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Home My WebLink AboutX2022-0356 - Permits (2)n��r1�a�r,�,� City of Newport Beach -Building Division d 100 Civic Center Drive, Newport Beach, CA 92660 µ Permit Counter Phone (949)644-3288 s' Inspection Requests Phone (949)644-3255 445 Combination Type - BLDG *X2022-0356* COMB Permit: X2022-0356 Project No: 1873-2021 Issued Date: 02/09/2022 Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0210912025 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: 2315 HEATHER LN NB Description: DELTA 5 NEW WALL 6 FT TALL X 3FT INSIDE PIL (REV22-01201) Legal Desc.: N TR 3138 LOT 35 • ° ° ° ° y ° Owner: WELLS CORINNE & MICHAEL Contractor: J M I AND ASSOCIATES INC Architect: n Address: 2315 HEATHER LN Address: 2046 MEYER PLACE Address: NEWPORT BEACH, CA 92660 COSTA MESA CA 92627 ° ° °•+ Phone: Phone: 714-350-9527 Phone: State Lic: Applicant: FLORJOSE Con State Lic: 951957 Engineer: MORAN TIMOTHY Address: 5364 VIA MARIA Lic Expire: 09/30/2022 Address: 23802 HUMPHREY CT YORBA LINDA, CA 92886 Bus Lic: BT30069739 MURRIETA CA 92562 • .... e co° Phone: 714-457-9177 Lic Exp Date: 11130/2022 Phone: 714-920-7680 State Lic:C-071701 • °°®,a Code Edit: 2019 Workers Compensation Insurance Designer: 4°° °• ° a ° ° ° Type of Construction: Carrier: SIRIUS AMERICA INS Address: ° G ° • ° �^ ° ° Occupancy Group: U Policy No: WC74001 a®° a •`c j9` Added/New sq.ft. Bldg: 0 Expire: 04129/2022 Phone: • 9°° Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: 10 Special Conditions: LANDSLIDE AREA No of Units : 1 Front: 20 WIAVER ATTACHED Bldg Height: 0 Left: 4 Bldg Sprinklers: Right: 4 Flood Zone: A Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $1,000.00 Building Permit Fee: $110.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $95.70 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: $14.00 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 WO 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 : $220.70 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $220.70 PROCESSED BY: i ry PUBLIC WORKS APPROVAL: ZONING APPROVAL: / PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: (Z',/at'�- 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 L) all of or U portions usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, thrOL Iprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of c nproved for the purpose of sale). I, as owner of ft property, am exclusively contracting with licensed Contractors to construct the project (Section A pply to an owrls;4 f property who builds or improves thereon, and who contracts for the projects with a licensed Contra r . SaIA exemptfronj jicensure under the Contractors' State License Law for the following reason: y my Agnatur'L belDw l acknowledge that, except for my personal residence in which I must have resided for at least o su astmcture that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. rofeaslons Code,' is available upon request when this application is submitted or at the following Web site: http://www.11 ignajure of P;OI Owner or Authorized Agent IltgMSED CONTRACTOR'S DECLARATION t ejgby affirm urkier penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section V ' nd effect. Licvr&e•Class License No Date QgKERS' COMPENSATION DECLARATION ARNING: FAILURE TO VSCURE WORKERS' COMPENSATION COVERAGE le UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE DST O*F COMPENSAIVOWDAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 10,41V affirm under penalty of perjury one of the following declarations: 1 have annd+milT maintain a certificate of consent to self -insure for workers' compensation, issued by the Direct( erformance of the work for which this permit is issued. Policy No. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for th nce carrier and policy number are: arrier Policy Number ame of Agent I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any It, if I should become sgbject to the Voers' compensation provisions of Section 3700 of the Labor Code, I shall nature of Applicant CLARATION REGA I ONSTRUCTION LENDING AGENCY areby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for ider's Name Lender's Address 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 to nt he ove-identified property for inspection purposes. mature of Prooertv Owner or Authorized Aaent C�� Print Prooertv Owner's ACTION DATE BY DECLARATION OF IRE ULATIONS PA T0630 TIIT E 40 AND AQMD RULECE WITH CODE OF FOR PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMIT EXTENDED AQMD PERMITFINAL �•q� Zn CERTIFICATE OF l•r V OCCUPANCYISSUED SBESTOS NOTIFICATION IS NOT APPLICABLE TO OPOSED OVA SIGNATURE: the work, and the structure is not intended or offered for sale (Section 7044, employees' or personal effort, builds or improves the property, provided that the pletion, the Owner -Builder will have the burden of proving that it was not built or Business and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). e year prior to completion of the Improvements covered by this permit, I cannot understand that a copy of the applicable law, Section 7044 of the Business and Date ,i on of the Business and Proons e, and m license is in full force Contractor Signatur AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE of Industrial Relations as provided for by Section 3700 of the Labor Code, for performance of the work for which this permit is issued. My workers' Date so as to become subject to the workers' compensation laws of California, and agree h comply with those provisions. Date 0__ O7 h this permit is issued (Section 3097, ClVilrode). USE ONLY