HomeMy WebLinkAboutX2019-1577 - PermitsCity of Newport Beach - Building Division COMB Permit: X2019-1577
100 Civic Center Drive, Newport Beach, CA 92660 it X 2 0 1 9 1 5 7 7
Project No : 1880-2018
Permit Counter Phone (949)644-3288
1 Inspection Requests Phone (949)644-3255
rd: Issued D : 05117/2019
Combination Type - BLDG
spection rea : 2
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST V ECT/ON.
Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday fr a.m. tyo� 6:00,p�r;y-No Work on Sundays r Holidays
JobDesctlption: NEW RETA NDOLPHIN
RETAINING WALBLS 353 LF X 10' HIGH MAX `f( `dp Y,,C'aP G % (eWnd
Legal Desc.: N TR 1700 LOT 1 t�tR1t�% �K O 1p0
Owner: DOLPHIN LLC y„,� -tractor: JACK W M L act: WILSON TYLER SC
Address: PO BOX 70fi7 Ad as LLE HERAL Address4:, 4471 C A DRIVE
NEWPORT Phone: 949 698 2256EACH, CA 9 e S 9N4 L 3M C 7 P%Qne. "O4-754 4040 OMtMON CA State Lic:CO3 19
Applicant: WILSON TYLER SCOT �°}��• fate Engineer: MANSHADI FARHAD
Address: 24471 CHRISANTA DRI c ire' 1 0 0 Address: 1800 E 16TH ST UNIT B
MISSION VIEJO, CA 926 us Lb: T30055847 SANTA ANA CA 92701
Phone: 714-754-4040 D 07131/2019 one: 714-835-2800 State Lic:C-0368 0
Code Edit : 2016 orker's Compensate -Insurance ' esigner:
Type of Construction: Carrie C EXEMP Address:
Occupancy Group: U P o: (NMPLO
Added /New sq.ft. Bldg: 0 Ex Phone: C
Added /New sq. ft. Garage: 0
No of Stories: 0 ng S s Rear 5' \/\� S�aitions:No d!
Bldg fHegUnits
ht: 0 Front:
Left: BLUFF V 00 WptK
Bldg Sprinklers: / ght&
ri,...n I l e 7nr, _ PR ki a _ e 0 Fire Hazard Zone : N
Construction Valuation:_ $74130.00
Bri'd-rg Permit Fee: $412.00
Plan Check Fee: $365.00
Overtime Plan CI.:
$0.00
Investigation Fee:
$0.00
R^ccrd Management:
$0.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disdbled Access:
$0.00
HizardoLa Mat $0.00
Bailding Green Fee : $3.00
TOTAL FEE : $455.00
PROCESSED BY:
ZONING APPROVAL:
100
at Fee : ($365.00)
Bonds Fee: $0.00
PC Consultant
Pr;rRit Fee:
W Insp. Fee: 00
Elec 'c $0.00
Mech o: io: $0.00
Plumbing %: $0.00
GRADING APPROVAL: F' s
Plan Check Fee
Planning
1nSP�
ii
+ ee :
$0.00
Building Dept Adms
Department
-
General Service
Park Dedication :
$0.00
Refund Deposit
PAW Plan Check :
$0.00
Grading Bond:
San Dist :
$0.00
NMUSD Fee:
$0.00
$0.00
Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$455.00
PLAN CHECK BY: 1'yt ` ` t�
APPROVAL TO ISSUE:
OWNER -BUILDER
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)
lion 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 applica permit subjects the applicant to a civil penalty of
more than five hundred dollars ($500).
IJ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the agiWiptWthe structure is not
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, thro p oyees' or personal effort, bull
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one completion, the Owner -Builder will have
improved for the purpose of sale).
bye • {, r
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to c the project (Sglpt siness anrJ�la'rrQf(fs�'iawvo l
apply to an owner of property who builds or improves thereon, and who contrac a projects with a IicenseMM r ctor pursuert&ta ntractors' State
❑ I am exempt from licensure under the Contractors' State Lic or the following reason: 01, OC Vl
By my signature below I acknowledge that, except form residence in which I m e resided for ate a year prior to completio a impr
sell a structure that I have built as an owner -bull as not b e on t ct d entirety by licen d contractors. I understand tha y of the applica
Professions Code, is available upon re en th' ica io 1 s or at the follovl r b http:/Avww.lIp0%to calaw.html.
Signature of Property Owner razed Agent W
Doled or offered for sale (Section 7044,
or improves the property, provided that the
le burden of proving that it was not built or
Contractors' State License Law does not
,arise Law).
s covered by this permit, I cannot
Section 7044 of the Business and
Date
ICENSED CONTRAC R'S DECLARATI I ✓ _ .
hereby affirm under penal of perlelaa�li a ens under p�tOviswnsof Chapter 9 (commit Section 70 'v' io of the Business and Profe sio
rid effect. License Class VV Licengge No Date Contractor Signature
VORKERS' COMPENSA ION OMPENS
ION
ARNING: FAILURE TO SECURE w REFS CO GE -`UNLAWFUL, AND SHALL SUBJECT YE T IMI PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TH UDST OF COMPENSATION,DAMAGE S PECTI F THE LABOR CODE, INT S hereby affirm under penalty of erjollowing declarations�`I have and will maintain a rti
r or n ion, ued by the Director of Industrial F a {d1� fojoe,
ertormance of the work for whit this cP w�►]I have and will maintain worke cora , a e y Section 3700 of the Labor F th k``!1' c of theL �or which t
Isurance carrier and policy numbe arest'ad
arrier _ ,. NNIO�k Exoiration Date
of Agent I TT
dify that, in the performance of a work for
I should becomes b to a rkers' co
ure of Applicant
hereby affirm under penalty M perjurynder penalty perjury th�t
ender's Name
@d, %Wemploy any person in any manner so as to
&Seicon 3700 of the Labor Code, I s
thall forthwith
agency for the ante of the work f Ich t
_JEeer'a Address
full force
DOLLARS ($100,000), IN ADDITION TO THE
3700 of the Labor Code, for
My workers'
subjectgrJd In laths of California; 51914 ogre
Dat�/
\ 7
is issued (Section 3097, Civil Code).
3y my signature below, I certify to each of a tollowing:
am the property owner or authorized t ct n t ¢¢�rope ner's behalf.
I have read this application and the infor a4iJ f a provided is corr
I agree to comply with all applicable city d county ordin n sta elating to building construction.
authorize representatives of this city or c ty ratified property for inspection purposes.
3ignature of Property Owner or Authorized e t Print Propert Owner's or Authorized Agent's Na ` ['ate
ACTION DATE BY E RATI N OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
EGULATIONS PART 610F TITLE 40 AND AQMD RULE
PERMIT EXPIRED
'p
U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
OEPA
PERMIT EXTENDED
QMD
PERMITFINAL
CERTIFICATE OF
OCCUPANCYISSUED
-
0 A513ESTQS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION
SIGNATURE: