HomeMy WebLinkAboutX2021-1291 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
H... Permit Counter Phone (949)644-3288
,. Inspection Requests Phone (949)644-3255
Combination Type - BLDG
COMB Permit: X2021-1291 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II
Project No: 2225-2019
Issued Date : 06/22/2021
Inspection Area : 5
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 06/22/2024 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: 4701 HAMPDEN RD NB
Description: SFR STEEL FENCE 6" X 105 LD (INSIDE P/L) REV21.0700
Legal Desc.: N TR 3357 LOT 25 � � � ��^
Owner: CHUNG YOON/SHINHYE Contractor: MILO CONSTRUCTION Architect: TEALE MARK C)
Address: 608 HIGHLAND BLUFF WAY Address: 101 VIA MONTE PICAYO Address: 2900 BRISTOL ST BLDG A203
LAS VEGAS NV 89138 SAN CLEMENTE CA 92673 COSTA MESA CA 92626
Phone: Phone: 949-290-6429 Phone: 949-975-0123 State Lic:CO22162
Applicant:
TEALE MARK
Con State Lic:
871429
Engineer:
HAKIM FADY •
•
Address:
2900 BRISTOL ST BLDG A203
Lic Expire:
03/31/2022
Address:
124 PEONY ....
COSTA MESA CA 92626
Bus Lic:
BT30038762
IRVINE CA 92618 .... o e • m n o
Phone:
949-975-0123
Lic Exp Date:
0313112022
Phone:
310-422-1536 State Lic:C-075736 0..' :
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:
Flood Zone: X
11 Construction Valuation: $11
Building Permit Fee: $246.00
Plan Check Fee: $0.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$246.00
Record Management:
$12.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
11 TOTAL FEE $385.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Worker's Compensation Insurance
Carrier: NO EMPLOYEES
Policy No:
Expire:
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant:
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical W
Plumbing %:
Rear: 15'
Front: 15'
Left: 6'
Right: 6'
Parkino Spaces
$0.00
($120.00)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee
Designer:
Address:
Phone:
Special Conditions:
Planning Department -
Plan check Fee
Fair Share:
SJH Trans :
In -lieu Housing Fee:
Public Works Department -
Park Dedication :
$0.00
PNV Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
$0.00 Fee Due a
PUBLIC WORK APPROVAL:
PLAN CHECK B WORK(
APPROVAL TO ISSUE:
Issuance
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$385.00
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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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) 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 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.htmi.
Signature of Property Owner or Authorized Agent Date
LICENSED CQN9'R'OOCTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 of Division 3 of the Business and Profess' Rs C e, and y licence is in full force
and.e✓ffeet. Licen a Glass License No Da 2d"' Contractor Signature
WORKERS' OOAFASATION DECLARATION
RARNING+FAILURE TOSECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI 7ALPENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I8100,0001, N ADDITION TO THE
dOSTBA COMPENSPTION.VMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
IAjetry affirm Ltogriolilalty of perjury one of the following declarations:
ave 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
e f nce of �haw'or& for which this permit is issued. Policy No.
&.*rwlv
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' compensatioi
carrierend tmlicy number are:
v . • • I : _ Policy Number Expiration Date
that, in the performance of the work for which
Duld become subject to the workers' comp na
Date G 'Z2'Z1
?CONSTRUCTION LENDING A NCY
:reby affirm under p�alty 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).
Ider'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 ate laws relating to building construction.
I authorize representatives of this city or county toe r the ove-i ntified p party for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Ag
ACTION DATE BY DECLARATION OF COMPLIANCE CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED EPA
of
is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and
ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
PERMITFINAL t ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF PROPOSED DEMOLITION
OCCUPANCY ISSUED SIGNATURE:
Name