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Home My WebLink AboutXR2022-2183 - Permits (2),�gWaoRT City of Newport Beach II III III I II I II I IIIII III II IIII III jj COMB Permit : XR2022-2183 :p' e. Community Development Department- Building Division X R 2 0 2 2 2 1 8 3 `�' 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : 2321-2021 � -4F' n' Permit Counter Phone: (949) 718-1888 Issued Date : 1011112022 V - S' newportbeachca.gov/civic Final Date: Combination Type- Permit Status: Issued Work Class - Other Inspection Area : 4 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 : 1969 PORT BRISTOL CIR Legal Desc : N TR 6623 BLK LOT 80 Description: DELTA 1 REVISION & ADD1 SCOPE: SHORING FOR POOL Owner: QUICK RICHARD KEVIN TR Contractor: SHEAR CONSTRUCTION Address: 2618 SAN MIGUEL DR #265 Address : 31 BLAKEMORE DR NEWPORT BEACH, CA 92660 LADERA RANCH, CA 92694 Phone: Phone: (714)615-6108 Applicant: ANDREW DESURRA Address : 31 BLAKEMORE DRIVE LADERA RANCH, CA 92694 Phone : (949) 636-0195 Owner/Builder : Address: Phone Code Edition : 2019 Type of Construction : V-B Occupancy Groups: U Bldg Height: Building Setbacks Flood Zone: Use Zone : PROCESSED BY: Front: 22, Side: 5, Side: 5, Rear: 10 X PC - Harbor View Hills SPECIAL CONDITIONS: Con State Lic : 760853 Lic Expire : 07/31/2026 Bus Lic: BT30049686 Bus Lic Expire : 01/31/2025 Workers' Compensation Insurance Carrier: PALOMAR SPECIALTY INSURANCE COMPANY Policy No: PSIC0701280801 W. C. Expire : 4/11/2024 Fire Sprinklers : Fire Hazard Zone No of Units : No of Stories Architect Address Phone: State Lic Engineer: Address Phone Designer: Address : Phone: DURAND JR PAUL HENRI 611 N G ST OXNARD, CA 93030 NO Construction Valuation : $8,500.00 NO Added/New/TI sq. ft. Bldg : 0 0 Alteration sq. ft. Bldg : 0 0 Add/New sq. ft. Garage : 0 TOTAL sq. ft. : 0 OWNER -BUILDER DECLARATION I hereby affirm under penalty 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 item(s) 3action 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 to permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 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 permit 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 offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or nyproved for the purpose of sale). J 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 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' State License Law). 1 am exempt from licensure under the Contractors' Stale 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 legally ell 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://www.leginfo.ca,gov/calaw.htmi, signature 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 (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 VORKERS' COMPENSATION DECLARATION FANNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGES UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,0001, IN ADDRION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, AND ATTORNEY's 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 'ormance 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' compensal irance, 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 if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applicant Date_ _ IECLARATION REGARDING CONSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). enders Name Lender's Address y 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 state laws relating to building construction. I authorize representatives of this city or county to enter the above -identified property for inspection purposes. signature of Property Owner or Authorized Agent Print PrODerty Owner's or Authorized ADent's Name ACTION I DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 403 PERMIT EXPIRED PERMIT CANCELLED PERMIT FINAL U ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATEOF I S PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: