HomeMy WebLinkAboutX2022-1443 - Permits1443' COMB Permit: X2022-1443
�wr,T,r City of Newport Beach -Building Division X2022-project No : 2349-2021
10o Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Issued Date : 05/2012022
Inspection Requests Phone (949)644-3255
o �> Combination Type - BLDG Inspection Area : 3
i'L BE
PaConlstruct on Hours: Monday �Frsiday 7 00 a.m. to 6A30 p.m. ands Saturday from 8 00 a.m. o 6:00 p.m No work on Sundays )or Holidays
Job Address: 1459 GALAXY DR NB A
TAL X 6' HI (INSIDE P/L) X2021-2712 PERMANENT MARKERS ONSITE
Description: BLOCK WALLS 190 LF TO/Av
Legal DeSC.: N TR 4224 LOT 257 architect:
Contractor: MILO CONSTRUCTION
Owner: VON DER AHE DANIELLE & GEOFF Address:
Address: 1459 GALAXY DR Address: 101 VIA MONTE PICAYO
SAN CLEMENTE CA 92673 Phone: State Lic:
NEWPORT BEACH, CA 92660 Phone: 949-290-6429
Phone: Engineer:
Applicant: MILO CONSTRUCTION
Con State Lic: 871429 Address:
Lic Expire: 03131/2024 ,
Address: 101 VIA MONTE PICAYO Bus Lic: BT30038762 phone: State Lic:
SAN CLEMENTE CA 92673 Lic Exp Date: 0313112023
Phone: 949.290-6429 Designer:
2019 Worker's Compensation NO EMPLOYEES Insurance Address: ,
Cade Edit : Carrier: ' •' -
Type of Construction: U Policy No: Phone:
Occupancy Group: 0 Expire:
Added /New sq.ft. Bldg: Special Conditions:
Added /New sq. ft. Garage: 0 Building Setbacks Rear: 6 -
No of Stories: Front: 15 ,
No of Units : 0 Left: 6
Bldg Height: 0 Right: 6 -'
Fire Hazard Zane : N
Bldg Sprinklers: ,
Use Zone: Parkin Spaces:
0 - '
Flood Zone:
Construction Valuation: S15 000.00 Fire Department
Excise Tax: $0.00 Planning Department - 52.00 Fire Inspection: $0.00
Building Permit Fee: $331.00 Plan check Fee : $ $0.00
Plan Check Fee: $287.97 Additional Fee : $0.00 Fair Share : $0.00 Fire Plan Rev
Grading Bonds Fee: $0.00 SJH Trans : $0.00 Demolition Fee
Overtime Plan Ck: $0.00 Grading PC Consultant : $0.00 Building Dept Adm $0.00
0.00 0.00 In -lieu Housing Fee : $0.00 $0.00
Investigation Fee: $ Grading Permit Fee: $ General Service
Record Management: $2.00 Public Works Department- Refund Deposit $0.00
Compliance: $0.00 Grading PC Fee: $0.00 park Dedication : $0.00 $0.00
Energy WQ Insp. Fee : $0.00 Grading Bond:
CA Seismic Safety : $0.00 PAN Plan Check : $0.00
Disabled Access : $0.00 $0 00 San Dist: $0.00 $0.00
Hazardous Mat $0.00
Electrical - $1 NMUSD Fee: $0.00 $0.00
Mechanical %:
Building Green Fee : $1.00 plumbing %: $0.00
TOTAL FEE : $673.97
Plan Check Fee : $0.00 Fee Due at Permit Issuance : $673.97
PUBLIC WORKS APPROVAL:
PROCESSED BY: PLAN CHECK BY:
ZONING APPROVAL:
APPROVAL TO ISSUE: .--
GRADING APPROVAL:
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 ir of the Business and
Professions Code) or that he or she is exempt from licensors 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
e work,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property w)ho, through Portion, of employeeand
the
ersonal structure
is not
intenduilds ored
or offered
the for
sale
rty, (Section 7044, 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
❑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).
I 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 Iegall,
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
LICENSED CONTRACTOR'S DECLARATION Date
I hereby affirm unr+er p=nalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 of Division 3 of the Business and Profes s Code d
and effect. License Cless License No
Date 2Z zz Contractor Signature Y cerise is in full force
VJO:3Y.ERS' C^AgPSNSATION DECLARATION
NARNING: FAILURE TO S-nURE 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 OL COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. nereuy affirm under penalty of perjury one of the following declarations:
:J ' ha,. e 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 th
)erformance of the work for which this permit is issued. Policy No.
. JI have; and wil' 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' compensatio
JI a vc carrier and policy number are:
,ac ier Policy Number
I e of Agent Expiration Date
`=rtlfy that,Jri the'performance o the work for which thi ermit is issued, I shall not employ an Phone #
iat, if I should b„comE subject to th workers' c ensat' p Y Y person in any manner so as to become subject to the workers' compensation laws of California, and agre
p provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant
DECLARATION REGAR G CO ST CTION LENDIN AGENCY Dat� 2Z - 2'L hereby affirm under penalty of perjury that there is a con n lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
seder's Name
y my signature below, I certify to each of the following: Lender's Address
1 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 inances d st a laws relating to building construction.
I authorize representatives of this city or county to e r the abo -ide ti ad property for inspection purposes.
gnature of Property Owner or Authorized A ant
CTION Print Property Owner's or Authorized Agent's Name 1C� D�(v2
DATE BY REGULATIOCLARATIONNS
OF PAC MPLF TITLE
WITH CODE OF FEDERAL Dafe ' Z2.-
REGULATIONSPART610FTITLE40ANDAOMDRULE FOR OFFICE USE ONLY
:RMIT EXPIRED 1403
RMIT r'e mrn r rn
I SUBMITTED A5BES 5 NOTIFICATION TO
PEMMITFINAI
CERTIFICATEOF ( J ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
OCCUPANCYISSUED PROPOSED DEMOLITION