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Home My WebLink AboutX2021-0392 - PermitsCity of Newport Beach - Building Division 1111111111111111111111111111111111111111111111Jill COMB Permit: X2021-0392 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 0 3 9 2 Project No: 2399-2019 �, ';, Permit Counter Phone (949)644-3288 si: Inspection Requests Phone (949)644-3255. ''.� .T Combination Type - BLDG Issued Date: 02119/2021 0nw a Inspection Area : 1 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0212012024 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 a Job Address: 4916 SEASHORE DR NB Description: SFR BLOCK WALL 42" X 55 LF INSIDE P1L *MARKERS ON SITE* Legal Desc.: N TR 3813 LOT 80 Owner: ALEJO PS69 LLC Contractor: JACOBSSON ENGINEERING CONSTRUCTION INC Architect: Address: 73-145 FIDDLENECK LN Address: P O BOX 14430 Address: M PALM DESERT CA 92663 PALM DESERT CA Phone: Phone: 760-345-8700 Phone: State Lie: e°eo Applicant: ALEJO PS89 LLC Con State Lic: 650389 Engineer: MORRIS KYLE Address: 73-145 FIDDLENECK LN Lie Expire: 0713112022 Address: 1401 DOVE ST #520 - PALM DESERT CA 92663 Bus Lie: BT30074279 NEWPORT BEACH CA 92660 ° ° • • ° Phone: Lie Exp Date: 02/2812022 Phone: 949-502-5323 State Lic:C-072911 Code Edit: 2019 Worker's Compensation Insurance Designer: Type of Construction: Carrier: EVEREST PREMIER INS CO Address: Occupancy Group: U Policy No: 76000021939201 Added /New sq.ft. Bldg: 0 Expire: 11/0112021 Phone: Added /New sq. k. Garage: 0 0 No of Stories: 0 Building Setbacks Rear: 10 Special Conditions: CONTRACTOR AUTH ..... No of Units : 0 Front: 5 LETTER ATTACHED Bldg Height: 0 Left: 3 ` ° ° Bldg Sprinklers: Right: 3 Flood Zone: Use Zane: Parking Spaces: 0 Fire Hazard Zone : N ° Construction Valuation: $3.500.00 Building Permit Fee: $144.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $125.28 Additional Fee: $0.00 Plan check Fee: $0.00 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: $2.00 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 WO Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access: $0.00 PAN 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 : $272.28 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $272.28 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION I hereby affirm under penally 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 thelusiness 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). 1, 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 (SeCtloU17044, lusiness 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 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). 7 1 am exempt from licensure under the Contractors' State License Law for the following reason: ly my signature below 1 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 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://Www.leginfo.ca.gov/calaw.htmi. signature of Property Owner or Authorized Agent to .ICENSED CONTRACTOR'S DECLARATION hereby affirm uatlerpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section }fie Business and Pro Ion a and my license is in full force pggyect. LicepsePlass License No Date (ContractorSignatur VORKERS' COMP&NSATION DECLARATION 'AIN114 y FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREb THOUSAND DOLLARS ($100,000), IN ADDITION TO THE OST.GF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm uwrisrpenalty of perjury one of the following declarations: 19fave and villi mgjntain 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 earmy nce of-th no, for which this permit is issued. Policy No. Nave 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 C Ce carrierandpylicy number are: arrier' Policy Number Expiration Date Vh4'oj Agent Phone # Ycertify that, in the part rmance of th work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' om at' n ws of California, and agre lot, if I should becom s bje h orkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applicant - Dat DECLARATION REG) ! NSTRUCTION LENDING AGENCY hereby affirm under' nal perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 Civil ode). ender's Name Lender's Address y 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 isrrect. I agree to comply with all applicable city and county ordinances state laws relating to building construction. I authorize representatives of this city, or coun t bn r a ve identified property for inspection purposes. �. nature of Property Owner or Authorized A ent Print Property Owner's or Authorized Agent's Name (/ l ` Dat 1CTION DATE BY CLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY 77 1 REG TIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED OEPA PERMIT EXTENDED qMD PERMITFINAL t9 rt IZA '(C ASBESTOS NOTIFIC IS OTAPPLICABLE TO CERTIFICATEOF (( PROPOSED DEAQOLIT)P{N) OCCUPANCYISSUED SIGNATURE: ��Y