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HomeMy WebLinkAboutX2021-3447 - PermitsCity of Newport Beach ��gWPO/?T @ Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 u r Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 C"9((i0HN\P newportbeachca.gov/inspections Combination Type - SFP ELEC MECH PLUM Work Class - New X 2 0 2 1 3 4 4 7COMB Permit : X2021-3447 Plan Check No : 3020-2021 Issued Date : 11/1512022 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 : 1700 PORT MANLEIGH CIR Legal Desc : N TR 6938 BILK LOT 51 Description: NEW SFR & GARAGE 4415/493 SF ` Owner: LLOYD RUCKER Contractor : Architect Address : 260 NEWPORT CENTER DR Address : Address NEWPORT BEACH, CA 92660 '.�. Phone: (949) 463-4509 Phone : Phone Con State Lic : State Lic Lic Expire Applicant: CRAIG HAMPTON Bus Lic: Engineer : FORBES DALE L Address : 5500 E QUARTERSAWN ST Bus Lic Expire : Address : 1800 E 16TH ST #B BOISE, ID 83716 SANTA ANA, CA 92701 Phone : (949) 209-8883 Workers' Compensation Insurance Phone : (714) 835-2800 Carrier : Owner/Builder : LLOYD RUCKER Policy No: Designer : CRAIG HAMPTON Address: 260 NEWPORT CENTER DR W. C. Expire: Address: 5500 E QUARTERSAWN ST NEWPORT BEACH, CA 92660 BOISE, ID 83716 Phone: (949) 463-4509 Phone : (949) 209-8883 Code Edition : 2019 Fire Sprinklers : YES Construction Valuation : $834,870.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 4,415 Occupancy Groups : U,R-3 No of Units: 1 Alteration sq. ft. Bldg: Bldg Height: No of Stories : 2 Added/New sq. ft. Garage: 493 TOTAL sq. ft.: 4,908 Building Setbacks : Front: 23, Side: 5, Side: 5, Rear: 10 Flood Zone: X Use Zone : PC - Harbor View Hills PROCESSED BY: L�((� </ - SPECIAL CONDITIONS: O/B FORM ATTACHED I$WT HIy awl t hereby affirm under penally 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 items) Ilion 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 ils issuance, also requires the a,,pllcant for 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 tho Business and fessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031 S by any applicant for a permit subjects the applicant to a civil penalty of more than five hundred dollars ($500). 1, as owner of the property, or my employees with wages as their sole compensation, will doKr I of or (_) portions of the work; and the structure Is not intended or offered for sale (Section 7044, `in s and Professions Code: The Contractors' State License Law does not apply to an ownemperty who, through employees' or personal effort, builds or improves the property, provided that the rovements 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 roved for the purpose of sale). 1, 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 ly to an owner of property who builds or Improvesthereon; and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law), J I am exempt from licensure under the Contractors' State License Law for the following reason ly my signature below I acknowledge that, except for my personal residence in which I must have resldod for at least one year prior to completion of the improvements covered by this permit, I cannot legal, oil a structure that I have built as an ownorvbuil r if III . as not been constructed in it ntiroty by licensed Contractors. I understand that a copy of the applicable law, SactLoo 7SM4 of the Business and 'rofessions Code., is available upon request when his lcafie su Vted or afollowing Web site:http:/Iwww.leginfo.ca.govlcalaw.html. fignature of Property Owneror Authorized Agent Dat / .ICENSED CONTRACTOR'S DECLARATIQ hereby affirm under penalty of perjury that I am II ensed under provisions of hapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions C de, and my license fs In full farce nd effect. License Class License No Date Contractor Signature VORKERS'COMPENSATION DECLARATION EARNING: 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 ($100,000). IN ADDITION TO THE DST OF COMPENSATION DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: I 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, forth erformance of the work for which this pannit is issued. Policy No. 11 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' compensatioi Isurance carrier and policy number are: arrier Policy Number Expiration Date lame of Agent Phone # ]I certify that, In the perform a 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 worke e mponsaiion laws of California, and agro tat, 1f I should become ubASTRU( t to the workers' comp nsauon provisions of Section 3700. of the Labor Code, I shall forthwith comply with those provisions. i ignalure of ApplicanDal ZO 2 �EGLARATiGN REGItl LENDING AGENCY hereby affirm underury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 Civil ode . Bader'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 application and the information I have provided is correct. I agree to comply with all applicable city and county rdi races and state s r sting to building construction. I authorize representatives of this city or county t e to 1 J„�`,'(V,e�rtcvp perfy for inspection purposes. ��//q ionature of Prooerty Owner or Authorized Agent I �� % Print Property Owner's or Authorized Agent's Nam@. %�GI /�Ui ��L to ACTION i DATE RY ! Ortni•ARATIONOP COMPANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGUUITIONS PART 61 F TITLE 40 AND AQNID RULE 1403 PERMIT CANCELLED ....._. ... .... ........................_...._. 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