HomeMy WebLinkAboutXR2023-1656 - Permits0.-
City of Newport Beach 1111�1111p1111111111111111111111111111111111111111111111111 jjj� COMB Permit:XR2023-1656
Community Development Department- Building Division100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No:
Permit Counter Phone: (949) 718-1888 Issued Date : 06/15/2023
newportbeachca.gov/civic g 1mo^e^+—s's.CoCombination Type - SFP PLUM a ,- A ys 4 Inspection Area : 2
It
Work Class - Alteration
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: 2811 BAY SHORE DR
Description: SFR WATER REPIPE 2 BATHWITH PEX
Owner:
TEAL JOHN C JR TR
Address :
2811 BAYSHORE DR
NEWPORT BEACH, CA 92663
Phone:
Applicant :
EMALEE JOSEPH
Address :
26111 YNEZ RD, C3
TEMECULA, CA 92591
Phone:
(877)600-0123
Owner/Builder :
Address :
Phone
Legal Desc : N TR 1014 BLK LOT 27
Contractor: NEXGEN A/C INC
Address: 5472 EAST LA PALMA AVENUE
ANAHEIM, CA 92807
Phone:
(657) 208-1987
Con State Lic:
1011173
Lie Expire :
02/29/2024
Bus Lie:
BT30055503
Bus Lie Expire : 06/30/2023
Workers' Compensation Insurance
Carrier: AMERISURE MUTUAL
COMPANY
Policy No: 212075500
W. C. Expire : 10/1/2023
Architect
Address
Phone:
State Lie
Engineer:
Address
Phone:
INSURANCE
Designer:
Address :
Phone :
Code Edition :
2022
Fire Sprinklers :
NO
Construction Valuation : $19,548.00
Type of Construction :
V-B
Fire Hazard Zone :
NO
Added/New/Ti sq. ft. Bldg : 0
Occupancy Groups :
R-3
No of Units :
1
Alteration sq. ft. Bldg :
Bldg Height :
No of Stories :
2
Added/New sq. ft. Garage: 0
TOTAL sq. ft. 0,, .,
Building Setbacks :
Front: 10, Side: 4, Side: 4, Rear: 10
Flood Zone :
X
,
Use Zone :
R-1 - Single -Unit Residential
NO CONSTRUCTION
NOISE
PROCESSED BY:
_
,
SPECIAL CONDITIONS: ON THE WEEKEND
I hereby affirm under penalty of perjury that I am exempt from the Contractors State License taw for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable Items)
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
is 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 cribs Business and
'rofossions Code) or that he or she is exempt from ¢censure and the basis for the alleged exemption. Any violation of Section 7031.6 by any applicant for a permit subjects the applicant to a civil penalty of
of more than rive hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work; and the structure is not Intended or offered for sale (Section 70",
tusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort; builds or improves the property, provided that the
nprovements 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
nproved for thepurpose 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
Ippiy to an owner of property who builds or Improvesthereon, 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:
ly my signature below I acknowledge that, except for 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 lagall
oil 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 theapplicable law, Section 7044 of the Business and
irofessions Code., is available upon request when this application is submitted or at the folfowing Web site:http://www.f info.ra.govlcalaw.html.
3lgnaturo of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00) of D))'vision 3of the Business and Profess(igOAs�C�o�de,�and my�i cerise is In full force
and effect. License Class License No Date (2 Contractor Signature
PORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 19 UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001. IN ADOTNON TO THE
AST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES,
hereby affirm under penalty of perjury one of the following declarations:
3 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, forth
jerfante of the work for which this permit Is issued. Policy No.
o7have 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' compansatioi
ranee carder and policy number are:
of Agent
Policy Number Expiration Date
Phone N
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 taws of California,
. if I should become subieclAe,the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of Applicant
Date�_J l 5i iZ-3
hereby afficn under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section3097, Civil Code).
end^r's Name Lenders Address
y m. signaPlre below, I 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 ruthorize representatives of this city or county to EBIerNhe above -identified property for inspection purposes.
ACTION I DATE BY LECLARATION OTCOMPLIANCE wrrH CODE OF FEDERAL' FOR OFFICE USE ONLY
REGULATIONS PART 61OF TITLE 40 AND AC2MD RULE
NOTIFICATION
PERmir FINAL pNF"' BESTOS NOTIFICATION IS NOT APPLICABLE TO
CERDOCATE OF-}I'�,l Vogt-PAO OSEO DEM IONw
OCLUPANCYISSUEO I -C li SIGNATURE:
/15/J,:;i