HomeMy WebLinkAboutX2021-1545 - PermitsJob Address:
Description:
Legal Desc.:
a
MUST BE
PER I EX. Construction Hours: SMondays Friday 00 a.mr toA6.30 p.m. andd Saturday from 8 00 a.m�toP6.00 p.mYNo/ work o� Sundays or Holidays y
1700 16TH ST NB
MFR- BLOCK WALL 7' X 90' WI ATT SHADE STRUCTURE ��-ro
P BK 15 PG 36 PAR
City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Request,:.-4hohe1949)644-3255
Combination Type - BLDG
Owner: UDR NEWPORT BEACH NORTH L
Address: 1745 SHEA CENTER DR STE 200
HIGHLANDS RANCH CO 80129
Phone:
Applicant:
HAMMERLUND ERIC
Address:
1102 STEARNS DR
LA CA 90035
Phone:
310-497-1331
Code Edit: 2019
Type of Construction:
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units : 0
Bldg Height: 0
Bldg Sprinklers:
Flood Zone:
Building Permit Fee: $799.00
Plan Check Fee: $695.13
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$0.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$2.00
Contractor:
Address:
Phone
Con State Lic:
Lic Expire:
Bus Lic:
Lic Exp Date:
IIIIIIXII�II0I1 I5�III45 IIII
RANSCAPESINC
P.O, BOX 50580
IRVINE CA 92619
866-883-9297
949437
06/3012022
BT30076593
09130/2022
Worker's Compensation Insurance
Carrier: ARCH INS CO
Policy No: MST5000832
Expire: 03M512022
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical W
Mechanical %:
Plumbing %:
Rear: I
Front: 1
Left: /
Right: I
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
ITOTAL FEE: $1,496A3 Plan Check Fee
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Architect:
Address:
Phone:
COMB Permit: X2021-1545
Project No: 1359-2021
Issued Date: 11123/2021
Inspection Area : 3
State Lic:
Engineer: NAM YOUNG-KEUN
Address: 17 SANTA EUGENIA
IRVINE CA 92606
Phone: State Lic:C-004029 ......
Designer: NUSSBAUM ARON °
°3000°
Address: 8549 WILSHIRE BLVD #136 °
BEVERLY HILLS CA 90211 °
Phone: 805-350-3470
Special Conditions: ° o
00 °.
Planning Department -
Plan check Fee
Fair Share :
SJH Trans :
In -lieu Housing Fee:
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Fire Department
°
o°®e°•
°
$0.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building tdm
General Service
Gene
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
$695.13 Fee Due at Permit Issuance : $801.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
°
o . °
.°°
o°
ouoa
UVV N'_18DILDER DECLARATION
I hereby affirm under penalty Of perjury that I am exempt from the Contractors' State License Law for the reason(s) indi!'cated below by the checkmark(s) I have placed next to the applicable item(s)
(Section it to ,Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prioRto it ,,'y�suance, 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 Se. s AsL,, anc , Division ir of the Business and
Professions Code) u that he she exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit in
in subjects the applicant to a civil penalty of
not more than five hundred dollars
is e
( s ex
❑ I, as owner of ons theSc
property, oThe r 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,
improvements are not intendedor ffered for sale, State License If, however, theabuiiloes ld building ortapply to an 0 improvement wrier
of property who, through one year of complet employees'
or Owner -Builder effort,
will have builds or improves
of proving property,
itwasnodt that built the
improved 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
❑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' State 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
sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. 1 of
Professions Code, is available upon request when this application is submitted or at the following Web site:hftp://www.legir
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (command
and effect. License Class License No ng with Se ion 7000)
NORKERS' EOAfPENSATION DECLARATION
YJrs2f�1�¢ FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL'
bS O •COMPEg*J1QiIl,J)AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under Ptnalty of perjury one of the following declarations:
7I•a and wil
hl maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of
erf Ships
of theeclk for which this permit is issued. Policy No.
ell and rill maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the pe
�tlr • arrier and policy number are:
Agent Policy Number
- _ �eivnllance or c wor rwhich this permit is issued, I shall not employ any person in any manner E
R .at, i? :should lleco'i�t,^,•F `lect th workp/js' c mpens lion provisions of Section 3700 of the Labor Code, I shall forthwith
�reby affirm under penally of perjury that there is a construction lending agency for the pertormance of the work for which
ider's Name
my signature below, I certify to each of the following: Lender's Address
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 provide rrect.
I agree to comply with all applicable city and cc " a I es d fate la relating to building construction.
I authorize representatives of this ci or cou¢ to en t ab a -id ntifi ro erty for inspection purposes.
lature of Property Owner or Au1hrAr.o�r\�
DATE BY
���m nup
DECIARATlO F COMPLIANCE WITH CODE OF FEDEI
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
IRED
1403
CELLED
OCERTIFIC4TEOF
SUBMITTED ASBESTOS NOTIFICATION TO
ENDED
EPA
AL
OF
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QMD
ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
YISSUED
N (
PROPOSED DEMOLITION
or
prior to completion of the Improvements covered by this permit, I cannot leg
land that a copy of the applicable law, Section 7044 of the Business and
1.gov/calaw.html.
Date
isigii 3 of the Busines ,^nd o ession o e, end licengp4s in full force
1 ra,nr.,,.i
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO
Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is issued. My workers'
Expiration Date
as to become subject to the workers' compensation law of California, and ogre
imply with those provisions.
DE� j, Za3 f�Ei =%
'S permit is issued (Section 3097, Civil Code).
FOR OFFICE USE ONLY
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