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Home My WebLink AboutXR2023-1268 - PermitsaEWPORT City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: XR2023-1268 C� 1 Community Development Department- Building Division X R 2 0 2 3 1 2 6 e 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-1123 u ? :-Permit Counter Phone: (,949) 718-1888 Issued Date : 05/15/2023 erk newportbeachea.gov/civic Inspection Area : 3 c9tIFO Rz„P Combination Type - ELEC PLUM Work Class - Other 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 : 1715 PALOMA DR Legal Desc : N TR.3176 BLK LOT 17 Description: SFR YARD DRAINAGE & GAS/ELEC FOR BBQ I F,ip - Owner: JENNIFER RUSH Address : 1715 PALOMA DR NEWPORT BEACH, CA 92660 Phone : (408) 218-8358 Applicant: JENNIFER RUSH Address : 1715 PALOMA DR NEWPORT BEACH, CA 92660 Phone: (408) 218-8358 owner/Builder: JENNIFER RUSH Address: 1715 PALOMA DR NEWPORT BEACH, CA 92660 Phone : (408) 218-8358 Contractor Address : Phone : Con State Lic Lic Expire Bus Lic: Bus Lic Expire Workers' Compensation Insurance Carrier : Policy No: W. C. Expire: Code Edition : 2022 Fire Sprinklers : NO Type of Construction : V-B Fire Hazard Zone : NO Occupancy Groups : U No of Units : 0 Bldg Height: No of Stories : 0 Building Setbacks : Front: 15, Side: 10, Side: 10, Rear: 10 Flood Zone : X Use Zone : R-1-10000 - Single -Unit Residential (10000 indicates minimum lot area) PROCESSED BY: SPECIAL CONDITIONS: Architect Address f `I� Phone: State Lic Engineer Address Phone: Designer: JENNIFER RUSH Address: 1715 PALOMA DR NEWPORT BEACH, CA 92660 Phone : (408) 218-8358 Construction Valuation : Added/New/TI sq. ft. Bldg : 0 Alteration sq. ft. Bldg : Added/New sq. ft. Garage : 0 TOTAL sq. ft. : 0 OWNER -BUILDER DECLARATION i hereby affirm under penalty of perjury that I am exempt from the Contractors' State 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 Cade: Any city or county (hat requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for :he 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 of the Businoss and 'rofessions 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 fora permit subjects the applicant to a civiLpenalty of ict more than five hundred dollars ($500). 1 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions ofthe work, and the structure Is not intended or offered for sale (Section 7044, 3usiness 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 mprovements 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 proved for the purpose of sale). Dlilas owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does not apply 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). 11 I am exempt from licensure under the Contractors' State License Law for the following reason: 3y my signature below f 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 legally ;all a structure that I have built as an owner -build if' has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law. Section 7 4 of the Business and orofesslons Code, is available upon request when pp 1 is submitted or at f Mowing Web site: hitpJiwww.leginfo.ca.gov/calaw html. !S Signature of Property Owner or Authorized Agent Da 5 LICENSED CONTRACTOR'S DECLAIRATICY4 hereby affirm under penalty of perjury that. I am Ilc d�Orider provisi • of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. License Class License No Date Contractor Signature NORKERS' COMPENSATION DECLARATION YARNING; 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 (5100.,000),IN ADDITION TO THE :Oer OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. 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 Ih Ierformance of the work for which this permit is issued. Policy No. have and will maintain wodcers' 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' Pence carrier and policy number are: Policy Number ie of Agent certify that, in the performance of the work for which this If I should becc sub' the workers' compe atfoi tature of Apr n Date is issued, I shall notemploy any person in any manner so as to become subject to the workers' ompansation laws of California, and agre :ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date :Y maby affirm under perrelbyar"perjury that there iU construction lending agency for the performance of the work for which this permit is issued (Section 3097, CII Code). ider's Name Lender's Address my signature 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 Damply with all applicable city and cow nerd' nces and state caws relating to building construction. I authorize representatives of this city or coun t /enter the Bove-Identi ,YCpno,rhh for inspection purposes. IA\ _ n,e ' / nature of Property Owner or Authorized Agent , ��— — —P;' sit � Print Prcoerty Owner's or Authorized AcenCs Name' Y . ��N/L� 1 � (ALL. / H. ACTION DATE DATE BY :: ATlON OF 90M P LANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLF. 40 AND AOMD RULE 1403 PERMITEXPIRED_ I S02MITTED ASBESTOS NOTIFICATIONTO _ PERMiTCANCElLED j��EPA PERMlT FlNAL (7 ,r �/ %�---y�jft�lp�gs'5Tp5 R7TIF: ,1tlON IS P:OT A7?�lCA6LE TO CERTIFICATE OF 9,gr 3 PROPOSED OEMOLITtOPI OCCUPANCYISSUEO SIGNATURE: