HomeMy WebLinkAboutX2022-1189 - Permits&w,f, City of Newport Beach - Building Division 'X2022. 1189` COMB Permit: X2022-11
k' P 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 0221-2021
Permit Counter Phone (949)644-3288
.� Inspection Requests Phone (949)644-3255 Issued Date : 0412512022
Combination Type - BLDG
Inspection Area : 5
Job Address:
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
424 FERNLEAF AVE NB
Description:
BLOCK WALL 24" HI X 45 LF (T WITHIN THE PIL)
Legal Desc.:
CORONA DEL MAR BLK 433 LOT 6
`O
Owner:
Address:
BIRE II LLC Contractor:
7642 W IRVING PARK RD Address:
MONTESANTOS BUILDERS INC Architect:
459 E ALLISON ST Address:
NORRIDGE IL 60706
ELMHURST IL 60126
Phone:
State Lic:
I"
Phone:
Phone:
630-514-5168
Applicant: MONTESANTOS GEORGE
Con State Lic:
1077463
Engineer:
Address: 2721 E COAST HWY, STE 105
Lic Expire:
0613012023
Address:
CORONA DEL MAR CA 92625
Bus Lic:
BT30076141
State Lic:
....
'
Phone: 9491239-2022
Lic Exp Date:
08/31/2022
Phone:
Code Edit: 2019
Worker's Compensation Insurance
Designer:
»
Type of Construction:
Carrier:
EXEMPT
Address:
occupancy Group: U
Policy No:
no employees
Added /New sq.ft. Bldg: 0
Expire:
Phone:
Added /New sq. ft. Garage: 0
0
Building Setbacks
Rear: /
Special Conditions:
,
No of Stories:
No of Units : 0
Front: /
-,
Bldg Height: 0
Left: /
Bldg Sprinklers:
Right: I
Use Zone: Parking S aces:
0 Fire Hazard Zone : N
,
Flood Zone:
0
Construction Valuation: $5,000.00
,
Building Permit Fee: $161.00
Excise Tax:
$0.00
Planning Department -
$52.00
Fire Department
Fire Inspection:
$0:60
,
Plan Check Fee: $140.07
Additional Fee :
$0.00
$0.00
Plan check Fee :
Fair Share : $0.00
Fire Plan Rev
$0.00
Overtime Plan Ck: $0.00
Investigation Fee: $0.00
Grading Bonds Fee:
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
General Service
$0.00
$0.00
Energy Compliance: $0.00
Grading PC Fee:
$0.00
$0.00
Public Works Department -
Park Dedication : $0.00
Refund Deposit
$0.00
CA Seismic Safety : $0.00
WQ Insp. Fee:
PNV Plan Check : $0.00
Grading Bond:
$0.00
Disabled Access : $0.00
Hazardous Mat $0.00
Electrical %:
$0.00
San Dist : $0.00
$0.00
Building Green Fee : $1.00
Mechanical %:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00
TOTAL FEE : $354.07
Plan Check Fee :
$0.00 Fee Due at Permit Issuance :
$354.07
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 reasons) indicated below by the checkmark(s) I have placed next to the applicable item (a)
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit toconstruct, 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
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 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 legalh
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 Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 Qiv 3 of the Business and Professions is in full force
and effect. License Class License No Date 7 Contractor Signature
NORKERS' COMPENSATION DECLARATION
NARNING: 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 I$100,000), IN ADDITION TO THE
COST OF COMP01S9 19N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm unr'er ?malty of perjury one of the following declarations:
I ha✓e and wi,, 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
)erformance of t':e wui:<for which this permit is issued. Policy No.
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'
:ante carrier aadpnlicy number are:
of Agent
erti`y that, to the performance of the
if I should become subjecNo the v✓D
igna,ure of Appli^Pot
Policy Number
Date
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 C lifornia, and agre
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
T Ei zS 2Z
Date_
IN I FN❑INr Af FNCV
hereby affirm under penalty of p'drjLry 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 qrdinarIces any state laws relating to building construction.
I authorize representatives of this city or county to baved property for inspection purposes.
ACTION
DATE
BY Z
DENARATION OF COMPLIANCE WITH CODE OF FEDERAL
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
UEPA
PERMIT EXTENDED
UAQMD
PERMITFINAL
�_.s .'�.`
ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF
PROPOSED DEMOLITION
OCCUPANCY ISSUED
SIGNATURE:
FOR OFFICE USE ONLY
Name
MID