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HomeMy WebLinkAboutX2020-0269 - Permitsfgwroq City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2020-0269 100 Civic Center Drive, Newport Beach, CA 92660 x 2 0 2 0 0 2 6 9 Project No : 0217-2020 h " Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - BLDG Issued Date : 10123/2020 t,a n NO CONSTRUCTION WORK Inspection Area : I PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 10/24/2023 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: 1608 E BALBOA BLVD NB Description: NEW BLOCK WALL 6' x 30 LF S 11' x 21 LF ON SATURDAYS Legal Desc.: Owner: 1610 EAST BALBOA PARTNERS Contractor: OWNER/BLDR Architect: OLDHAM RYAN Address: 1800 CENTURY PARK E#800 Address: AUTH AGENT: Address: 2651 E. CHAPMAN AVE #110 LOS ANGELES CA 90067 MARSZALEK KRZYSZTOF FULLERTON, CA 92831 Phone: Phone: 626-203-1403 Phone: 714-482-8296 State Lic:CO29715 ryy Applicant: OLDHAM RYAN Con State Lie: OIB Engineer: LAYNE DAVID M Address: 2651 E CHAPMAN AVE #110 Lie Expire: Address: 40810 COUNTY CENTER DR #110 FULLERTON CA 92831 Bus Lie: FULLERTON, CA 92831 M Phone: 714-482-8296 Lie Exp Date: Phone: 951-600-0032 State Lic:C-074349 Code Edit: 2019 Worker's Compensation Insurance Designer: O Type of Construction: VB Carrier: Address: Occupancy Group: U Policy No: Added /New sq.ft. Bldg: 0 Expire: Phone: - Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: 5 Special Conditions: LIQUEFACTION AREA No of Units: 0 Front: 5 HIGH DENSITY Bldg Height: 0 Left: 3 Bldg Sprinklers: Right: 3 Flood Zone: X-0.2 Use Zone: Parking Spaces: 0 _ _ Fire Hazard Zone : N Construction Valuation: $6,000.00 Building Permit Fee: $356.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $66.00 Additional Fee: $0.00 Plan check Fee : $46.25 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: $24.00 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 PNV Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist : $0.00 Building Green Fee : $1m Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $493.25 Plan Check Fee : $365.00 Fee Due at Permit Issuance : $128.25 PROCESSED BY: �U-ILIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: 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 is 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 of more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) 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 p ly 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). 7 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 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, ell a structure that I have built as an owner -builder if has not been constructed in its entirety by license contractors. I understand that a copy of the applicable law, Section 7044 of the Business and 'rofessions Code, is available upon request whe appli 1 is submitted or a the fo wing We e: ttp://www.leginfof�gov/calaw.html. 'signature of Property Owner or Authorized Agenti.'�?.J rJ'Gm.�fr .ICENSED CONTRACTOR'S DECLARATI N hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force nd effect. License Class License No Date Contractor Signature COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SU13JECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS IS100,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: I I 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 the 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' rance carrier and policy number are: Policy Number of Agent Date certify that, in the �perrfformance 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 Califomia, and agre naturehould of Applicant es bject to et • 2 �/� compens n provisiG�%Section 3,✓�aY33the � or Cede, I shall forthwith comply with those provisions. QQ Y^ C// at �0 CLARATION RE C NSTRU TION LENDING AGENCY Ireby 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). Ider'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 provided is correct. ,..� I agree to comply with all applicable city and county ordii5lances and state Jews rel to building construction. ( GZ `(J G 1 authorize representatives of this city or tour to en th ve-ida d erty for inspection purposes. L f Signature of Property Owner or Authorized Agen JZ Print Property Owner's or Authorized A ent's Name 1 f-�4 Da .2 ACTION DATE BY DECLARATION MwCOMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQM D RULE 1403 PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED UEPA PERMIT EXTENDED UAQMD PERMIT FINAL `s (6 1/I- ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF /J�PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: ,