HomeMy WebLinkAboutX2021-3089 - Permitsr�,wrrkr City of Newport Beach - Building Division *X2021-3089* COMB Permit: X2021-3089
Ltiyir,\'�� 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 2288-2021
Permit Counter Phone (949)644-3288
I ti R t Phone 194M644-3255
nspec ion eques s A ,sy 1
..���� � Issued Date :11/15/�021
Combination Type - SFP g s a a n i :. ,
Inspection Area : 5
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1111512024 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: 328 HAZEL DR NB
Description: SFR TEMPORARY SHORING (X2021-2636)
Legal Desc.: TRACT NO 673 BLK A LOT 52 POR OF LOT AND POR ABAND STR (GLEN DRIVE)
Owner:
GUPTA ANJULIA
Address:
2806 MOUNTAIN LANE
PLANO, TX 75093
Phone:
Applicant:
KREBER JOHN
Address:
921 COAST VIEW DR
LAGUNA BEACH, CA 92651
Phone:
949-595-5278
Code Edit :
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 0
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Flood Zone:
11 Construction Valuation:
Contractor:
TERRA STRUCTURAL DRILLING
Address:
921 COAST VIEW DR
LAGUNA BEACH CA 92651
Phone:
949-395-5278
Con State Lic:
1061448
Lic Expire:
12131/2021
Bus Lic:
ST30077241
Lic Exp Date:
11/30/2022
2019 Worker's Compensation Insurance
Carrier: STATE COMP. INS
R3/U Policy No: 9308433
0 Expire: 1110512022
0
Building Setbacks Rear: 10
Front: 1
Left: 3
Right: 3
X Use Zone: Parkina Soaces: 0
Building Permit Fee: $609.00
Plan Check Fee: $964.00
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 :
$3.00
TOTAL FEE : $1,628.00
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 %:
Architect
Address:
Phone: State Lic:
Engineer: SONG,ZHENYU
Address: 12631 IMPERIAL HWY, STE E-125 '
SANTA FE SPRINGS CA 90670
Phone: 562-863-9999 State Lic:S-005266 "" '
Designer:
Address:
Phone:
Special Conditions: LANDSLIDE AREA "
OFUEL MOD/HAZARD
REDUCTION ZONE
Fire Hazard Zone : Y
$0.00
Planning Department -
Fire Department
$0.00
Plan check Fee :
$52.00
Fire Inspection:
$0.00
$0.00
Fair Share :
$0.00
Fire Plan Rev
$0.00
$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
P/W 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 :
$1,628.00
PUBLIC WORKS APPROVAL:
_
1
PLAN CHECK BY:
l�
`__
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
:he 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 U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business 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
improvements 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
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 year prior to completion of the improvements covered by this permit, I cannot legally
sell a structure that I have 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
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0) O i is n 3,ggf the Business and Professici& C de m license is in full force
end effect. License Class License No Date 1coritractor Signature
WORKERS' COMPENSATION DECLARATION
NARNING FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLA ($'190,000), IN ADDITION TO THE
COST')- COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm u7d:r fenalty of perjury one of the following declarations:
I,idve 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 th
pe:-fu:n.ance of :he work for which this permit is issued. Policy No.
Tave 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' compensatiol
sd,ancz Carrier and policy number are:
Policy Number
Tie of Agent
Date
I certify that, in the p6rform 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 California, and agre
hat, if I should become bj ct to a workers' compensation pr Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant Datl�
)ECLARATION REGA DIN N N LENDING E CY
hereby affirm under penalty of perjurMhat there is a constructi lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
.ender's Name Lender's Address
Sy 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 ord' no s and state laws relating to building construction.
I authorize representatives of this city or county t t the a o 4dentifie prop pection purposes.
signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam at
ACTION DATE BY DECLARAT N OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED (SUBMITTED
PERMITCANCELLED i I f l)EPA
PERMITFINAL CERTIFICATE OF ROPOCCUPANCY SUED t1/ I I SIGN DECO ITIOIJ 10 IS NOTA