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Home My WebLink AboutX2022-1492 - Permits (3)City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2022-1492 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 2 1 4 9 2 Project No : 1169-2022 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 -- _ - Issued Date : 0512612022 r"ir,x7�aR`� Combination Type - BLDG Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0512612025 OR PERMIT WILL BE INVALID M 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: 18 NAUTIL Description: SFR RETAINIX 60 LF *MARKERS ON SITE* (DELTA 1) Legal Desc.: 3763 LOOwner: EKEDAL Contractor: EKEDAL CONCRETE INC Architect: Address: 2018 NAUTILUS LN Address: 19600 FAIRCHILD RD STE 123 Address: NEWPORT BEACH CA 92660 IRVINE CA 92612 Phone: Phone: 9491729-8082 Phone: State Lic: Applicant: EKEDAL CONCRETE INC Address: 19600 FAIRCHILD RD STE 123 IRVINE CA 92612 Phone: 9491729-8082 Code Edit : Type of Construction: Occupancy Group: 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: Con State Lic: 487590 Lic Expire: 02/29/2024 Bus Lic: BT00005971 Lic Exp Date: 10/31/2022 2019 Worker's Compensation Insurance Carrier: LONGSHOREMAN-ZURICH U Policy No: WC380494701 0 Expire: 10/01/2022 0 Building Setbacks Rear: 6 Front: 20 Left: 6 Right: 6 Use Zone: Parkino Spaces: 0 Construction Valuation: $25,000.00 Building Permit Fee: $501.00 Plan Check Fee: $435.87 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 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $991.87 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Engineer: Address: Phone: Designer: Address: Phone: State Lic: Special Conditions: PIL AGREEMENT ATTACHED Excise Tax: $0.00 Planning Department - Additional Fee : $0.00 Plan check Fee Grading Bonds Fee: $0.00 Fair Share Grading PC Consultant : $0.00 SJH Trans Grading Permit Fee: $0.00 In -lieu Housing Fee Grading PC Fee: $0.00 Public Works Department - WO Insp. Fee: $0.00 Park Dedication : $0.00 PAN Plan Check: $0.00 Electrical %: $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 �NSPE T Fire Department $52.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adorn $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 Plan Check Fee : $991.87 Fee Due at Permit Issuance : $0.00 PU9'.IC WORKS APPROVAL: PLAN CHECK BY: --vigAr 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) (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 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). ❑ 1, 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.html. 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 V4 Di 'aio the Business and Protiol Code, and my license is in full force and effect. License Class License No Date ntractor Signature WORKERS' COMPENSATION DECLARATION WARNING: 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 COST 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: 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 )rmance of the work forwhich this permit is issued. Policy No. 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' compensa rance carrier and policy number are: Policy Number ie of Agent Date certify that, in the performanc 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 I. if I should become'. s�bjeCt tie workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant ]\\ / /^ Date CLARATION REGAR NG'C TRUCTION LENDING AGENCY areby 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 cou ty to trer the above -identified property for inspection purposes. ,�// nahire of Prnnerty Owner nr Authorized Anent tI print Prooertv Owner's or Authorized Aaent's Name /t Date _lo ACTION PERMIT EXPIRED PERMITCANCELLED PERMIT EMENDED PERMITFINAL CERTIFICATE OF OCCUPANCYISSUED DATE By 1V 3 LATIONS PART TION OF 061 OF IIT E 40 AND CE WITH ODE OF AQMD RULE FOR OFFICE USE ONLY I SUBMITTED TO of 15, 42 /�� LI ASBESTOS NOTIFICATION IS NOT APPLICABLE TO l/ljI PROPOSED DEMOLITION SIGNATURE: