HomeMy WebLinkAboutX2022-1492 - PermitsU411
City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - BLDG
11�1 11111111111111111111111111111111111111111111111111111COMB Permit: X2022-1492
x 2 0 2 2 1 4 9 2 Project No: 1169-2022
Issued Date : 05/26/2022
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY
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:
2018 NAUTILUS LN NB
Description:
SFR BLOCK WALL 6' HIGH X 60 LF ON P/L *MARKERS ON SITE*
Legal Desc.:
N TR 3763 LOT 74
"' ^
Owner:
EKEDAL RYAN
Contractor:
EKEDAL CONCRETE INC
Architect:
Address:
2018 NAUTILUS LN
NEWPORT BEACH CA 92660
Address:
19600 FAIRCHILD RD STE 123
IRVINE CA 92612
Address:
�Sa��� ^ °
Phone:
Phone:
9491729-8082
Phone:
�"
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1 Er.�
j
Applicant:
EKEDAL CONCRETE INC
Con State Lic:
487590
Engineer:
°��°
Address:
19600 FAIRCHILD RD STE 123
Lic Expire:
02129/2024
Address:
IRVINE CA 92612
Bus Lic:
BT00005971
Phone:
9491729-8082
Lic Exp Date:
1013112022
Phone:
State Lic:
Code Edit: 2019
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:
Construction
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:
rLN 01I LI re7A:RRAYIA III
GRADING APPROVAL:
Worker's Compensation Insurance
Carrier: LONGSHOREMAN-ZURICH
Policy No: WC380494701
Expire: 10/0112022
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %
Plumbing %:
Rear: 6
Front: 20
Left: 6
Right: 6
king Space
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
0
Designer:
Address:
Phone:
Special Conditions: P/L AGREEMENT ATTACHED
Fire Hazard
Planning Department -
Plan check Fee
Fair Share:
SJH Trans:
In -lieu Housing Fee:
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Fire Department
$52.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
Pian Check Fee : $0.00 Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
00
" 00"
090 "
0 00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$991.87
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)
ction 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).
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
liness 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
rovements 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
roved 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
ly 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:
'y rn; ..ignatula 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 cover
all a structure that ;lave 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
rofesslons Code. is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
'ignawre of Pronerty Owner or Authorized Agent Date _
of the Business and
.!CEJSED CONI RACTOR'S DECLARATION
hem.Ly affirm under oenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 ) of Di^isio 3 of the Business and Pr ssio Code, and my license is in full force
nd Pffect. Lic' nce Class License No Dati Contractor Signal
IlORKERS' COMPENSATION DECLARATION
V'N7 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
OF �OMPENSAnON, VAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
I h^ve and .,All r.Jaiatain 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
ormance of the work for which this permit is issued. Policy No.
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'
carrier and policy number are:
Policy Number
of Agent
Date
I certify that, in the performan4 of the work forwhich 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 agre
iat, if I should becomes jec the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
lignature of Applicant Date'
IECLARATION REG RDIN G AGENCY
hereby affirm under penalty perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
enders Name Lender's Address
ly 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 hav provided is correct.��
I agree to comply with all applicable city and county d'Dances and state laws relating to building constru n.
I authorize representatives of this city or county to r the above -identified property for inspect�i "p rposes.
lianature of ProDedv Owner or Authorized Agent ant Prooertv Owner's or Authorized ADent's Namk ate !•
ACTION I DATE BY
PERMITEXPIRED
PERMIT EMENDED
PERMIT FINAL
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CERTIFICATE OF
�J
�47
OCCUPANCYISSUED
n,
OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
PART 61 OF TITLE 40 AND AQMD RULE
1403
[SUBMITTED ASBESTOS NOTIFICATION TO
EPA
_ AQMD
IS NOTAPPLICABLE TO