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Home My WebLink AboutX2021-3288 - PermitsCity of Newport Beach - Building Division *X2021-3288" 100 Civic Center Drive, Newport Beach, CA 92660 p " r Permit Counter Phone (949)644-3288 COMB Permit: X2021-3288 Project No : 0957-2020 v "$ Inspection Requests Phone (949)644-3255 + � 9 -r- � r ^ Issued Date: 06/21/2022 Combination Type - BLDG a � j Inspection Area (� PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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: 620 POPPY AVE NB Description: SFR SITE WALLS 6'X 70LF (INSIDE P/L, MARKERS ON SITE) Legal Desc.: N TR 673 BLK B LOT 11 ' Owner: JACKSON PATIJENNIFER Contractor: PATTERSON CONSTRUCTION Architect: _ > Address: 620 POPPY AV Address: 15 CORPORATE PLAZA STE.150 Address: , CDM CA 92625 NEWPORT BEACH CA 92660 Phone: Phone: 949-723-1800 Phone: State Lic: Applicant: ENGLAND JEFF Con State Lic: 802367 Engineer: MANSHADI FARHAD Address: 15 CORPATE PLAZA Lic Expire: 07/31/2022 Address: 1800 E 16TH ST UNIT B ^ NEWPORT BEACH CA 92660 Bus Lic: BT02110534 SANTA ANA CA 92701 Phone: 714-277-9198 Lic Exp Date: 0913012022 Phone: 714-835-2800 State Lic:C-036840 , Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: STATE COMP Address: Occupancy Group: U Policy No: 9065406 Added /New sq.ft. Bldg: 0 Expire: 0810112022 Phone: Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: 10' Special Conditions: LANDSLIDE, FIRE HAZARD No of Units: 0 Front: 20' SEVERITY ZONE, Bldg Height: 0 Left: 3' Bldg Sprinklers: Right: 3' Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $11,130.00 Building Permit Fee: $280.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $243.60 Additional Fee : $0.00 Plan check Fee : $0.00 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: $32.00 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 PAN 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 : $556.60 Plan Check Fee : $243.60 Fee Due at Permit Issuance : $313.00 PROCESSED BY: -') PUBLIC WORKS APPROVAL: W /�` ZONING APPROVAL: iA PLAN CHECK BY: G 5 Mr GRADING APPROVAL: APPROVAL TO ISSUE: _ moo, OWNER -BUILDER DECLARATION I 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 he 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 Irofessions 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 lot 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, 3usiness 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 Tlprovements 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 mproved 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 Ipply 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). 3 1 am exempt f•om ':censure under the Contractors' State License Law for the following reason: 3v 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 legall} el' a structure tha; 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 Cod:, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. >Ignature of Property Owner or Authorized Agent Date .ICLidSED CONTRACTOR'S DECLARATION Lar„ Ly affirm ul,oer penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of ivisi n 3 of the Business and Profes ions Code, and my license is in ll force '.rc' cfect. License Class License No Date 2L Contractor Signature VCRl'ZRS' COMPENSATION DECLARATION :ARNING. FAILURL To bECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T USAND DOLLARS ($100,000), IN ADDITION TO THE :DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37H OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. herebv affirm Under penalty of perjury one of the following declarations: 3 1 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 thi erformance 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' ranee carder and policy number are: Policy Number of Agent Date 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 agre if I should become subject toothe �workers' ccoompensationprovisions f Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Iature of Applicant /l---+,l�A / /� Date1� 6�L1/Z Z CLARATION REGARDING CONS t1CTION LENDING AGENCY ereby affirm under penalty of perj ry that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ider's Name Lender's Address By my signature below, I certify 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 ordinances and state laws relating to (ding construction. I authorize representatives of this city or county t e abov -identified roe pection purposes. Signature of Property Owner or Authorized Agen rint Property Owner's or Authorized Ag ACTION DATE I BY D RATIO OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY ULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMITEXPIRED LI I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED OEPA PERMIT EXTENDED. QUID PERMIT FINAL q ASBESTOS NOTIFICA_N IS NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLIT/ON OCCUPANCY ISSUED SIGNATURE: ��. L- Name Dale �_IZ L