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Home My WebLink AboutX2022-1052 - PermitsCity of Newport Beach - Building Division *X2022-1052* COMB Permit: X2022-1052 100 Civic Center Drive, Newport Beach, CA 92660 - Project No : 0967-2022 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 3 9"-�-y 5 e"� , Issued Date : 04/11/2022 P'�c'rrayu�"a Combination Type - BLDG a �� i ... Sa i :` - Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LA�T VALID INSPECTION. PROJECTS MUST BE -COMPLETED BY 0411112025 OR PERMIT WILL BE INVALID Construction Hours: Monday - Friday 7:00 a. . 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: 501 TUSTIN AVE NB Description: SFR BLOCK WALL 22' LONG X 6' HIGH *CITY STANDARD* WITHIN P/L; PERMANENT MARKERS ONSITE Legal Desc.: FIRST ADD TO NEWPORT HEIGHTS BLK 35 LOT 24 •0Gi Owner: MOHR CAMMY&STEVE Contractor: ADAMSON MARK Architect: Address: 501 TUSTIN AV Address: 104 OKRA Address: °ia• �°o°cv NEWPORT BEACH CA 92663 IRVINE, CA 92618 • ° Phone: 909-223-7720 Phone: 714-376-6301 Phone: State Lic: ®° • Applicant: ADAMSON MARK Con State Lic: 590874 Engineer: THOMPSON MATTHEW Address: 104 OKRA Lic Expire: 02129/2024 Address: 12021 NTUSTIN AVE T•°�i• ° •°• `° IRVINE, CA 92618 Bus Lic: BT30057889 ANAHEIM CA 92807 • • ° ° Phone: 714.390-6301 Lic Exp Date: 02/2812023 Phone: 714-630-6100 State Lic:C-086051 ;°p"° B°6-°• Code Edit: 2019 Worker's Compensation Insurance Designer: oa• Type of Construction: V-B-SPR Carrier: STATE COMPENSATION INS FUND Address: a° Occupancy Group: R3/U Policy No: 9225662 °9• °• 3 Added/New sq.ft. Bldg: 0 Expire: 0210212023 Phone: °® • v`-�°o; Addedew sq. ft. Garage: 0 • • •ai• No of Stories: 2 Building Setbacks Rear: 5 Special Conditions: ° • ° No of Units : 1 Front: 20 Bldg Height: 0 Left: 4 Bldg Sprinklers: Y Right: 4 Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $6,000.00 Building Permit Fee: $178.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $154.86 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: $2.00 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 : $387.86 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $387.86 PROCESSED BY: 3 5 ZONING APPROVAL: C wC GRADING APPROVAL: PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: 5 OWNER -BUILDER I hereby affirm under penalty ofperjury 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 to 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 'rofessions 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 of more than five hundred dollars ($500). 3 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, usiness 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 nprovements 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 nproved 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 pply to an owner efproperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 1 am exempt 4em licensure under the Contractors' State License Law for the following reason: IXwlignatusabelow 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 legalh ell a structure thacl,hyve 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 Irofeesions Code is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. ;igr"ure of Property Owner or Authorized Agent D to ,ICE.NSED r.(%;r 4CTOR'S DECLARATION htpej affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700p) Div ion 3 of the Business and Professio s de, and my li se is in full force n d effect. Lir e�h�s% ass License No Date Contractor Signature VORtCERS' COMPENSATION DECLARATION 'ARNING: FAILURE TD SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,000J, IN ADDITION TO THE 1511'(5*010PENSpTIOM DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereblaffrm Lgar penalty of perjury one cf the following declarations: ... �I aae and will �ntain 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 ert ance of tkawonk 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' Policy Number Expiration Date Ie of Agent UI Certify that, in the performan o he work f hich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compens ion laws of California, and agre that, if I should become subje t orker compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant% Date/ DECLARATION REGARDING ONSTRUCTION LENDING AGENCY I 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). Lender's Name Lender's Address By 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 p ovided is correct. I agree to comply with all applicable city and count ordi as and state s relating to building construction. I authorize representatives of this city or countxt,G, ter above' ified property for inspection purposes. lc+�5� J'C ` �� Signature of Property Owner or Authorized Agent 7� Print Property Owner's or Authorized Agent's Name � V yl &,r(L'- i DatEL ACTION DATE BY &9ARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMIT EXTENDED QM D PERMITFINAL ASBESTOS NOTIFICATI N IS NOT APPLIC TO CERTIFICATEOF ' ^ PROPOSED DEMOLj IION OCCUPANCYISSUED �(/ SIGNATURE: \_ 1''-.