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Home My WebLink AboutX2019-0726 - Permits$5Y1gt City of Newport Beach - Building Division COMB Permit. X2019-0726 Excise Tax: $0.00 Plan Check Fee: $365.00 IIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIII�II .$0.00. Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Investigation Fee: $0.00 - Grading PC Consultant: $0.00 II $0.00 Grading Permit Fee: a 100 Civic Center Drive, Newport. Beach, CA 92660 $0.00 - X 2 0 1 9 0 7 2 64 Project NO.: 2665-2018 $0.00 ta, +� Permit Counter Phone (949)6443288 Disabled Access: $0.00 $0.00 -. Inspection Requests Phone (949)644-3255 $0.00. Electrical %: $0.00 �'.a ax�'� Combination Type.- BLDG Mechanical %: Issued Date: 03/05/2019 .. Plumbing %: $0.00 -.. Inspection Area : 1 Plan Check Fee PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, � L 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: 110 VIA PALERMO NB Description: : BLOCK WALL 23 LF (SOUTH SIDE), 13 LF (NORTH SIDE) BOTH ON THE P/L, MARKERS ON SITE Legal Desc.: TR 907 LOT 100(AND NELY 10 FT LOT 99 Owner. KING LISA & DAVE Contractor: VALLEY MASONRY Architect: 0. E TO u Address: 110 VIA PALERMO Address: 264 NORTH SHAFFER Address: A NEWPORT BEACH CA 92663 ORANGE CA 92866 Phone: 415-740-4557 : Phone: .714-488-6393. Phone: - State Lie: •O `O• 'Applicants VALLEY MASONRY Con State Lie: 390882 Engineer: BERHE MAICHEL e • ° • e °, e o ° ° � � ,` Address: 264 NORTH SHAFFER Lie Expire: 01/3112021 Address: 1700 E GARRY AVE STE 104 ORANGE CA 92866 Bus Lie: BT30062400 SANTA ANA CA 92705 e • • ° ° `� Phone: 714.488-6393 Lie Exp Date: 09/30/2019 Phone: 949-335-9698 State Lic:C-076445 °• • ° <. ° • • ° `° Code Edit 2016 Workers Compensation Insurance Designer. • ° °. �° ° ° Type of. Construction: Carrier: EMPLOYERS COMP Address:' o` ° • : ° ° ° C Occupancy Group: UPolicy No: EIG157791607 Added/News .ft: Bldg: 0 Expire: 9 9 P 10/01/2019 Phone: P °pCp Added /New sq. ft. Garage: 0. - ° o00 a ° • ° ° ° o o° ° No of Stories: 0 Building Setbacks Rear: / Special Conditions: "LIQUEFACTION"' ° No of Units: Bldg Height: 0 0 Front l - Left I �'t_('� °•m®O• o°pOp° °° •m°°° Bldg Sprinklers: Right: I Flood Zone: Use Zone: Parking Spaces: a Fire Hazard Zone : N Building Permit Feer $412.00 Excise Tax: $0.00 Plan Check Fee: $365.00 Additional Fee :. .$0.00. Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Investigation Fee: $0.00 - Grading PC Consultant: $0.00 Record Management: $0.00 Grading Permit Fee: $0.00 Energy Compliance: $0.00 - Grading PC Fee: $0.00 CA Seismic Safety: $0.00 WQlnsp. Fee: $0.00 Disabled Access: $0.00 $0.00 Hazardous Mat $0.00. Electrical %: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 Plumbing %: $0.00 -.. TOTAL FEE: $818.00 Plan Check Fee � L PROCESSED BY:. ZONING APPROVAL: GRADING APPROVAL: Planning Department - Fire Department Plan check Fee $40.00 Fair Share: $0.00 SJH Trans : Fire Plan Rev. In -lieu Housing Fee: $0.00 Public Works Department- Park Dedication: $0.00 P/W Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 $0.00 Fee Due at Permit Issuance: $818.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: Fire Department $40.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev. $0.00 :. $0.00 Demolition Fee $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance: $818.00 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) lection 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 'rofessions 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). 7 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) 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 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 n roved 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 pply 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: 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 legally ell a stryat ire jhat 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 'rofessfopb Ciode, is available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw.htmi. ignature of Ploperty Owner or Authorized Agent Date ICENSEMAONTRACTOR'S DECLARATION {Iereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 000) of Division 3 of the Business a d Professi�d m e is in full force ryd effect. license Class License No to 2 �T� Contractor Si nature VORKER�� aJAAPENSATION DECLARATION ARNING: FAILURE j0 SECURE WORKERS' COMPENSATION COVERAGE la UNLAWFUL, ANO.SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E700,000), IN ADDITION TO THE OST OF corip SATON, DAMAGES As PROMDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. heleby affirm Ifi'der penalty of perjury one of the following declarations: TI have and will inaintain 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 thi BR(tmance,Qftheajork for which this permit is issued. Policy No. •ve and wgi 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 fsLisnce cartia r.Elnli'policy number are: Vn er Policy Number Expiration Date ame of Agent Phone # I certify that, in the performance 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 wort ers' compensation laws of California, and agrei iat, if I should bgoome subject to the_%ygrlyers' compensatjgn provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / signature LDate_ C )ECLARATI N REGARDING CON�ONLENDING AGENCY hereby 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). .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 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 or county to r t above-iden yfor inspection purposes. -✓ Print Pro ert Owner's or Authorized A ent' me Da Signature of Property Owner or Author ed A - 9 ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIREDISUBMITTEDASBESTOS NOTIFICATIONTO PERMITCANCELLED EPA PERMITFINAL U ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF. 7-.2 %- ®w-/` PROPOSED DEMOLITION OCCUPANCYISSUED -_ SIGNATURE: