HomeMy WebLinkAboutXR2022-2183 - Permits�EWPpRT City of Newport Beach II III I I I II I I III II I III II
p� COMB Permit : XR2U22-2183
Community Development Department- Building Division
1y" 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : 232
Permit Counter Phone: (949) 644-3288 Issued Date : 10/11
u w 2 Inspection Requests Phone: (949) 644-3255 Inspection Ar
Cq/,,p�pN�P newportbeachca.gov/inspections
Combination Type -
Work Class - Other` a�"h <<
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BU TER T EARS ���ww�7799-- 6RIGINAL IS ANCE DATE
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DE AREA , � OR�140'Nr$t�IVDAY AND HO A IN ALL AREAS
Job Address: 1969 PORT BRISTOL CIR Legal : N TR 6623 B 'LOT 80
Description: DELTA 1 REVISION & ADD'L SCOPE: SHORIN POOL
Owner: QUICK RICHARD KEVIN TR ,a ont a SHEAR'0ONSTRO&IO % Architect . '�`% •
Address : 2618 SAN MIGUEL DR #265 P R ss 31 BLAKEMORE DR Address
NEWPORT BEACH, CA 92 C.l r�� ' "�`LADERA RANCH CA 92694 ^-•q
Phone : Phone (714) 615 6108 • Phone
Con State Lic : 760853 State Lic:
Lic Expire :. 07/31 /2024 �r
Applicant : Shear Construction, In Bus Lic BT30060650 �;, Engineep� N PAUL HE RI
Address : 31 Blakemore Drive Bus Lic Expi, Yz'ti16 aAidrs* 11CA 93
Ladera Ranch, CA 9269 "; ,an 2'nr ' d '@..
Phone: (949 636-0195 � Workers' a tion l surance a 5
Carriers 01, RITY INSURANCE C MPA-Y��
Owner/Builder: Policy No "r XWS61231341 �*signer:
Address : W. C. Expire : 4/11/2023 v Address
P /g.
Phone: P e :
Code Edition : 2019 Fir r,,NN� t'+�, I ./, Co ruc ' aluation
Type of Construction : V-B Fir
�9ndon � ,Gl Lj C K d ew/TI sq. ft. Bldg
Occupancy Groups : U o t nits : \'.I:, E) 0 eration sq. ft. Bldg
Bldg Height : of Se'etil (0 Added/New sq. ft. Garage : 0
TOTAL sq. ft. Bldg : 0
Building Setbacks : Front: 22, Side: 5, Side: 5, Re : 10
Flood Zone : X
Use Zone! PC - Harbor View Hills
S `/w
PROCESSED BY:
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of pedury that I am exempt from the ContractorsState License Law for the reason(s) indicated below by the ark(s) I w
often 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or any structure, prior I it
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License spier 9 (commencing with S
dessions Cede) or that he or she is exempt from licensors and the basis for the alleged exemption. Any violati ction 7031.5 by any applicant for a. pe
more than We hundred dollars ($500).
1, as owner of the property, or my employees with wages as their sole compensation, wit of or (_)�ortiorys iirAbfantl the strh�tu i hl Izm
;mess and Professions Code: The Contractors State License Law does not app11 owner of property w 611 ��}j employee op����+���P fort, builds of
movements are not Intended or offered for sale. If, however, the bulidin rovemem is sold within one y aT od tempt ligq;�tt ew r-8uildar will have the
moved for the purpose of sale), o �0 V
1, as owner of the property, am exclusively comrac' Icensed Contractors to ucl the project (Sao 4. Business and Proles ,and Profes o
y to an owner of property who builds or im eon, nd who contra he projects a ensed Contractor4puOsFlt to ntractors' Stale; Li
am exempt from licensure un on'r for ' I�'Li on for lha folio; re _ _..,,._„
_.. _
my signature below I a ge that, Ego¢ r al residence it +hi h I. or a ne year prior to completion of in nhAFd
a structure that] h ullt as. an owner -build s not been corctd(plin entirety ,,Ilcep�p - clots. understand that a Copy of the appi'
next to the applicable items)
ce, also requires the applicant for
i) of Division 3 of the Business and
s the applicant to a civil penalty of
red for sale (Section 7044,
the property, provided that the
proving that it was not built or
Professions Code Ill ilable est-arEl thls a4pllcatlo subr>�ttf91. .`.fit fall ink; f`e14`site http:(fwww.leginfo.ca.gov/calaw html. r'
Signature of Pro - D e
g pafly`O er or sized Agent _..
LICENSED CCRIS DEC TIO
ke
I hereby affirm unden ITofp fti n h 1 Slsed a iderisi o Chapter 9 (wrc n in Station 00) of Division 3 of the Business and Prole 'o
end effect. License ITS__LC No r �`_ Dat - - - 2Z Contractor Signature
NORKERS' COMP.E ,S ION ECLA ION '"" ,�,�
19
NARNING: FAILURE TO SEC�W KER N COVERAGE IS UNLAWFUL GNU SIIALC UGJ CI AN FMPLOYFH TO CRIMINAL PENALTIES AND CIWL FINES o 9 DUSAN 1
COST OF COMPENSATION. O ASP FOR IN SECTION37e50F THE V,DOR CODE INTERF-ST AND ATTORNEY'S FEES.
hereby affirm under no ' a erjuryone o Ilowiifg eclat I ions "�' ° �a+.,�71
I have and will maim Fi a nlit(r, e of en 1 to Rell nsure ;trir wnrkem compensation, Issued a ire or f�nQMslnal Flat or video for iy Section
3erformance of L)te work for whic this rmit iR 1 sued Policy No 061- S G f j I
�I have and will maintain wbrke co foD:insuranrP as required by 5 tlon 3 of the Labor e for the �1g�rr ante of the work for whic erim s [I
nsurance carrier and policy h'L{mb are: '` .\
terrier Policy Numlgr 11100% Ion Datp,.
Vama of Agent
—1I certify that, in the performance of a we
Ihat, if I should become sgpjectrto tl-A we
Signature of Applicant„rCq.,r iyvvo
DECLARATION REGARDI
NG
CONSTR TION LENDING AGEI,
hereby affirm under penaltyof perjuryth there is a construction
f hot employ any person m nner so as to
37DO of the Labor shall forthwith oomals
the
_enders Name �� rK1€rs APr�
By my signature below, I certify to each of t
I am the property owner or authorized to c on the property o s bah
I have read this application and the infer Lion hav Ided It.
I agree to comply with all applicable city a city a as and state laws relating to building construction.
I authorize. repreaentalives of this city or c me®Ihe above -identified property for inspection purposes,
State License Law does not
of the Business and
license is in full force
ADDITION TO
Labor Code, for
compensation laws of California, and
l0 (I - Z.Z
this permit is issued (Section 3097, Civil Code).
G CT:ON
DATE
By DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
F;_'M77 EXPIRED
I SUBMITTED A59F5T05 NOTIFICATION TO
PERMIT CANC ELLEO
EPA
PchMiT EXTtNT'ED_�j.I�Lggivfp__
PLR MIT FINAL
W A59EST05 NOTIFIC ION 15 Ngk APPLICABLE TO
.-'h TINCATE OF
=. PROPOSED DEMOLI N
I O_,.I PAPJCY 65UF0
I SIGNATURE: