HomeMy WebLinkAboutX2021-1179 - PermitsCity of Newport Beach - Building Division
"X2021-1179`
COMB Permit: X2021-1179
i I
c'rzz�aA'�a .
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - BLDG
Project No : 2842-2019
Issued Date : 07/29/2021
Inspection Area : 6
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, PROJECTS MUST BE COMPLETED BY 07/29/2024 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: 1017 SANDCASTLE DR NB
Description: SFR DELTA 7, NEW RETAINING WALL 7' HIGH MAX X 74 LF (POOL AREA) & REVISE GRADING (REV21-0723)
Legal Desc.: N TR 6425 LOT 78
Owner: PEDERSEN NIELS & STEPHANIE Contractor: CORNERSTONE CONSTUCTION Architect: BAILEY DAVID ....
Address: 1017 SANDCASTLE DR Address: 15540 ROCKFIELD BLVD STE A 110 Address: 23183 LA CADENA DR #101 °
CORONA DEL MAR CA 92625 IRVINE, CA 92618 LAGUNA HILLS CA 92653
Phone: 949-228-2833 Phone: 949-369-1979 Phone: 949-573-1050 State Lic:CO27404
,a o
Applicant:
BAILEY DAVID
Address:
23183 LA CADENA DR #101
LAGUNA HILLS CA 92653
Phone:
949-573-1050
Code Edit: 2019
Type of Construction: VB
Occupancy Group: U
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 0
No of Units : 0
Bldg Height: 0
Bldg Sprinklers:
Flood Zone: X
Construction
Building Permit Fee: $280.00
Plan Check Fee: $243.60
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
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
TOTAL FEE: $975.35
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Con State Lie:
1033864
Lie Expire:
1213112021
Bus Lie:
BT30061583
Lie Exp Date:
12/3112021
Worker's Compensation Insurance
Carrier: ACCREDITED SURETY & CASUALTY
Policy No: IATCA160006212
Expire: 11/22/2021
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
WILSON KALEN °
23152 VERDUGO DR #102 °
LAGUNA HILLS CA 92653
714-576-6524 State Lic:C-083753
Rear: 6' Special Conditions:
Front: 15'
Left: 6
Right: 6'
co °
0
•
$0.00
Planning Department -
Fire Department
$0.00
Plan check Fee :
$52.00
Fire Inspection:
$0.00
$0.00
Fair Share :
$0.00
Fire Plan Rev
$0.00
$275.52
SJH Trans :
$0.00
Demolition Fee
$0.00
In -lieu Housing Fee :
$0.00
Building Dept Adm
$0.00
$60.48
Public Works Department -
General Service
$0.00
$0.00
Park Dedication : $0.00
Refund Deposit
$0.00
PAN Plan Check: $50.75
Grading Bond:
$0.00
$0.00
San Dist: $0.00
$0.00
NMUSD Fee: $0.00
$0.00
$0.00
$0.00
Plan Check Fee
: $332.85 Fee Due at Permit Issuance :
$642.50
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
0
0 0 0
mo .
•
a• .
o•°•o
0
000.o
o°.
00
00000•
•
oo.o
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
he 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
3rofessions 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
lot more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
3usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
mprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
mproved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
rpply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I am exempt from licensure under the Contractors' State License Law for the following reason:
3y my signalrlRE 891%w I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot Iegall�
;ell a structure•419PI have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
;r9fe$sions Godal Is.available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm].
signature of TAerty Owner or Authorized Agent pa ne
ICENSED CQNTRACTOR'S DECLARATION
Itarety affirm nder�penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 0) of v' i 3 of the Business and Pro s 6 ns an y license is in full force
and effect. Ucense Class License No Date q Contractor Signatur
IOORRERS' COMPENSATION DECLARATION
yyaNING: FAILURE Te SL•CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREDTH USAND DOLLARS ($7(10,000(, IN ADDITION TO THE
:DST OF COMPENMI IN, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
••
he•reby affirm urlber penalty of perjury one of the following declarations:
TI have an4 wilFmSintain 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
T jfs()pance of "a work for which this permit is issued. Policy No.
. J ileve and t 1-d'i5litain 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
nsurance carrier and policy number are:
Policy Number
me of Agent _
Date
I certify that, in the performance the hich t permit is issued, shall not employ any person in any manner so as to become subject to the workers' ompensatio laws of lifornia, and agre
hat, if I should beco ubject t the m anon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. IV
_21��
Signature of Applicant DaY
)ECLARATION REGPPDI T UCTION LENDING AGENCY
hereby affirm under penalty erjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 , C it Cod ).
-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 owpeP behalf.
I have read this application and the information I have provi i c ct.
I agree to comply with all applicable city and cou 0rdi nce ate laws relating to building construction.
I authorize representatives of this city or county ant th ove an ad property for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's NamL D
ACTION DATE BY QfZMATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED I SUBMITTED ASBESTOS NOTI FICATION TO
PERMITCANCELLED EPA
PERMIT FINAL �,����� I � � OPOSED fJOTIFIC 0 lifePUC TO
CERTIFICATE OF PR -ASSES D OL ON
OCCUPANCY ISSUED SIGNATURE: