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Home My WebLink AboutX2021-1545 - PermitsJob Address: Description: Legal Desc.: a MUST BE PER I EX. Construction Hours: SMondays Friday 00 a.mr toA6.30 p.m. andd Saturday from 8 00 a.m�toP6.00 p.mYNo/ work o� Sundays or Holidays y 1700 16TH ST NB MFR- BLOCK WALL 7' X 90' WI ATT SHADE STRUCTURE ��-ro P BK 15 PG 36 PAR City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Request,:.-4hohe1949)644-3255 Combination Type - BLDG Owner: UDR NEWPORT BEACH NORTH L Address: 1745 SHEA CENTER DR STE 200 HIGHLANDS RANCH CO 80129 Phone: Applicant: HAMMERLUND ERIC Address: 1102 STEARNS DR LA CA 90035 Phone: 310-497-1331 Code Edit: 2019 Type of Construction: Occupancy Group: U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 0 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Flood Zone: Building Permit Fee: $799.00 Plan Check Fee: $695.13 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green Fee : $2.00 Contractor: Address: Phone Con State Lic: Lic Expire: Bus Lic: Lic Exp Date: IIIIIIXII�II0I1 I5�III45 IIII RANSCAPESINC P.O, BOX 50580 IRVINE CA 92619 866-883-9297 949437 06/3012022 BT30076593 09130/2022 Worker's Compensation Insurance Carrier: ARCH INS CO Policy No: MST5000832 Expire: 03M512022 Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical W Mechanical %: Plumbing %: Rear: I Front: 1 Left: / Right: I $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ITOTAL FEE: $1,496A3 Plan Check Fee PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Architect: Address: Phone: COMB Permit: X2021-1545 Project No: 1359-2021 Issued Date: 11123/2021 Inspection Area : 3 State Lic: Engineer: NAM YOUNG-KEUN Address: 17 SANTA EUGENIA IRVINE CA 92606 Phone: State Lic:C-004029 ...... Designer: NUSSBAUM ARON ° °3000° Address: 8549 WILSHIRE BLVD #136 ° BEVERLY HILLS CA 90211 ° Phone: 805-350-3470 Special Conditions: ° o 00 °. Planning Department - Plan check Fee Fair Share : SJH Trans : In -lieu Housing Fee: Public Works Department - Park Dedication : $0.00 PAN Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department ° o°®e°• ° $0.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building tdm General Service Gene $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 $695.13 Fee Due at Permit Issuance : $801.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: ° o . ° .°° o° ouoa UVV N'_18DILDER DECLARATION I hereby affirm under penalty Of perjury that I am exempt from the Contractors' State License Law for the reason(s) indi!'cated below by the checkmark(s) I have placed next to the applicable item(s) (Section it to ,Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prioRto it ,,'y�suance, 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 Se. s AsL,, anc , Division ir of the Business and Professions Code) u that he she exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit in in subjects the applicant to a civil penalty of not more than five hundred dollars is e ( s ex ❑ I, as owner of ons theSc property, oThe r 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, improvements are not intendedor ffered for sale, State License If, however, theabuiiloes ld building ortapply to an 0 improvement wrier of property who, through one year of complet employees' or Owner -Builder effort, will have builds or improves of proving property, itwasnodt that built the improved for the purpose of sale). ❑ 1, 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 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). I am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. 1 of Professions Code, is available upon request when this application is submitted or at the following Web site:hftp://www.legir Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (command and effect. License Class License No ng with Se ion 7000) NORKERS' EOAfPENSATION DECLARATION YJrs2f�1�¢ FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL' bS O •COMPEg*J1QiIl,J)AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under Ptnalty of perjury one of the following declarations: 7I•a and wil hl maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of erf Ships of theeclk for which this permit is issued. Policy No. ell and rill maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the pe �tlr • arrier and policy number are: Agent Policy Number - _ �eivnllance or c wor rwhich this permit is issued, I shall not employ any person in any manner E R .at, i? :should lleco'i�t,^,•F `lect th workp/js' c mpens lion provisions of Section 3700 of the Labor Code, I shall forthwith �reby affirm under penally of perjury that there is a construction lending agency for the pertormance of the work for which ider's Name my signature below, I certify to each of the following: Lender's Address 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 provide rrect. I agree to comply with all applicable city and cc " a I es d fate la relating to building construction. I authorize representatives of this ci or cou¢ to en t ab a -id ntifi ro erty for inspection purposes. lature of Property Owner or Au1hrAr.o�r\� DATE BY ��m nup DECIARATlO F COMPLIANCE WITH CODE OF FEDEI REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE IRED 1403 CELLED OCERTIFIC4TEOF SUBMITTED ASBESTOS NOTIFICATION TO ENDED EPA AL OF ///�� 2.. / QMD ASBESTOS NOTIFICATION IS NOT APPLICABLE TO YISSUED N ( PROPOSED DEMOLITION or prior to completion of the Improvements covered by this permit, I cannot leg land that a copy of the applicable law, Section 7044 of the Business and 1.gov/calaw.html. Date isigii 3 of the Busines ,^nd o ession o e, end licengp4s in full force 1 ra,nr.,,.i AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO Relations as provided for by Section 3700 of the Labor Code, for of the work for which this permit is issued. My workers' Expiration Date as to become subject to the workers' compensation law of California, and ogre imply with those provisions. DE� j, Za3 f�Ei =% 'S permit is issued (Section 3097, Civil Code). FOR OFFICE USE ONLY �T ✓Ylcci�l