HomeMy WebLinkAboutX2022-1717 - Permits,��:„�
City of Newport Beach - Building Division
'X2022-1717*
COMB Permit: X2022-1717
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100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Project No : 1570-2022
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Inspection Requests Phone (949)644-3255
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Combination Type - BLDG
Issued Date : 07/01/2022
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Inspection Area : 6
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, PROJECTS MUST BE COMPLETED BY 0710112025 OR PERMIT WILL BE INVALID
Construction Hours:
Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from
8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays
Job Address: 1528 KEEL DR NB
Description: SFR RETAINING WALL 5' HIGH
MAX X 92 LF INSIDE P/L
Legal Desc.: N TR 6152 LOT 116
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Owner: ANDERSON CAMILLE & TIMOTHY
Contractor:
CIS CONSTRUCTION INC
Architect:
Address: 1528 KEEL DR
Address:
PO BOX 12109
Address: ° °• +
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CORONA DEL MAR, CA 92660
COSTA MESA 92503
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Phone: 949-500-8644
Phone:
949-285-8326
Phone: State Lic: ,
Applicant: FIGUEROA FREDDY
Con State Lic:
1021012
Engineer: ZHANG YAO ......
Address: 2280 W CHAPMAN AVE 9162
Lic Expire:
11/30/2022
Address: 15375 BARRANCA PKWY, H106 °°O°
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ORANGE, CA 92086
Bus Lic:
BT30069027
IRVINE CA 92618 ° •
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Phone: 714--791-9194
Lic Exp Date:
09/30/2022
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Phone: 949-788-0424 State Lic:C-074572 •
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Code Edit: 2019
Worker's Compensation Insurance
Designer:
Type of Construction:
Carrier:
STATE FUND
Address: y •o °
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Occupancy Group: U
Policy No:
9224879
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Added /New sq.ft. Bldg: 0
Expire:
0112412023
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 0
Building Setbacks
Rear: 6
Special Conditions:
No of Units : 1
Front: 10
Bldg Height: 0
Left: 6
Bldg Sprinklers:
Right: 6
A
Construction Valuation: $15,000.00
Fire Hazard Zone : N
Building Permit Fee:
$331.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $287.97
Additional Fee :
$0.00
Plan check Fee:
$52.00
Fire Inspection:
$0.00
Overtime Plan Ck:
$0.00
Grading Bonds Fee:
$0.00
Fair Share :
$0.00
Fire Plan Rev
$0.00
Investigation Fee:
$0.00
Grading PC Consultant :
$0.00
SJH Trans :
$0.00
Demolition Fee
Record Management:
$8.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee :
$0.00
Building Dept Adm
$0.00
Energy Compliance:
$0.00
Grading PC Fee:
$0.00
Public Works Department -
General Service
$0.00
CA Seismic Safety:
$0.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
Disabled Access :
$0.00
P/W Plan Check:
$0.00
Grading Bond:
$0.00
Hazardous Mat
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Building Green Fee :
$1.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE: $679.97
PROCESSED BY:
ZONING APPROVAL: �{
GRADING APPROVAL: G
Plan Check Fee : $339.97 Fee Due at Permit Issuance : $340.00
PUBLIC WORKS APPROVAL: (�/�
PLAN CHECK BY: c 1 l
APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State 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
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 for a 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 U 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 o%W pf property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
❑ 1 am exd`!Utrorcn licensure under the Contractors' State License Law for the following reason:
By my signafuure I4%Ipw 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 lega111
961[ ;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
Professions Lode, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
�Sgnature of Property Owner or Authorized Agent Date
L11_%NSED 90111TRACTOR'S DECLARATION
1 yer`eby affirm tnQEt penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of ivision 3 of the Business and Professions Cod and my license is in full force
and Effect. License Class License No Date 7 ar Z� Contractor Signature SC_
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GVdRLSERS'•COaM�NSATION DECLARATION
N%FSRVING: 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
Q06i4lf cOMPEN%ATI(ttI.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm*gVgr penalty of perjury one of the following declarations:
PFhive and will�rfiq'intain 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
perF�ance ofthe 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:
ie of Agent
certify that, in the performance of the
if I should become subject to the we
Policy Number
Date
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 agre,
y / compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of Applicant / � DateLxx 2 /c, V �
XCLARATION REGA DING CO t TRUCTION 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).
-enders Name Lender's Address
3y my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owners behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of this city or county to enter the a e-identified pro erty for inspection purposes. X
signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam Date 7 alle,
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMITEXPIRED S iv ITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED EPA
CERFICATE OF G-tZ +rf— 5 GOPC
NPOSE
ATUR DE�OLIITION ION IS N TAPPLICABLE TO
OCCUPANCY ISSUED i