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Home My WebLink AboutX2014-2301 - Permits�vrr City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIINIIIIIIIIIIIIIIIIIIIIIIIIIIII 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 4 2 3 0 1 Permit Counter Phone (949)644-3288 w xi cw Combination Type - BLDG Job Address: 4507 HAMPDEN RD NB Description: RETAINING WALLS AT 3 SIDES 2. 8" X 350 LF Inspector Area: 6 Legal Desc.: N TR 3357 LOT 9 Owner: 4507 HAMPDEN NB LLC Address: 161 FASHION LANE #206 TUSTIN, CA 92780 Phone: Applicant: SHAM ZACHARY J Address: 2600 NEWPORT BLVD #154 NEWPORT BEACH CA 92663 Phone: 949-675-7322 Code Edit: 2013 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: Valuation: Building Permit Fee: $339.00 Plan Check Fee: $244.08 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $2.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Fee Increase: Fee: $0.00 Additional Fee : $0.00 Hazardous Mat : $0.00 Building Green Fee: $1.00 TOTAL FEE: $676.08 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: OW NER/BLDR Address: 4507 HAMPDEN NB JACK HERRON Phone Con State Lic: O/B Lic Expire: Bus Lic: Lic Exp Date: Worker's Compensation Insurance Carrier: Policy No: Expire: Building Setbacks Use Zone: Excise Tax: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: / Front: / Left: / Right: I $0.00 $0.00 $34.80 $0.00 $23.20 $0.00 $0.00 $0.00 COMB Permit: X2014-2301 Project No : 1829-2014 Inspection Requests Phone (949)644-3255 : uorunar ry Architect: SHAM ZACHARY J Address: 2600 NEWPORT BLVD #154 NEWPORT BEACH CA 92663 Phone: - 949-675-7322 State Lic:0005004 Engineer: Address: Phone: State Lic: Designer:. Address: Phone: Special Conditions: Fire Planning Department - Plan check Fee: Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PM Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department $32.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $676.08 " o;UB4iC;VCYRKS APFR0Vk>o. . PLAN�CHECK'BY:' 0 0 o APPROVAL TO ISSUI&: o a PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LA&T V AOLWNSPECTION. 0 o a OOV ,OB Y• a ! p0• G• 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 '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 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 U 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 reprovements 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 reproved 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 Ipply 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). 3 1 am exempt from licensure under the Contractors' State License Law for the following reason: Sy 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 legall, ell a structure that I have built as an owner -builder if it not been con ructed 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 hen this do s s ad or at the following b site:http:/ ale info.c .g v/cola tml. y signature of Property Owner or Authorized Agent Date 0 7 .ICENSED CONTRACTOR'S DECLARATI N hereby affirm under penalty of perjury that I am license under provisions of Chapter 9 (commencing with Section 700�) of Division 3 of the Business and Professions Code, and my license is in full force nd effect. License Class License No Date Contractor Signature VORKERS' COMPENSATION DECLARATION 'ARNING: 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 ($100,000), IN ADDITION TO THE DST 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: I 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 th erformance of the work for which this permit is issued. Policy No. ]I have 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' compensation �surance carrier and policy number are: anner Policy Number Expiration Date a�Ime of Agent Phone # Scertify 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 workers' compensation laws of California, and agree at, if I should become sect to the w. ens' compensation provisions of Section 3700 the Labor Code, I sh II forthwith c mply with those provisions. ignature of Applicant ECLARATION REGAR CONSTRUCTION LENDING AGENC iereby affirm under pens ty of perjury that there is a Construction lending agency for the performance of the work for w ich this permit is issued (Section 3097, Civil Code). �nder'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 is correct. r I agree to comply with all applicable city and county ordinanc s and state laws relating to building construction. I authorize representatives of this city or coun t t t above -identified rop�#or i ction rposes. -� gnature of Property Owner or Authorized Agent 77L /1 \ Print o e y Owners or Authorized Agent's Na (7U ( %^)prrYt L LLB RYM At"T"J JJ.ATF IJY DECLARATION OFCOMPLDWCEI CODE OF tuns Ol-H{.T 05t G KT -- FEDERAL REGULATIONS PART 6I OF THIEJDAND R L'I�fi�! :l PFRtu4tTRXP1RFn ' • • SEAR rw)AcIiST0gW17WATEWTD- :3' EPA • : • • ❑ AWD ' ac;�farT ar�ccLLrD :': • P£,3tiR7Tfsr.TEn,•rEi� - 0 ASBESTOS NORHCA7MtSNOTAPPLJC4SLE To FEWTTJNAL GE,RTFTCATEOF • • PROPOSE D DEd/OL[MAI. • ' OCY'?IoAtdCYfS5tJE0 l � e•� ee : � St•.im1'AXfiit:. o o