HomeMy WebLinkAboutU2024-5053 - Permits�r.w Nok^ City of Newport Beach IIiII IIIIIIIIIIiIIIIIIIIIIIII II COMB Permit : UZO24-5053
p`' y,$ 6 Community Development Department- Building Division U 2 8 2 4 5 e 5 s
„! kE=,1 n 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-1425
i. Permit Counter Phone: (949) 718-1888 Issued Date : 06/07/2024
newportbeachca.gov/civic Final Date:
`'row" ` Combination Type - Permit Status: Issued
Work Class - New F r'..—+ r—� '
9 i Inspection Area : 2
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 : 204 RUBY AVE Legal Desc : A TR BALBOA ISLAND SEC 2 BLK 10 LOT 16
Description: DUPLEX BLOCK WALL W/ PARTIAL RETAINING 42" HIGH X 30 LF INSIDE P/L 'MARKERS ONS ITE" & DRAINAGE (CHANGE OF CONTRACTOR TO PERMIT
XR2023-1115)
Owner: RICK WOODLAND
Contractor: PACIFIC BREEZE BUILDING
Architect:
SOLUTIONS, INC.
Address : 204 RUBY AVE
Address : 15512 GRAHAM ST
Address
NEWPORT BEACH, CA 92662
HUNTINGTON BEACH, CA 92649
Phone : (925) 588-8134
Phone : (714) 379-0744
Phone
Con State Lic : 1019675
State Lic
Lic Expire : 04/30/2025
Applicant : RICK WOODLAND
Bus Lic : BT30074316
Engineer
Address : 204 RUBY AVE
Bus Lic Expire : 02/28/2025
Address
NEWPORT BEACH, CA 92662
Phone: (925) 588-8134
Workers' Compensation Insurance
Phone:
Carrier: MARKEL INS CO
Owner/Builder :
Policy No: MWC017446004
Designer:
Address :
W. C. Expire : 9/27/2024
Address
Phone:
Phone:
Code Edition : 2022
Fire Sprinklers : NO
Construction Valuation :
$40.00
Type of Construction :
Fire Hazard Zone : NO
Added/New/Ti sq. ft. Bldg :
0
Occupancy Groups : U
No of Units :
Alteration sq. ft. Bldg :
0
Bldg Height:
No of Stories :
Add/New sq. ft. Garage:
0
TOTAL sq. ft. :
0
Building Setbacks : Front: 7, Side: 3, Side: 3, Rear: 5
Flood Zone : X
Use Zone : R-BI - Two -Unit Residential, Balboa
Island
PROCESSED BY: Fs —
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penally of perjury that I am exempt from the ContractorsSlate License Law for the reason(s) indicated below by the checkmark(s) 1 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 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
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).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) 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 one year of completion, the Owner -Builder will have the burden of proving that It was not built or
improved for the purpose of sale).
❑ 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).
❑ I am exempt from licensure under the Contractors' Stale License Law for the following reason:
By 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 legall•,
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 70" of the Business and
Professions Code, is available upon request when this application is submitted or at the following Web site:http:llwww.leginfo.ca.govlcalaw.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 7000) of Divi4s,ion 3 of the Business and ProfessionsC d==�'—�1�� ma's 'n full force
and effect. License Class License No Date 6 ^ 7 - dH Contractor Sign��� —�
COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,0001, IN ADDITION TO THE
'DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES.
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 th
performance 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'
rance carder and policy number are:
Policy Number
of Agent
Date
11 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 Califomia, and al
tat, if I should become sub t-le-theiverJ ' compensation provisions of Section 3700 of the Labor Code, I shall (orlhwith comply with those provisions. '-11
iynature of Appli t �� Dale_
DECLARATION REGARDING � STRUCTION 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).
adder's 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 property owner's behalf.
I have read this am.calion and the information I have provided is correct. �� y
I aprae to comply with all applicable city and county ordinances and stale laws relating to building construction.
I aufi Iorize rLprosen:atives of this city or county to enter the above -identified property for inspection purposes.
tunature of Prooerhr Owner or Authorized ADent _n_, v1.,Y+ -) /" ram-�, Print Prooertv Owner's or Authorized ADenfs Name Date b—�-
nCTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
EXPIRED
I SUBMITTED ASBESTOS
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SIGNATLIRF�
PERMIT FEE DETAILS FOR PERMIT U2024-5053
Fee Name
Fee Amount Fee Paid Amount
Transaction Date Payment Method
Trans. Paid Amount Paid By
Building
Building Permit Fee • Valuation
$40.00 $40.00
06/07/2024 CC EPL
$40.00 RICK WOODLAND
GRAND TOTAL: $40.00 $40.00
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