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Home My WebLink AboutX2021-0700 - Permitsaxt'z,, City of Newport Beach - Building Division IIIIIIIIII'llllllll�lllllllllllll�lll II COMB Permit: X2021-070 r 100 Civic Center Drive, Newport Beach, CA 92560 X 2 0 2 1 0 7 0 a Project No : 0643-2021 Permit Counter Phone (949)644-3288 .. Inspection Requests Phone (949)644-3255 Issued Date: 03125/2021 Combination Type - BLDG GRAD PLUM Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, PROJECTS MUST BE COMPLETED BY 03/25/2024 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: 4645 CAMDEN DR NB Description: SFR RETAINING WALL 3' HIGH WI GUARDRAIL X 60 LF & DRAINAGE WI GASLINE TO FIRE PIT Legal Desc.: N TR 3357 LOT 127 Owner: MAI MICHAEL THANG Contractor: AJM CONSTRUCTION SERVICES Architect: Address: 4645 CAMDEN DR Address: 9414 EL CAMINO AVE Address: CORONA DEL MAR, CA 92625 FOUNTAIN VALLEY CA 92708 Phone: Phone: 714-863-9573 Phone: State Lie: Applicant: TUCKER MICHAEL Con State Lie: 562156 Engineer: KOLODZIEJ KENNETH J Address: 9414 EL CAMINO Lie Expire: 0313112023 Address: 400 E ESTHER PLACE , FOUNTAIN VALLEY, CA 92708 Bus Lie: BT30074776 PLACENTIA CA 92870 Phone: 714-863-9573 Lie Exp Date: 0313112022 Phone: 714-996-1219 State Lic:C-064768 - 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: Construction Building Permit Fee: $416.00 Plan Check Fee: $361.92 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $8.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $1,251.36 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9042025 Expire: 10101/2021 Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WO Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: 30 Front: 6 Left: 6 Right: 6 Designer: Address: Phone: Special Conditions: Fire $0.00 Planning Department - Fire Department $0.00 Plan check Fee : $0.00 Fire Inspection: $0.00 $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 $0.00 SJH Trans : $0.00 Demolition Fee $232.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 $195.00 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 $37.44 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $1,251.36 _ PUBLIC WORKS APPROVAL: PLAN CHECK BY: 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 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 (_) 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 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 t,a✓e 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 ass Professions Code, :E r.vailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Siibreba= of Property Owner or Authorized Agent Date LICENSED CO'dTRPCTOR'S DECLARATION I hereby`gffirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0) of 'visi f�he Business and Prof s ions Co , a y ' an ull force ar.J eKest. License Class License No Date / Contractor Signature WORKERS' CGMPEN'SATION DECLARATION NARNINU9 FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T OUSAND DOL Re ($100,000(, IN ADDITION TO THE COST OF r.OMPENSSTION, DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I herebv a/Frm under penalty of perjury one of the following declarations: C : lute 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-formar.:e oft" wc,k or which this permit is issued. Policy No. 1 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' compensation s -Lr.ca carrier adL jcl.zy number are: :arrier Icy u r Expiration Date Jame of Agent Phone # :1I certify that, in the perfo ante of theLwf "i� e is ed, I shall not employ any person in any manner so as to become subject to the workers' compensation (aws of California, and agree hat, if I should become ject to the wvia s of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of Applicant Date )ECLARATION REGA ING CONSTRUCTI N LENDING AGENCY hereby affirm under penalty of perjury that th re is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Ci 'I Code). _ender's Name Lender's Address 3y my signature below, I certify to each of the following: I am the property owner or authorized to act on the proJows beh If. I have read this application and the information I have porre .I agree to comply with all applicable city and county ordt a ng to building construction. I authorize representatives of this city or coun ante' ant' p erty for inspection purposes.�{Signature of Propert Owner or Authorized AgentC Print Property Owner's Authorized Agent's Name 1 I v Dat' ✓ ACTION DATE BY LARA ION OF COMPLIANCE WITH CODE OF FEDERAL FOR OF SE ONLY REGU INS PART 61 OF TITLE 40 AND AQMD RULE 1 PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMIT EXTENDED qM PERMIT FINAL r V f —Z( b 1 A STO N IFICATION AP ICABLE TO CERTIFICATE OF l• �t'_1 ROPOS D OLITION OCCUPANCYISSUED SIGNATURE: