HomeMy WebLinkAboutX2022-1410 - PermitsCity of Newport Beach - Building Division `X2022-1410'
COMB Permit: X2022-141100
Civic Center Drive, Newport Beach, CA 92660
Project No : 2120-2018
Permit Counter Phone (949)644-3288Inspection Requests Phone (949)644-3255
(9)
g,� `1a.9 `!�
Issued Date : 0512412022
Combination Type - BLDG
Inspection Area : 5
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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: 323 DRIFTWOOD RD NB
Description: DELTA 8 (STRUC) & 10 (ARCH), BLOCK WALL 8"x 27 LF (INSIDE P/L, MARKERS ON SITE) REV22-0882
Legal Desc.: N TR 1116 LOT 31
Owner: MCELROY SARAH Contractor:
PATTERSON CONSTRUCTION Architect:
BRANDON CHRISTOPHER
Address: 4720 CORTLAND OR Address:
15 CORPORATE PLAZA STE.150 Address:
151 KALMUS DR #G-1 .,...,
CORONA DEL MAR, CA 92625
NEWPORT BEACH CA 92660
COSTA MESA CA 92626
Phone: 949-422-1541 Phone:
949.723-1800 Phone:
714-754-4040 State Lic:C031637
Applicant: JOHNSON JUSTIN Con State Lic: 802367 Engineer:
MANSHADI FARHAD
Address: 151 KALMUS DR #G-1 Lic Expire:
07/31/2022 Address:
1800 E 16TH ST UNIT B
COSTA MESA CA 92626 Bus Lic:
BT02110534
SANTA ANA CA 92701
Phone: 714-754-4040 Lic Exp Date:
09/3012022 Phone:
714-835-2800 State Lic:C-036840
Code Edit : 2019 Workers Compensation Insurance Designer:
Type of Construction: VB Carrier:
STATE COMP Address:
_
Occupancy Group: U Policy No:
9065406
Added /New sq.ft. Bldg: 0 Expire:
08/01/2022 Phone:
"
Added /New sq. ft. Garage: 0
No of Stories: 0 Building Setbacks
Rear: 6' Special Conditions:
. ,
"•
No of Units : 0
Front: 25'
Bldg Height: 0
Left: 6'
Bldg Sprinklers:
Right: 6'
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 : $6.00 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
PNJ 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 : $391.86
Plan Check Fee : $206.86 Fee Due at Permit Issuance : $185.00
PROCESSED BY:
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
M
ZONING APPROVAL: (J li
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
.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
Drofessions Code) or that he or she is exempt from Iicensure 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
lot more than five hundred dollars ($500).
1, 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).
❑ 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
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).
❑ 1 am exempt from Iicensure 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 heat Knave 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
Prof3_Lions Cuda, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/caiaw.html.
Signature of Property owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I heieuy affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 f Division 3 of the Business and ProfesslGr�rCpde, and r}�y licaAse is in full force
and ei£ect. License Class License No Date �i' Contractor Signature };�ii/iis. Zy ice _
NORKERS' 0(7).MPENSATION DECLARATION
4IFN,NG: FAILURE Tn SFCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
rnFT C� COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
berPhy affirm under penalty of perjury one of the following declarations:
�❑ have and will na,-main 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,
rc .c. rr:nce of the work for which this permit is issued. Policy No.
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'
carrier and policy number are:
is of Agent
certify that, in the performance of
if I should become subject to the
re of
Policy Number
Date
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,
compe nsatign pro isions of Section 3 0 of the Labor Code, I shall forthwith comply with those provisions. —
(//1: Datex
CLARATION REGARDING CqRSTRUCTION LENDING AGENCY
!reby affirm under penalty of erjury 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
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 an e�bove-identid gr9perty for in ' n purposes. A
of
PERMIT EXPIRED
PERMITCANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
Print Prcoerty Owner's or Authorized Acent's Name
DATE BY ! RECLARATION OF EGULATIONS PART 061 OF TITLE 40AND MPLIANCE WITH OAQMD RULEDE OF RAL I FOR OFFICE USE ONLY
3-31-
I SUBMITTED ASBESTOS NOTIFICATION TO
PROPOSED
SIGNATURE:
NOTIFICATIONIJINOT APPLICABLE TO