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Home My WebLink AboutX2022-0356 - Permits.,,� City of Newport Beach - Building Division *X2022-0356* COMB Permit: X2022-0356 ' Tm 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 1873-2021 �, a Permit Counter Phone (949)644-3288 is: Inspection Requests Phone (949)644-3255 r,+zrou'' Combination Type - BLDG Issued Date : 02/09/2022 9 Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 02/09/2025 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: 2315 HEATHER LN NB Description: DELTA 5 NEW WALL 6 FT TALL X 3FT ON P/L (REV22-01201) Legal Desc.: N TR 3138 LOT 35 - Owner: WELLS CORINNE & MICHAEL Contractor: J M I AND ASSOCIATES INC Architect: Address: 2315 HEATHER LN Address: 2046 MEYER PLACE Address: NEWPORT BEACH, CA 92660 COSTA MESA CA 92627 Phone: Phone: 714-350-9527 Phone: State Lic: Applicant: FLOR JOSE Con State Lic: 951957 Engineer: MORAN TIMOTHY Address: 5364 VIA MARIA Lic Expire: 09/30/2022 Address: 23802 HUMPHREY CT YORBA LINDA, CA 92886 Bus Lic: BT30069739 MURRIETA CA 92562 Phone: 714-457-9177 Lic Exp Date: 11/30/2022 Phone: 714-920-7680 State Lic:C-071701 Code Edit: 2019 Worker's Compensation Insurance Designer: Type of Construction: Carrier: SIRIUS AMERICA INS Address: Occupancy Group: U Policy No: WC74001 Added /New sq.ft. Bldg: 0 Expire: 04/29/2022 Phone: Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: 10 Special Conditions: LANDSLIDE AREA No of Units : 1 Front: 20 WIAVER ATTACHED Bldg Height: 0 Left: 4 P/L FENCE AGMT ATT Bldg Sprinklers: _ Right: 4 Flood Zone: A Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $1,000.00 Building Permit Fee: $110.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $95.70 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 : $14.00 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 : $220.70 Plan Check Fee : $220.70 Fee Due at Permit Issuance : $0.00 PROCESSED BY: ZONING APPROVAL: PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: 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) action 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 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 fessions 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 more than five hundred dollars ($500). 1 LJ 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, 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). J I am exempt from Iicensure under the Contractors' State License Law for the following reason: I y my signature below I acknowledge that, except for my personal residence in which I must have resided for at least orja year prior to completion of the improvements covered by this permit, I cannot legally 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.html. ignature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) 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 IIORKERS' 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 thf 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' compensatior Isurance carrier and policy number are: arrier Policy Number Expiration Date of Agent certify 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 if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. of Date CLARATION REGARDING CONSTRUCTION LENDING AGENCY .reby affirm under penalty 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 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 county to enter the above -identified property for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Date I ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED LJEPA PERMITEXTENDED QMD PERMITFINAL �/ q^ ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO CERTIFICATE OF . (� lL PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: