HomeMy WebLinkAboutXR2023-3119 - Permits;aEW�,oRT. City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XR2O23-3119
o� I Community Development Department- Building Division X R 2 0 2 3 3 1 1 9
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : 0112-2022
Permit Counter Phone: (949) 718-1888 Issued Date : 11/02/2023
.a< newportbeachca.gov/civic Final Date:
CpC/F00.�`P Combination Type - Permit Status: Issued
Work Class - Other - 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 : 1942 GALAXY DR
Legal Desc : N TR 4224 BLK LOT 18
Description: SFR ADD CITY STANDARD BLOCK WALLS W/'3A FTG DETAIL' 6' HIGH BY 8' LONG INSIDE P/L (REV2023-2188)
Owner: MANOUCH MOSHAYEDI
Contractor: TUSCANY CONSTRUCTION CO
Architect
Address : 255 W COAST HWY
Address: 1560 SUPERIOR AV, STE B3
Address
NEWPORT BEACH, CA 92663
COSTA MESA, CA 92627
Phone: (949)723-6449
Phone: (949)548-3355
Phone:
Con State Lie : 494601
State Lie
Lie Expire : 07/31/2D24
Applicant : TUSCANY CONSTRUCTION CO
Bus Lie : BT30051434
Engineer:
Address: 1560 SUPERIOR AV, STE B3
Bus Lie Expire: 06/30/2024
Address
COSTA MESA, CA 92627
'
Phone: (949) 548-3355
Workers' Compensation Insurance
Phone:
Carrier: EVEREST PREMIER INSURANCE COMPANY
Owner/Builder :
Policy No : 7600024896231
Designer: TUSCANY CONSTRUCTION CO
Address :
W. C. Expire : 10120/2024
Address : 1560 SUPERIOR AV, STE B3
COSTA MESA, CA 92627
Phone:
Phone: (949) 548-3355
Code Edition : 2022
Fire Sprinklers : NO
Construction Valuation : $850.00
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 : 1,
Bldg Height :
No of Stories : 0
Added/New sq. ft. Garage : 0
TOTAL sq. ft, 0
Building Setbacks:
,
Flood Zone : X
Use Zone: R-1-6000 - Single -Unit Residential
(6000 indicates minimum lot area)
93
PROCESSED BY:
''•,
SPECIAL CONDITIONS: REV2023-2188
OWNER -BUILDER DECLARATION
I hereby affirm under penally of perjury that I am exempt from the ContractorsState License Law Tor the reason(s) indicatedbelow 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 he or sheds licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code) or that he or she is exempt from toonsure 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).
I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) 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 property who, through employees' or personal effort, builds or improves the property, provided that the
Improvements are not intended or offered for sale. If,however, the building or improvement is sold within oneyear of completion. the Owner -Builder will have the burden of proving that it was not built or
Improved for the purpose of sale).
❑ 1, as owner of the property, am exclusively Contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Slate License Law does not
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 Aconsure under the Contractors' Slate License Law for the following reason
By my signature below I acknowledge that,. except for my personal residence in which 1 must have resided for at [east one year prior to completion of the improvements covered by this permit I cannot legal
sell 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 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:nttp:/fwww,leginfo.ca.govlcalaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION r
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 of ision 3 of the Business and Profesi s Cad , niljm license is in full force
and effect, license Class License No Date '1. Contractor Signature ! i�
WORKERS' COMPENSATION DECLARATION
WARNING. FAILURE TO SECURE WORKERS' COMPENSATION CDVERACE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TOONE HUND THOUSAND DOLLAR' Is 0,000), IN ADURION TO TH
COST OF CCMPENSATVON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR COVE, INTEREST, Me ATTORNEYS FEES.
I hereby affirm under penalty of perjury one of the following declarations:
1 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 ti
port rmance 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 which this permit is issued. My workers' compansatk
nsurance carrier and policy number are:
Policy Number
of Agent
Date
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 agree
t, If I should become sZG
ct �o tile w rke s' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant1 . Date�CLARATiON REGARD CONSTROC N LENDING AGENCY
areby affirm under penalty of perjury that th re is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code)..
ider's Name Lender's Address
my slgnatura below, I certify to each of the following: �^
I am the property owner or authorized to act on the property owner's behalf.
I nave rear this Epplication 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.
t authorize representatives of this city or county tr,Tf�yrluer the �l bovr�lidentified property for inspection purposes. 1�' �f I �f 1 0 n 9
nature of P,00env Owner or Authorized Agent { I�1.. l? (�.. 111 4i1 Print Property Owner's or Authorized Agents Name .f�� U-Q l lam- `--"1 Date 11 IL Iz<
DATE I BY I DECLARATION OF`C¢NnPUANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
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