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HomeMy WebLinkAboutx2019-0982 - Permitswt City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 E. q Permit Counter Phone (949)544-3288 Inspection. Requests Phone (949)644 3255 Combination Type - BLDG *X2019-0982* COMB Permit: X2019-0982 Project No: 0022-2019 Issued bate : 03/29/2019 Inspection Area : 2 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VAUD INSPECTION. 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: 439 EL.MODENA AVE NB Description: BLOCK WALL 5' X 85 LF (INSIDE THE Pit.), 6'H X 90 LF (ON THE P/L) Legal Desc.: FIRST ADD TO NEWPORT HEIGHTS BILK 26 LOT 15 Owner. ZOE FAMILY TRUST. Contractor: OWNERIBLDR Architect: Address: ..439 EL MODENA.AVE Address: RUIZ JAMES Address: NEWPORT BEACH, CA 92663 AUTH LETTER ON FILE Phone: 949-307-7737 Phone: Phone: State Llc.'' Applicant: ZOE FAMILY TRUST Con State Lie: O/B Address: 439 ELMODENA AVE. Lie Expire: - NEWPORT BEACH, CA 92663 Bus Lie: Phone: - Lie Exp Date: Code Edit :. 2016 Worker's Compensation Insurance Type of Construction: Carrier Occupancy Group:. U Policy No: Added /New sq.ft. Bldg: 0 Expire: Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear. /S' No of Units : 0 Front: I ? a Bldg Height:. 0 Left: I `V Bldg Sprinklers: Right: I it Flnnd 7nna- 11.. 7-- b.d.;.,, c:.­n - Construction Valuation: 15 Building Permit Fee: $412.00 Plan Check Fee: $365.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $2.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTALFEE: PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Engineer: Address: Phone: State Lie: Designer. ®®®. Address: ° ease° Phone: ° ° o Special Conditions: PIL AGRMNTB SURVEY WAIVER ATTACHED TO PLAN ® a 0 0 ° o °o° ° em Fire Hazard Zone : N ° $0.00 Planning Department - Fire Department $0.00 Plan check Fee : $40.00 Fire Inspection: ' $0.00 $0.00 Fair Share: $0.00 Fire Plan Rev $2,00. $0.00 SJH Trans: $0.00 Demolition Fee .... - $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 $0.00 Public Works Department - General Service $0.00 $0.00 Park Dedication : $0.00 Refund Deposit $0.00 PAN Plan Check: $0.00 Grading Bond: $0.00 $0.00 San Dist: $0.00 $0.00 NMUSD Fee: $0.00 $0.00 $0.00. $0.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $820.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: ' o ° . ° ease• 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) action 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 pe it 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 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 P�ne"oand an five hundred dollars ($500). wner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, 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 ,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). 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 Ily 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), J I am exempt from licensure under the Contractors' State License Law for the following reason: - y my signature below I acknowledge that, except for my pens ich I must have resided for at least one year prior to completion of the improvements Covered by this permit, I cannot legs ell a structure that I have built as an ow -build ifs not been constructe 'n ' ' Sty by licensed contractors. I understand that a copy of the applicable law, S ctien 7044 of the Business and 'rofessions Code, is available upon reques n t application is r t ollowing Web site:http://www.leginfo.ca.gov/calaw.html. ignature of Property Owner or Authorized Kent � ate / / ICENSED CONTRACTOR'S DEC L`V hereby affirm under penalty of perjury that I am li `ed unde ons of hapter 9 (commencing with Section f D�vivpn 3 C Busi a\ fessi I is in full force nd effect. License Class License No @,ITe "6-7 ' �L Contra VORKERS' COMPENSATION DECLARATION 7� 'ARNING: 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 TOT DST OF COMPENSA'(Ift DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hyereby affirm ufldgrpgttalty of perjury one of the following declarations: {r ftg'T 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 ee�rf•ormance of Melt' i•Iefor which this permit is issued. Policy No. ; l lv:d? 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' compensat IC,urarce carrier and policy number are: (arfle�r• - -1 . Policy Number Expiration Date lam f,Anenf • • • Phone # Ice of the work for thI ermit is issued, I shall not employ any person in any manner so as to become subject to the work prs' compensation laws of California, and agree to the workers' co pert atio visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. TnNCTRI If:Tin , Af-FNrY to ^ Hereby affi^a- ti+& penalty of periuw4batffere•IZ`a.6onstruction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). .ender's 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 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 building construction. I authorize representatives of this city or county er th above-identi Inspec Ion purposes. signature of Property Owner or Auj or d_Agent TrintRoperty Owner's or Authorized Ag n s N ---- ACTION DATE J B _UDARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITC4NCELLED EIEPA PERMIT EXTENDED QMD PERMITFINAL ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF P POSED DEMOLITION OCCUPANCYISSUED SIGNATURE: