Lie : m Lie Expire : 02/29/2024 Applicant: BEAROOZ YACOOBI Bus Lie: 'BT00016282 Engineer: MANSHADI FARHAD Address : 101 SHIPYARD WAY Bus Lie Expire : 10131/2022 Address : 1800 E 16TH ST UNIT B NEWPORT BEACH, CA SANTA ANA, CA 92701 Phone: (949) 514-1728 Workers' Compensation Insurance Phone: (714) 835-2800 Carrier: INSCO OF THE.WEST Owner/Builder : Policy No: WSD5051828 Designer Address : W. C.'Expire : 11/11/2022 Address Phone: Phone: Code Edition : 2019 Fire Sprinklers NO Construction Valuation : $75,000.00 Type of Construction : Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg: Occupancy Groups : U No of Units : 0 '' Alteration sq. ft. Bldg Bldg Height: No of Stories : Added/New sq. ft. Garage: 0 TOTAL sq. ft. Bldg : 0 Building Setbacks Flood Zone: X Use Zone: - MU-W2 - Mixed -Use Water PROCESSED BY:� SPECIAL CONDITIONS: ° •o o•o . o ,a a° 1$500), rovements are not intended or offered for sale. If, however, the building or improvement is sold c roved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors iG construct the €y to an owner of property who builds or Improves thereon, and who contracts for the projects wit I am exempt from f;censure under the Contractors' State License Law for the following reason: ny signature below f acknowledge that, except for my personal residence in whichI must have r$ a structure that I have butt asan owner -budder if it has not been constructed in its ":entirety by lic n Grip year of completio , the Owner -Builder will have the burden of proving: that it was not built. or tact (Section 7044, Bust ass and Professions Code; The Contractors State License Law does not. icansed Contractor pu want to the Contractors' State License Law), t hereby affirm under penalty of perjury that I am licensed under provisions of Chapter.9. (Commencing with Section 7. ) of and effect. License Class License No Date P ORKERS' COMIPENSATICIN DECLAPATION WARNING: FARURE TO SECURE WORKERS' COMPENSATION COVERAGE IS. UNLAWFUL:; AND SHALL SUBJECT AN. EMPLOYER TO CRaWAL PERALT COST OF COMPENSATION, DAMAGES AS: PROVIDED FOR M SECTION 3706.OF THE LABOR CLUE, INTEREST. AND ATTORNE" FEES, -" 1 hereby affirm under. penalty of perjury one of the following declarations: © I haveand wilt maintain a Certificate of cohsent to selflnsure for workers compensation, issued by the Director tfommance of the work for which this permit is issued. Policy. No, I have and Will maintain workers' compensation losurarrm as required by Section 3700 of the Labor Code, for the pe1 su nce carrier and. policy number, are: Carrier... Policy Number. Name of Agent, Dicertify that. In th4 pe orm ance of the for which this permit is issued. I shall not employ any. person in any manners that it I -should becom s b ect toiha wor rs' m ensation: rov€stons of.Section 3700'of the Labor Code, I shall forthwith I am the pr I have reac t agree tpt I authod e on a •"LWA • • _ • • MIF • • ' TIRCATI [r : • • • •� St➢1A05 : Ll'fOLN ON VS NOT F£ TO C€RFItAi€CTf t� OCCUPANCY fSSU€t) 0 o e e e e o • s • e ooe •ee •e s e lie• e• work for which - ofl AM FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($IKe0e) M ADDITION TO I at Relations as provided for by Section 3700 of the Labor Code, for as of the work for which this permitis issued.. My workers'compensa Expiration (Date )Boom$ subject to the workers' mpeasation laws of California, and ag with those provisions. r3a�e I O �31 %22 /L