HomeMy WebLinkAboutX2020-0883 - PermitsWW1 $ City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIII II COMB Permit: X2020-0883
o +� 100 Civic Center Drive, Newport Beach, CA 92660 X 2 9 2 0 0 8 8 3 Project No : 2837-2019
Permit Counter Phone (949)644-3288
zj Inspection Requests Phone (949)644-3255
Combination Type - BLDG Issued Date:
Inspection Arearea :2020
7
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 06/20/2023 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: 1011 CAMELBACK ST NB
Description: COMM RETAINING WALL 82 LF
X 10' HIGH MAX 8 BLOCK WALL 102 LF X THIGH MAX
Legal Desc.: TR 6680 LOT 2 POR OF LOT 2 AND POR OF LOT 3
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Owner: BAT YAHM TEMPLE
Contractor:
KRAUS CONSTRUCTION INC Architect: JEANNETTE BRION S
Address: 1011 CAMELBACK ST
Address:
18265 MOUNT BALDY CIR Address: 470 OLD NEWPORT BLVD
NEWPORT BEACH CA 92660
FOUNTAIN VALLEY CA 92708 NEWPORT BEACH CA 92663
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Phone:
Phone:
714-536-1429 Phone: 949-645-5854 State Lic:0008012
Engineer: MANSHADI FARHAD
Applicant: JEANNETTE BRION S
Con State Lie:
377814
Address: 470 OLD NEWPORT BLVD
Lie Expire:
0713112021 Address: 1800 E 16TH ST UNIT B
NEWPORT BEACH CA 92663
Bus Lie:
BT30036947 SANTA ANA CA 92701
Phone: 949-645.5854
Lie Exp Date:
09/30/2020 Phone: 714-835-2800 State Lic:C-036840
Code Edit: 2016
Worker's Compensation Insurance Designer:
Type of Construction: VB
Carrier:
EVEREST NATIONAL Address:
Occupancy Group: U
Policy No:
7600011706191
Added /New sq.ft. Bldg: 0
Expire:
07/0112020 Phone:
Added /New sq. ft. Garage: 0
No of Stories: 0
Building Setbacks
Rear: 0 Special Conditions:
No of Units : 0
Front: 0
Bldg Height: 0
Left: 0
Bldg Sprinklers:
Right: 0
Flood Zone: X
Use Zone: Parking Spaces: 0 Fire Hazard Zone : N
Construction Valuation: $20,750.00
Building Permit Fee: $411.00
Excise Tax:
$0.00 Planning Department - Fire Department
Plan Check Fee: $367.57
Additional Fee :
$0.00 Plan check Fee : $41.50 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 : $0.00
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
P/W Plan Check: $42.50 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: $853.57
PlanCheckFee:o $0.00 Fee Due at Permit Issuance: $853.57
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ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
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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).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) 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 1 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 CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 -of D' isio 3 of the Business and Professio s C and my lic is in full force
and effect. License Class License No Date Contractor Signature
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NORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (6100,000), IN ADDITION TO THE
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
1 have 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 the
)er*mance of the work for which this permit is issued. Policy No.
0 have and will tain 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' compensatior
nsuranc arr' ran p icy number re: �/
farrier N oli y Pnbar l D 3 l' L L-F iOD 7 �. L( -b Z Expiration Date J
Jame of Agent Phone #
:1I certify that, in the performance of the work for which this Ioermit 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(
hat, if I should become sub' ct to thew rkers' compens tiop provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ����
signature of Applicant D2te� 11
)ECLARATION REGA DING CGRSTRILICTIPIN aNDING AGENCY
hereby affirm under penalty of perjury th aplere 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 this city or c unl to enter bove-identifi d ro arty for inspection purposes.
3i nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name G/V Date !!!
ACTION DATE BY DECLARATI OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
RE G ULATI 5 PART 61 OF TITLE 40 AND AOMD RULE
14U3 • •u •• •••
PERMITEXPIRED U I SUBMITTED ASBESTOS NOTTIFICATON TO
• ••
PERMIT CANCELLED EPA • • • • • • ••
PERMIT EXTENDED qMD
PERMITFINAL ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
CERTIFICATE OF ��)��.1 PROPOSED DEMOLITION •• ••• • • • •••
OCCUPANCY ISSUED
SIGNATURE: • • • • • • •
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