HomeMy WebLinkAboutXC2023-0182 - PermitsyEw o City of Newport Beach II IIIIII I IIIIIII IIIIIIIII IIII IIII II IIII I II COMB Permit : XC2O23-01 82, �� Rr.
pm Community Development Department -Building Division X C 2 0 2 3 0 1 8 2
Y 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-1282
Permit Counter Phone: (949) 718-1888 Issued Date : 05/26/2023
newportbeachca.gov/civic Inspection Area : -7
"`",�,�Foa'" Combination Type -
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: 844 HALYARD Legal Desc :
Description: COMM - RPL DECKING AROUND COMMUNITY POOL. UPDATE DRAINAGE `NEWPORT KNOLLS HOA`
Owner: NEWPORT KNOLLS
Address : 874 HALYARD
NEWPORT BEACH, CA 92663
Phone
Applicant:
PAUL ELLISON
Address:
24642 VIA RAZA
LAKE FOREST, CA 92630
Phone:
(949)683-9861
Owner/Builder
:
Address :
Phone
Contractor :
TESERRA
Address :
P O BOX 1280
COACHELLA, CA 92236
Phone:
(760)398-9222
Con State Lic
: 656128
Lic Expire :
10/31/2024
Bus Lic :
BT30078953
Bus Lic Expire : 06/30/2023
Workers' Compensation Insurance
Carrier: STARSTONE NATIONAL INS CO
Policy No: T10230999
W. C. Expire : 1/1/2024
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
Building Setbacks
Flood Zone
Use Zone:
PROCESSED BY
Architect
Address
Phone:
State Lic:
Engineer
Address
Phone
Designer: PAULELLISON
Address: 24642 VIA RAZA
LAKE FOREST, CA 92630
Phone: (949)683-9861
Construction Valuation : $6,500.00
Added/New/TI sq. ft. Bldg : 0
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage: 0
TOTAL sq. ft. : 0
SPECIAL CONDITIONS: z
I hereby affirm under penally 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 applicableitem(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 rile a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Lew (Chapter 9 (commencing With Section 7000) of Division 3 of the Business and
Professions 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 civil penalty of
not more than five hundred dollars ($500).
0 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is not intended proffered 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 one year of completion, the Owner -Builder will have the burden or proving that It was not built or
Improved for the purpose of sale),
0 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
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).
rl 1 am exempt from licensure under the Contractors' State License Law for the following reason:
-----
By my signature below 1 acknowledge that, except for my personal residence in which I must have resided for at. IeaSfona 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:http:l/www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700o)- is' in of the Business and Pm Cod , an y lice is In full force
and effect. License Class License. No Date 71 >vontractor Signatu
WORKERS' COMPENSATION DECLARATION
tARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND Cri PINES UP TO ONE
OST OF COMPENSATION: DAMAGES" PROVIDED FOR IN SECTION 373E OF THE LABOR CODE, INTEREST, ANP ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
(SSaa a90), IN ADDITION TO THE
and Will maintain a certificate of consent toself-insurefor workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
a 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'
carrier and policy number are;
Number
of Agent
Date
JI certify that, in the pe rmat
wo for ieh 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 agre
ist, If I should become bjectk rs' mpen tion provisions of Section 3700 of the Labor Code; I shall forthwith comply With those provisions. 7
DIX 15/Ld,4
igmaiure of Applicant v`
ZCLARATION REGA . LENDING AGENCY
hereby affirm under penalty f perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Coda).
enders Name Lenders Address
y my signature below. I certify to each of the. following:
I am the property owner or authorized to act on the pro arty owner's bah
1 have read this application and the information. I h e p videtl is c ct.
I agree to comply with all applicable city and cou ordl es are aws Ling to building construction.
I authorize representatives of this city of count t Bab e- ntifie on
for inspection purposes. y Q. /�` z,6
ignature of Property Owner or Authorized Agent. Print Probertv Owner's or Authorized Anant's Name �i "" �r ���- n.,
ACTION ( DATE BY �I V6CkRiAT10FR'ISF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
i GULATIONS PART SI OF TITLE 40 AND AOMD ROLE
PERMITCANCELLED
PERMiTEXTENDED
PERMIT FINAL
CERYIfrCAtE OF r_
NOT-FICAr' )N 15 NOT APPLICABLE TO