HomeMy WebLinkAboutX2022-1218 - PermitsCity of Newport Beach - Building Division
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'X2022-1218*
COMB Permit: X2022-121
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Project No : 0953-2022
Inspection Requests Phone(949)644-3255Combination
Type - BLDG
Issued Date : 2022
rea :
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: 387 VISTA BAYA NB
Description: SFR BLOCK WALL 5' @ POOL EQUIPMENT
Legal Desc.: N TR 2609 LOT 15
Owner: RISCALIA DANIEL/MICHELINE Contractor:
SO - CAL POOLS Architect:
Address: 387 VISTA BAYA Address:
18223 BETONY
PLACE Address:
NEWPORT BEACH, CA 92660
SAN BERNARDINO,
CA 92407
-
Phone: Phone:
909-843-7172
Phone:
State Lic: '
a
Applicant: HOLDER AARON Con State Lic: 877295
Engineer:
"
Address: 18223 BETONY PLACE Lic Expire:
06/3112024
Address:
SAN BERNARDINO, CA 92407 Bus Lic:
BT30065408
'
Phone: 661-487-2396 Lic Exp Date:
1213112022
Phone:
State Lic:
a
Code Edit: 2019 Worker's Compensation
Insurance
Designer: HOLDER
AARON
Type of Construction: VB Carrier:
EXEMPT NO EMPLOYEES
Address: 18223 BETONY
PL
Occupancy Group: U Policy No:
SAN BERNARDINO
CA 92407
Added /New sq.ft. Bldg: 0 Expire:
Phone: 909.843-7172 "
Added /New sq. ft. Garage: 0
No of Stories: 0 Building Setbacks
Rear: 20
Special Conditions:
No of Units: 1
Front: 20
Bldg Height: 0
Left: 5
Bldg Sprinklers:
Right: 5
Flood Zone: X Use Zone:
Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $15,000.00
Building Permit Fee: $331.00 Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $287.97 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:
$0.00
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
PAN Plan Check : $0.00
Grading Bond: $0.00
Hazardous Mat $0.00 Electrical %:
$0.00
San Dist: $0.00
Building Green Fee : $1.00 Mechanical %:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $619.97
Plan Check Fee
: $0.00 Fee Due at Permit Issuance : $619.97
PROCESSED BY: 7 �j
PUBLIC WORKS APPROVAL:
C
�^
5 fiC
ZONING APPROVAL: 1
PLAN CHECK BY:
GRADING APPROVAL:
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 (a) 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 3 of the Business and
Professions Code) orthat 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).
❑ 1, 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 f,Lr,l ,icensure under the Contractors' State License Law for the fallowing reason:
By my signature te'c n 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,
call A stmoture thPt I hive 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
F:ofessiGns Coda, 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 Date
L-CENSED CONTRACTOR'S DECLARATION
I hereby affirm unr'er p':nalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7X of Division 3 of the Business and Profess1on and my li Is in full force
a,,d uffec, License Class License No Date 1 - Contractor Signature JG "
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.
Eereby affirm under pLr.alty 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
formar.ce of the worh.-or, which this permit is issued. Policy No.
have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code,
trance carrier and policy number are:
Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
for the performance of the work for which this permit is issued. My workers'
Policy Number Expiration Date
ie of Agent Phone #
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
if I should become su/bje/ct ty/t�e''n kers' compensa Islons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. X
lature of Applicant /�` ( I Date- ` — 12 - Z Z
CLARATION REGARDWO CONSTRUCTION LENDING AGENCY
ereby 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).
Ider's Name Lender's Address
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 and state laws relating to building construction.
authorize representatives of this city or county to enteCAUaa4pven
8fied property for inspection purposes.
Signature of Property Owner or Authorized Age
ACTION I DATE I BY
PERMIT EXPIRED
PERMITCANCELLED
PERMITEXTENDED
PERMITFINAL ����
CERTIFICATE OF
OCCUPANCYISSUED
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
15 NOTAPPLICABLE TO
FOR OFFICE USE ONLY
Date s 1'Z..-
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