HomeMy WebLinkAboutXR2023-3382 - Permits�EWPORT City of Newport Beach II IIIIIIIIIIIIII IIII II II I IIII II COMB Permit : XR2023-3382
D� A Community Development Department- Building Division X R 2 0 2 3 3 3 8 2
r 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-0914
u z Permit Counter Phone: (949) 718-1888 Issued Date : 11/30/2023
a newportbeachca.gov/civic Final Date:
C9"on
/FO0.N�P Combination Type - Permit Status: Issued
Work Class - Other Inspection Area :
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: 1001 TILLER WAY
Description: NEW SFR TEMP SHORING W/STEEL PIPES
Owner: ROCKSHORE REAL ESTATE LLC
Address: 461 OLD NEWPORT BLVD
NEWPORT BEACH, CA 92663
Phone:
(949)975-0123
Applicant:
MARK TEALE
Address :
2900 BRISTOL ST BLDG A203
COSTA MESA, CA 92626
Phone:
(949)975-0123
Owner/Builder
Address:
Phone:
Legal Desc :
Contractor:
J P CONTRACTING
Address :
3419 VIA LIDO #233
NEWPORT BEACH,
Phone:
(714)337-3700
Con State Lic
: 620654
Lic Expire :
05/31/2025
Bus Lic:
BT30046672
Bus Lic Expire : 07/31/2024
D\.A �`cA
Architect: MARK TEALE
Address: 2900 BRISTOL ST BLDG A203 COSTA
CA 92663 MESA, CA 92626
Phone: (949)975-0123
State Lic : C 22162
Workers' Compensation Insurance
Carrier: EXEMPT- NO EMPLOYEES
Policy No; EXEMPT
W. C. Expire:
Engineer: KALENWILSON
Address: 23022 LA CADENA DR,201
LAGUNA HILLS, CA 92653
Phone : (714) 576-6524
Designer:
Address:
Phone :
Code Edition : 2022
Fire Sprinklers :
NO
Construction Valuation :
$25,000.00
Type of Construction : V-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg :
0
Occupancy Groups : U
No of Units :
0
Alteration sq. ft. Bldg :
0
Bldg Height :
No of Stories :
0
Add/New sq. ft. Garage:
0
TOTAL sq. ft.:
0
Building Setbacks
Flood Zone
Use Zone :
9:bZ9*Y-941]Will
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penally of perjury that I am exempt from the Contractors' Stale License Law for the reason(s) indicated below by the checkmark(s) I 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
10 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 Secfion 7000) of Division 3 of the Business and
'rofessions Code) or that he or she is exempt from licensers 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 U all of or U portions of the work, and the structure Is not Intended or offered for sale (Section 7044,
usiness 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
nprovenlents 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
nproved for the purpose of sale).
11, 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).
I am exempt from licensure under the Contractors' Stale License Law for the following reason:
y 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 legafl,,
all 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:lAWvw.leginfo.ce.govlcalaw.htmi.
ignature 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
COMPENSATION DECLARATION
YARNING: 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 ($11110,000), 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:
-11 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 PH
3erformance 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 carrier and policy number are:
Policy Number
Date
1e of Agent Phone N
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.
of
Date
ereby 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).
lder's Name Lender's Address
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owners behalf.
1 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 relating to building construction.
I authorize representatives of this city or county to enter the above-identffed property for inspection purposes.
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
1403
PERMIT EXPIRED
PERMITCANCELLED
PERMIT FINAL
CERTfFICATE OF
OCCUPANCY ISSUED
/57 I 01 _ I UASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
a4 _P7 Z_ PROPOSED DEMOLITION