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Home My WebLink AboutXR2022-2479 - PermitsCity of New ofBeach II Ili l I I III IIII IIIII 0 Community Development Department- Building Division Permit Counter Phone: (949) 644-3288 >e100 Civic Center Drive, Newport Beach, CA 92660 Inspection Requests Phone: (949) 644-3255 newportbeachca.gov/inspections Combination Type - SFP Work Class - Other COMB Permit: XR2022-2479 Plan Check No : PC2022-2330 Issued Date : 09/16/2022 Inspection Area : 2c 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: 23 HARBOR ISLAND Legal Desc : N TR 802 BLK LOT 23 TR 802 LOT 23 ALL -INC BET SAME & HIGH T IDE, Description: SFR DEADMAN AND COUPLER REPLACEMENT ONLY (NO WORK IN THE WATER) Owner: PICKUP TODD TR PICKUP LIVING TR Contractor: DYER J C COMPANY INC Architect Address : 23 HARBOR IS Address : - 1540 S COAST HWY #205 Address : �`�;�+, NEWPORT BEACH, CA 92660 LAGUNA BEACH, CA 92651 E J Phone : Phone : (714) 809-3258 Phone: Con State Lic : 586784 State Lic : y r" Lic Expire : 03/31/2024 e Applicant: DYER J C COMPANY INC Bus Lic : BT98042174 Engineer : JAFARI MASOUD Address : 1540 S COAST HWY #205 Bus Lic Expire : 02/28/2023 Address : 23 ORCHARD #250 LAGUNA BEACH, CA 92651 LAKE FOREST, CA 926�B� Phone: (714) 809-3258 Workers' Compensation Insurance Phone: (949) 206-9929 Carrier: EVEREST PREMIER INS CO Owner/Builder : Policy No : 7600012640221 Designer Address : W. C. Expire : 1/1/2023 Address Phone: Phone: Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $40,000.00 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 : Added/New sq. ft. Garage : 0 - Building Setbacks : Front: 15, Front: 15, Side: 4, Side: 4 Flood Zone.: X " Use Zone: R-1 - Single -Unit Residential PROCESSED BY: �=� I SPECIAL CONDITIONS: ALL WORK DONE ON PRIVATE PROPERTY OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractors' Slate 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 lie or she is liconsod pursuant to the provisions of the Contractors State Liconse 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). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do L) 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' State License Law does not apply to an owner of properly who, through employees' or personal effort, builds or improves the properly, 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)- 0 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 net 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' State License Law). ❑ I am exempt from licensure under the Contractors' Stale License Law for the following reason: .. . ............T,. __._._.._._ --- .......___ .... ...._____ __._. By my signature below I acknowledge that, except tot my personal residence in which I must have resided for at least one year prior to completion of the Improvements covered by this permit, I cannot legall sell a structure that I have built as an owner-buildor if it has not been constructed in its entirely 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;httpJlwww.leginfo.ca.gov/celaw.html. Signature of Property Owner or Authorized Agent _ _ _ Date LICENSED CONTRACTOR'S DECLARATION i hereby affirm under penally of perjury that. I am licensed under provisions of Chapter 9 (commencing with Section ) Division 3 of the Business and Pggpessions Code, and my license is In full force and effect. License Class License No Dat /6-.Z 7_ Contractor Signal WORKERS' 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 I%100,000).111 ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3T06 Or THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: I 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 th K=o farmaneo of the work for which this permit is issued. Policy No -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' compensabo insurance carrier and policy number are: Carrier Policy Number Expiration Dale Name of Agent Phone ff Ell 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 agra that, if I should become bject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions- 'a Cy Signature of Applic _ Date/ 4.. ��'" Z- _Z— DECLARATION RE ARf)IN UCTIO�N LENDING AGENCY ill [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, Ci j Code). Lender's Name Lender's Address By my signature bel-ace I certify to each of the following: I Are the propert/ :nrvTer or authorized to act art the property owner's behalf, I Le.✓J read this application and the information I have provided is correct. I agree to comply with all applicable city and county direness and state laws relating to building construction. I runrepresentatives of this city or county enter the above -identified property for inspection purposes. Si nature of Properry Owner or Authorized Agent Print PropertyOwner's or Authorized Agent's Name (N ��"1— Date _Z L ACTIGN DATE BY DM - OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY '. REGULATIONS PART61 OFTITLE 40ANDAQNID RULE 1403 PER06tI EXPIRED -�I SUBMITTED ASBESTOS NOTIFICATION TO PT Cf hCE!!ED _� IJE CRNIPA PERM7T EXTENDED �� i�T I SBOMO .._ PcA,L11T fl{A! � uASBESTOS NO11FICAfION IS NOT APPLICABLE 10 CERTIFICATE OF , PROPOSED DEMOLITION OCCUPANCY ISSUED �JZ �J' i SIGNATURE: