HomeMy WebLinkAboutXR2023-3463 - PermitsagWPORT City of Rl,2wipert 9erlch II III I IIII II I IIIIII IIIII IIII II II COMB Permit XR2023-3463
D� Community D..velopment Depertr,er/ Bui-dir, g Division
F 100 Civic Cemer Drivn, Nev,po t Fea ;h, Cr, 9s.660 Plan Check No : PC2023-0327
>A ¢ Permit Ccumer Pho. ie: (949) 71' 18- Issued Date : 12/15/2023
.a. newportbeachca.gov/civic Final Date:
C9L/FOftN�P Combination Type - SFP Permit Status: Issued
Work Class Cther Inspection Area : 5
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: 552 SEAWARD RD Legal Desc : N TR 1237 BLK LOT 178 TRACT NO 1237 LOT 178 AND TR
Description: SFR - CMU RETAINING BLOCK WALL 2'8" X 90 LF W/ METAL FENCE INSIDE PL, MARKERS ON SITE
Owner:
Address
Phone:
Applicant
Address
Phone:
BRYAN ROGERS CALIFORNIA RESIDENCE Contractor: MDM SCAPES INC
TRUST
552 SEAWARD RD
CORONA DEL MAR, CA 92625
POOLHAUS DESIGN & BUILD
PO BOX 4092
NEWPORT BEACH, CA 92661
Owner/Builder :
Address :
Address : PO BOX 23021
SANTA ANA, CA 92711
Phone: (714)478-2304
Con State Lie : 990933
Lie Expire : 02/29/2024
Bus Lie: BT30049876
Bus Lie Expire : 02/28/2024
Workers' Compensation Insurance
Carrier :
Policy No: PSIC0701213702
W. C. Expire : 9/13/2024
Architect
Address
Phone:
State Lie
Engineer
Address
Phone:
Designer:
Address
Phone: Phone:
Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $10,000.00
Type of Construction : V-B Fire Hazard Zone : YES Added/New/TI sq. ft. Bldg : 0
Occupancy Groups : U.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: 5, Side: 6, Side: 6, Rear: 6
Flood Zone : X
Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area)
PROCESSED BY:
SPECIAL CONDITIONS: REV2023-1909
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 che-krnx'((s) I'lave placed nextio lire applicable ilem(s)
Section 7031-5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any stricture prior to Is 'es'ierce, riso requires the applicant for
1D permit to file a signed statement that he or she is licensed pursuant to the provislons of the Contractors' State License Law (Chapter 9 (com,.r i,lg will I Section 7000) of Division 3 of the Business and
'rofessions Code) or that he or she is exempt from liceasure 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
of more than five hundred dollars ($500).
3 I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work; and the rtructcre'a not Infcnde. 3r offs*ei for ;Lle (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, ouilds or improves Pie property, provided that the
I provements are not intended or offered for sale If, however, the building or Improvement is sold within one year of completion, the Owner -Baader will have the hl:rden of pra'viro'that it was not builtor
nproved for the purpose of sale).
3 I, as owner of toe property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
pply 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),
3 1 am exempt from iCensure under the Contractors' State License Law for the following reason:
ry 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 legally
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 the applicable law, Section 7044 of the Business and
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:/1www-leginfo.ca.gov/calaw,btml,
tignahure 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 (commencling with Section 7000) f ivi ion 3 of the Business and Pr a si as Code d i ease is In full force
nd effect. License Class License No Date t Contractor Signature i
PORKERS' COMPENSATION DECLARATION
ARMING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS VNLAWFVL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T OUSAND DOLLARS (S100,00i ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706OF THE L.ASOR 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
4w4lance of the Work for which this permit is issued. Policy No.
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'
carder and policy number are
Policy Number Expiration Date
to of Agent
certify that, in the performance of he work for which this permit.
if I should become subject to t workers' compensation
Iature of Applicant it,
Ued. I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree
of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Date
I hereby affirm under penalty of Werjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Namell Lender's Address
By 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 comply with all applicable city and county ordinances and slate laws plating I,wilding construction.
I authorize representatives of this city or County to ter lira above-fdentif` ope inspection purposes.
Signature of Prc erty Owner or Authorzed A en[ �� Print Property Owner's or Authorized Agent's Name-:;;,•'�,< d'�i i Dzte r' i-5
ACTION DA7E By DECLARATION. OF COMPLIANCE WIT14 CODE OF FEDERAL FOR OFFICE usE ONLY
' REGULATIONS PART 61 OF TITLE AO AND AQN1D RULE
1403
PERMITEXPfRED —FI �E—BMI71ED A5f3ESTOS NOTIFICATION TO
PERAgIT CANCELLED j 1_ICPA
PERMiT EXTFNDED �LJgiZMO_,
PCRNrl7 FINAL 5,2-L�. �1f ASBESTOS NOI IFICA'IION 15 NOI'APPLICABL£ 10
CERAFlCATE OF PROPOSED D WOLITION
OCCUPANCY ISSUED 1 SIGNATURE: