HomeMy WebLinkAboutX2009-1699 - Permitsems_
City of Newport Beach Building Department
COMB Permit No: X2009-1699
N
Project Number: 1366.2009
PO Box 1768 Newport Beach, California 92658-8915 Permit Counter TelE;phone (949)644-3288 Inspection Requests/Telephone (949)644-3255
Combination Type - BLDG/ I
Job Address: 157 SHORECLIFF RD NB
Description:60' PERMANENT SHORING W/RETAINING WALL
Inspector Area: 6 Legal Desc.: N TR 1116 LOT 109
Owner: WHELAN JOHN Contractor: OWNERIBLDR
Architect:
Address: 228 HAZEL DR Address: WHELAN JOHN
Address:
r,
CORONA DEL MAR CA 92625
..t
Phone: 949.760-1885 Phone:
Phone:
State Lic: �ki�
Applicant: GUIDERO WILLIAM Con State Lic: O/B
Engineer:
DAILEY TIMOTHY �.A
Address: 425 30TH ST #23 Lic Expire:
Address:
9332 WINTERWOOD CIR
NEWPORT BEACH CA 92663 Bus Lic:
HUNTINGTON BEACH CA 92626
Phone: 949-675-2626 Lic Exp Date:
Phone:
714.962-6903 State Lic:C-039489
Code Edit :
2007
Type of Construction:
V-B
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
0
No of Units :
1
Bldg Height:
0
Bldg Sprinklers:
Y
Flood Zone:
Issued Date: 09/16/2010
Construction Valuation:
$23,000.00
Building Permit Fee: $381.90
Plan Check Fee: $274.97
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$1.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Fee Increase: Fee:
$11.40
Additional Fee :
$0.00
Hazardous Mat:
$0.00
Building Green Fee:
$1.00
TOTAL FEE : $670.27
PROCESSED BY:
Worker's Compensation Insurance
Carder:
Policy No:
Expire:
Building Setbacks Rear: I
Front: /
Left: /
Right: I
Use Zone:
Parking Spaces: 0
Solar System PC : $0.00
Excise Tax: $0.00
Grading Permit Fee: $0.00
Grading PC Fee:
$0.00
WQ Insp. Fee:
$0.00
Electrical W
$0.00
Mechanical %:
$0.00
Plumbing %:
$0.00
Plan Check Fee
Designer: GUIDERO WILLIAM
Address: 425 30TH ST #23
NEWPORT BEACH CA 92663
Phone: 949.675-2626
Special Conditions
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
N
Fire Department
$0.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
$274.97 Fee Due at
PUBLIC WORKS APPROVAL:
ZONING APPROVAL: 1 Iy i!I�V PLAN CHECK BY: _
GRADING APPROVAL: �_ _ APPROVAL TO ISSUE:
:�YRlll, F:.PIFE W DAY,d AFTER ISSUANCE OR LAST VALID INSPECTION.
$0.00
$0.00
Issuance : $395.30
TE:
I hereby affirm under penalty of perjury that i am exempt from the Contractors' State License Law for the reason(s)
indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions PERMIT EXPIRED
Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its
issuance, also requires the applicant for the permit to file a signed ,statement that he or she is licensed pursuant to the
provisions of the Contractors' State License Law (Chapter 9 (cos' ned state h Section 7000) of Dpivision 3 violation
Business and
70 1 5 by any applicant fora pnrmlt a ecispthe applicant to a crvllhpe'alty of not more9han flue hu�dredndollsrs I($SOOSection PERMIT CANCELLED
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (� all of or ( ) 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 he
to an owner of property who, through employees' or personal effort, builds or improves the PERMIT EXTENDED
��CCAAerty, provided tha�yt�tt a improvements are not intended or offered for sale. If, however, the building or improvement Is sold
�v'seln one year of2comDletion, the Owner -Builder will have the burden of proving that it was not built or improved for the
PVeo�. PERMIT FINAL
er of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or
eon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License CERTIFICATE OF
Law). OCCUPANCY ISSUED
❑ 1 am exempt from licensure underthe Contractors' State License Law for the following reason:
m
it O
that,
Section 7044 of the Business and rrotessions c
ollowing Web site:http://www.leginfo.ca.gov/calaH
Signature of Property Owner or Authorized Agent
itch I must have resided for at least one year DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
ell a structure that I have built as an own - REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE 1403.
iderstand that a copy of the applicable I
when this application is submitt ❑ I SUBMITTED ASBESTOS NOTIFICATION TO:
Da �.rO Q ❑ EPA
❑ AOMD
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licens under provisions of Chapter 9 (commencing with Section 7000)
of Division 3 of the Business and Professions Code, and m icense is in full force and effect.
License Class License No.
Date Contractor 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.
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 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 the performance of the work for which this permit is
issued.
Policy No.
❑ 1 have and will maintain workers' compensation insurance, as requiredinsurance
Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued. My workers' compensation carrier and policy number are:
Carrier Policy Number Expiration Date
Name of Agent Phone #
❑ 1 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 tothe workers' comppensation laws of California and agree that, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY
1 hereby affirmunder penalty of pperjury that there is a construction lending agency for the performance of the work for
which this permit is issued (Section 3097, Civil Code).
Lenders Name
Lender's Address
By 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 anq state la
I authorize representatives of this city or county tognter th 5P ve dentifiec
Signature of Property Owner or Authorized Agent
Print Property Owner's or Authorized Agent's
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
construction. '
n purpose . �/
late
)
FOR OFFICE USE ONLY
0110112009