HomeMy WebLinkAboutX2021-1542 - PermitsCOMB Permit: XZUZI 104L
fl'or City of Newport Beach -Building Division lllllllllllllllllllllllllllllllllllllllllly����
x z e z i 5 a z Project No 1 1359-202
1i too Civic Center Drive, Newport Beach, CA 92660 Issued Date: 1112312021
H: Permit Counter Phone (949)644-3288
inspection Requests Phone (949)644-3255 Inspection Area : 3
r 4> Combination Type - BLDG ELEC PLUM GRAD
tires
VALID
Friday 7:00 a.m. to 6:30 p.m. and Saon Sundays or Holiday ��
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTturday from 8:00 a.m. to 6:00 p.m. No work ION. PROJECTS MUST BE COMPLETED BY 11/23OR PERMIT WILL BE ys
Construction Hours: Monday -
Job Address: 1700 16TH ST NB IS� �a
Description: MFR - LANDSCAPING & DRAINAGE. PERGOLA (EAST - 480 SF)
Leqal Desc.: P BK 15 PG 36 PAR 1
Owner: UDR NEWPORT BEACH NORTH L
Address: 1745SHEA CENTER DR STE 0
HIGHLANDS RANCH CO 80129
Phone:
Applicant:
HAMMERLUND ERIC
Address:
102 S EARNS DR
LP90035
Phone:
310-497.1331
Code Edit : 2019
Type of construction -
occupancy
Occupancy Group: 0
Added /New sq.ft. Bldg:
Added INew sq. ft. Garage: 0
No of Stories: 0
No of Units: 0
Bldg Height:
Bldg Sprinklers:
Building Permit Fee:
$5,139.00
Plan Check Fee: $4,470.93
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$11 00
Energy Compliance:
$0.00
CA Seismic Safety'
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee:
$.moo
TOTAL FEE: $14,023.52
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor:
Address:
Phone
Con State Lie:
Lie Expire:
Bus Lie.
Lie Exp Date:
RANSCAPESINC
P.O, BOX 50680
IRVINE CA 92619
866-883-9297.
949437
06/3012022
BT30076593
09/30/2022
Worker's Compensation Insurance
Carrier: ARCH INS CO
Policy No: MS 5 202232
Expire:
Building Setbacks Front: /
Left: 1
Right: 1
Excise Tax:
$0.00
$0.00
Additional Fee :
$0.00
Grading Bonds Fee:
Grading PC Consultant:
$1,102.08
Grading Permit Fee:
$973.00
Grading PC Fee:
$24192
. 00
WQ Insp. Fee
Electrical %:
$672.70
Mechanical %:
$0.00
Plumbing %:
$864.89
S� •
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer.
Address:
Phone:
State Lie
NAM YOUNG-KEUN
17 SANTA EUGENIA
IRVINE CA 92606 a
State Lic:C-004029 a • • ®, •
NUSSBAUM ARON oaa®°ea
WILSHIRE BLVD #136
8549
BEVERLY HILLS CA 90211
806-305.3470
Special Conditions:
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
Plan Check Fee: $5,881.31
I:
Fire Department
$416.00
Fire Inspection:
$om
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
•
Deese•
a •
oa®•
00
a000•
o oeo•a
a• eeoae
®•.aoe o.ea
• $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Fee Due at Permit Issuance : $8,142.21
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable (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;oits,i-ssuance also r
the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter i (commencing with Section Issuance
of Division ir of the Sus
Professions Code) or that st or she is exempt from licensure and the basis for the alleged exemption. Any 'Sviotate of Section (Chap b an a oIt item(s)
❑not more than five hundred dollars ($500). equir�,_the applicant for
I, as owner of the property, or m Y Y pplicant for a permit subjects the applicant to a civil penalty of
Business and Professions Code: The ContractorsPwath wate ges as
cease Law does not apply
will do U allOf Or
lof
Improvements are not intended or offered for sale. If, however, the building or improvement is sod within one year of completion the O
PP Y to an owner of propert w)ho, through ehmployeese work, nortpersohe nal effort, buildsucture is not orimproves the pros eirt (Section 7044,
improved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 70
❑aPPIY to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra
I am exempt from licensure under the Contractors' State License Law for the following reason:
3y my signature below I acknowledge that, except for m
sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I
y personal residence in which I must have resided for at least or
'rofessions Code, is available upon request when this application is submitted or at the following Web sitd con l/www.le
ICENSED CONTRgCTOR'SDDErCLARpTION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (comm
nd effect. License Class
wner-Builder will have the burden of provingPhat itwasof built that the
or
Business and Professions Code: The Contractors' State License Law does not
it pursuant to the Contractors, State License Law).
year prior to completion of the improvements covered by this cannot leg
permit, I
iderstand that a copy of the applicable law, Section 7044 of the Business and
IfO. ca. g ov/ca law. h tm I.
Date
NORKERS' License No encmg w th Sect', n 7 0)J f Divi ion 3 of the Bu
CD11QP,�NSATION DECLARATION D ss and ofessions de, an m
JARNINCy FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES UP TO ONEIH UNDREO THOUS y h nse is in full force
:hereby OMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm 4 0 N, v r;
penalty of perjury one of the following declarations:
�19,flabe and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for b AND DOLLARS ($16a,006), IN ADDITION TO THE
rto ne o�thevarlc for which this permit is issued. Policy No.
i and wlil 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' compensatio
r7lpgr Agent • Policy Number
�I certify that •in tff� perfo f t Expiration Date
M,.iLlshould beco subject f ° or which this permit is issued, I shall not employ an Phone #
1 .t workers' om e y person in any manner o as to become subject to the workers' compensation. aws of California, and ogre
jnsfure of App
p sation provisions of Section 3700 of the Labor Code, I shall forthwith) comply with those provisions.
CLARATIONARDI G CON
�reby affirm under enalt of a u ION ENDING AGENCY
Ider's Name P Y P q rY that there is a construction lending agency for the performance of [he work for which (this permit is issued (Section 3097,tCivil Cv�
ode)Z� /
my signature below, I certify to each of the following: Lender's Address
I I have read this athe property owner or authorized to act on the property owner's behalf.
pplication and the information I have provided ' ect.
nd
I agree to comply with all applicable city ac
I authorize representatives of this city o o t o en es and s ate laws relating to building construction.
lature of Property Owner or Authorized y e abo a -id ntifiPr9perty for inspection purposes.
ION DATE ' Print Property Owner's or Authorized nt's Name r
BY DECLARATION F COMPLIANCE WITH CODE OF FEDERALV�,V1LCo It/2,j/z REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE FOR OFFICE USE ONLY Da
IAITCv...... 140R
NUi IFICATION TO
PERMITEXTENDED EPA
OCCUPANCYISSUED h_S��Z� �/� I PROPOSED DEMOLITION
IS NOTAPPLICABLE TO