HomeMy WebLinkAboutX2021-2840 - PermitsCity of Newport Beach - Building Division 11111111111111111111111111111111111111111111111111111COMB Permit: X2021-2840
' 100 Civic Center Drive, Newport Beach, CA 92660 x 2 0 2 1 2 8 4 0 Project No
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Issued Date : 10/19/2021
`Oz,yoa' Combination Type - BLDG GRAD
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, PROJECTS MUST BE COMPLETED BY 1011912024 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: 409 CATALINA DR NB
Description: SFR SLURRY FILL WHERE FOOTING UNDERMINED BY UNPERMITTED TRENCH AT FRONT ELEVATION *STOP WORK*
Legal Desc.: N TR 1136 LOT 60
Owner:
ANDERSON PAUL
Contractor:
Address:
409 CATALINA DR
Address:
NEWPORT BEACH, CA 92663
Phone:
310-709-6579
Phone:
Applicant:
ANDERSON PAUL
Con State Lie:
Address:
409 CATALINA DR
Lie Expire:
NEWPORT BEACH, CA 92663
Bus Lie:
Phone:
310-709-6579
Lie Exp Date:
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 Valuation:
Building Permit Fee:
Plan Check Fee: $0.00
Overtime Plan Ck:
Investigation Fee:
Record Management
Energy Compliance:
CA Seismic Safety:
Disabled Access
Hazardous Mat
Building Green Fee
PROCESSED BY:
OWNER/BLDR Architect:
Address:
1w
S P C CTO R
Phone:
1 I V
State Lie:
O/B Engineer:
Address:
Phone:
State Lie: ,
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
Building Setbacks
Use Zone:
$0.00
Excise Tax:
Additional Fee
$0.00
Grading Bonds Fee:
$0.00
Grading PC Consultant
$0.00
Grading Permit Fee:
$0.00
Grading PC Fee:
$0.00
WQ Insp. Fee:
$0.00
$0.00
Electrical W
$0.00
Mechanical %:
Plumbing %:
TOTAL FEE: $1,946.00
ZONING APPROVAL:
GRADING APPROVAL:
Rear: /
Front: /
Left: 1
Right: /
Parking Spa
$0.00
$0.00
$0.00
$0.00
$1,946.00
$0.00
$0.00
$0.00
$0.00
$0.00
Designer:
Address:
Phone:
Special Conditions: O/B FORM ATTACHED
121.3068
Fire Hazard Zone : N
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
Plan Check Fee : $1,946.00
Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Fee Due at Permit Issuance : $0.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
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
:he 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 Iicensure 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
for the purpose of sale).
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 Iicensure 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 legall,
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, Secti n 7044 of the Business and
Professions Code, is available upon request en applica own js s netted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm). '
Signature of Property Owner or Authorized Ag D t NOV 4 2 /
LICENSED CONTRACTOR'S DECLARATION
I 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
and effect. License Class License No Date Contractor Signature
COMPENSATION DECLARATION
ARNING:FAILURE TO SECLRE 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 UI UOMPENSP1014, 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:
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 thi
erfornlance of ttr.e perk for which this permit is issued. Policy No.
6Lve 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'
rance carrier aril policy number are:
r E-
a.c cf Agent
Policy Number
Date
4Nde'hify that, in file performance of thew r w this permit is issued, I shall not employ any person in any manner so as to become subject to the wor rs' compensation laws of California, and agre,
fat, if, should beco subject to the wor s' on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of App nt co ate_ 4-/y4 / u
ECLARATIO GARDING CONSTRUCTION LENDING AGENCY
hereby 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).
ender's Name Lender's Address
y 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 I es a state laws relating to building construction. f�
I authorize representatives of thi r county to er the bove-i entified property for inspection purposes.
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ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY v V
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
DEPA
PERMIT EXTENDED
DAQMD
PERMITFINAL
CERTIFICATE OF
OCCUPANCY ISSUED
Z 'JL3/Z
3N%Pk �W
B,(-
ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION
SIGNATURE:
a?op
;wrnt, City of Newport Beach - Building Division *X2021-2840*
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
m mr-
I Requests Phone (949)644-3255 INS
Combination Type - BLDG GRAD � �'! --�
COMB Permit: X2021-2840
Project No
Issued Date : 10/1912021
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 10/19/2024 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:
409 CATALINA DR NB
Description:
SFR GRADING 8 RECOMPACTION
WHERE FOOTING UNDERMINED BY UNPERMITTED TRENCH AT FRONT ELEVATION *STOP WORK*
Legal Desc.:
N TR 1136 LOT 60
Owner:
ANDERSON PAUL
Contractor:
OWNER/BLDR Architect:
Address:
409 CATALINA OR
Address:
Address:
NEWPORT BEACH, CA 92663
Phone:
310.709-6579
Phone:
Phone: State Lic: '
Applicant:
ANDERSON PAUL
Can State Lic:
O/B Engineer:
Address:
409 CATALINA DR
Lic Expire:
Address:
NEWPORT BEACH, CA 92663
Bus Lic:
Phone:
310-709-6579
Lic Exp Date:
Phone: State Lic:
Code Edit : 2019 Worker's Compensation Insurance Designer:
Type of Construction: Carrier: Address: ,
Occupancy Group: U Policy No:
Added /New sq.ft. Bldg: 0 Expire: Phone: , • "'
Added /New sq. ft. Garage: 0
No of Stories: 0 Building Setbacks Rear: / Special Conditions: O/B FORM ATTACHED
No of Units : 0 Front: / I21-3068
Bldg Height: 0 Left: /
Bldg Sprinklers: Right: /
r=in,H 7nno Ilse 7nne: Parkina Spaces: 0 Fire Hazard Zone : N
Construction Valuation:
$0.00
Building Permit Fee:
$0.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $0.00
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:
$0.00
Grading Permit Fee:
$1,946.00
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
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
Disabled Access :
$0.00
P/W Plan Check:
$0.00
Grading Bond:
$0.00
Hazardous Mat
$0.00
Electrical W
$0.00
San Dist:
$0.00
Building Green Fee :
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $1,946.00
Plan Check Fee
: $0.00
Fee Due at Permit Issuance :
$1,946.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE: JI
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)
(Section7031.5, 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 L) all of or L) 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
pp n 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 II -ensure under the Contractors' State License Law for the following reason:
Dp my-s'gnature hrlm^, 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 stlucture chat I have built as an owner -builder if i has not bee cted in its entirety by licensed contractors. 1 understand that a copy of the applicable law, Section 70 4 of the Business and
Professions Code, is available upon request when I application is subnabAd or at the following Web site:http://www. leginfo. ca.gov/calaw.html.
Cignctjre of Property Owner or Authorized Agent Date )� CY 2/
LICENSED Cl nITPACTOR'S DECLARATIO
i herehy 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
and effect. License Class License No Date Contractor Signature
WORKERS' CLIMPENSATION DECLARATION
�INAPN'NGFAILURE 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
GOUT OF COMPENS'.TION ^AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm urd=r 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 the
performance of the wort( for which this permit is issued. Policy No.
1 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
insurance carrier and policy number are:
Carrier Policy Number Expiration Date
Name of Agent Phone #
I 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 agree
that, if I should become 9Ubject to th r er ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant`' Date
DECLARATION REGARDI STR CTION LENDING AGENCY
I hereby 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 IS).
Lender's 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 owners behalf.
I have read this application and the information I have provPa
adct. \
I agree to comply with all applicable city and count ordinato laws relating to building construction. ) /90(�Z/
I authorize representatives of this city or count enter thtified property for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name 7C�`w't� D
ACTION DATE BY DECLARATION dF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
CERTIFICATE OF
OCCUPANCY ISSUED
�ts'^
I SUBMITTED ASBESTOS NOTIFICATION TO
EPA
TO