HomeMy WebLinkAboutXR2023-1834 - Permits04'.
City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit:XR2023-1834
Community Development Department- Building Division X R 2 0 2 3 1 3 3 4
100 Civic Center Driv&. Newport Beach, CA 92660 Plan Check No : PC2023-1123
Permit Counter Phone: (949) 718-1888 Issued Date : 07/06/2023
newportbeachca.gov/civic .. �T"Final Date:
Combination Type - Permit Status: Issued
Work Class - Other s`1 ``--" t t'"
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 : 1715 PALOMA DR Legal Desc : N TR 3176 BLK LOT 17
Description: DELTA 1 REVISION & ADD'L SCOPE FOR IN) PLANTER RETAINAING WALL 20" HIGH BY 10' LONG *INSIDE P/L*
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:
Architect
Address
Phone:
State Lic
Engineer:
Address:
Phone
Designer: JENNIFERRUSH
Address: 1715 PALOMA DR
NEWPORT BEACH, CA 92660
Phone : (408) 218-8358
Code Edition :
2022
Fire Sprinklers :
NO
Construction Valuation :
$300.00
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 :
0
Added/New sq. ft. Garage:
0
TOTAL sq. ft.
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:
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 fteni
Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, after, Improve, demolish. or repair any structure, prior to its issuance, also requires the applicant for
to permit to file a signed statement that he or sheds licensed pursuant to the provisions of the Contractors' State License Lew (Chapter 9(Commencing with Section 7000) of OLvision 3 of the Business 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 for a poonit subjects the applicant to a civil penalty of
of more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, Will do (_) all of or U portions of the work, and the structure Is not intended or offered for sale (Section 7044,
lusiness 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 offeredfor sale. If, however, the building or improvement issoldwithin one year of completion, the Owner -Builder will have the burden of proving that it was not built or
n roved for the purpose 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
ply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' Slate License Law),
I am exempt from ticensure under the Contractors' State 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 legalli
ell a structure that I have built as an owner -builder if it has not been constructed in its entirely by licensed contractors. I understand that a copy of the applicable law, Soclion 7044 of the Business and
'rofessions Coda Is available upon request whep -lMs-ep nation Is sub hied or a following Web site:http:JhAn .leginfo.ca.govlcalaw.html.
signature of Property Owner or Authorized Ager4th� d`�, / Date —71(e
.ICENSED CONTRACTOR'S DECLARAT
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
nd effect. License Class License No Date Contractor Signature
COMPENSATION DECLARATION
IARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 19 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO' ONE HUNDRED THOUSAND DOLLARS (11100,000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3T06 OF THE LABOR CODE, INTEREST, "a ATTORNmrS FEES.
hereby affirm under penalty of perjury one of the following declarations:
31 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
erfornnance of the work for which this permit is issued. Policy No.
have and will maintain workers' Compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for whichthis permit Is issued. My workers'
ranee carder and policy number are:
ter Policy Number Expiration Date
of Agent
certify that, In the performance of the work for which this permit Is issued, I shall notemploy any person in any manner to as to become subject to the workers' compensation laws of Califomia., and agre
if I should become subject to the workers Compensation prov' s of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
iature of Applica g,,�Z Date— 7
I hereby affirm under-perrai 7af perjury that thereis'a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code)..
Lenders Name Lenders Address
By my signature below, I certify to each of the following:
I am the prrpe�b' owner or authorized to act on the property owner's behalf.
I have read this application and the information I have provided Is correct.
' ngree to comely with all applicable city and county ordinances and state laws rotating to building construction.
1 authoriz. representatives of this city or count enter the above-Ildeiritified property for inspection purposes.
Fi nelure of Property Owner or Authorized A ent - Print Property Owner's cr Authorized Agent's Name il/ Date
ACTION GATE DEC RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
4E7?MT fXPI'EO I U I SUBMITTED ASBESTOS NOTIFICATION TO
KhRd)TEXITADEO LIAOMD
PERMIT FfNi.t Vq ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
ATIFICATEOF 1z 2 PROPOSED DEMOLITION �7