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Home My WebLink AboutX2021-0282 - PermitsMawr City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII� II COMB Permit: X2021-0282 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 0 2 8 2 Project No: 2896-2018 r Permit Counter Phone (949)644-3288 q it Inspection Requests Phone (949)644-3255 Combination Type - BLDG Issued Date : Area : 2021 cJraw Inspection Area 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0411912024 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: 621 ROCKFORD RD NB h rrr111 Description: NEW RETAINING WALL 24 LF X 30-36" HI @ NORTH SIDE YARD (INSIDE PIL) RFV20.1336 Legal Desc.: N TR 3519 LOT 138 V 1 i Owner: CHRISTENSEN DANAE Contractor: BLACK PETE CONSTRUCTION INC Architect: OLDHAM RYAN Address: 621 ROCKFORD RD Address: 1788 MONROVIA AVENUE Address: 2651 E. CHAPMAN AVE #110 CORONA DEL MAR, CA 92625 Phone Applicant: OLDHAM RYAN Address: 2561 E CHAPMAN AV #110 FULLERTON CA 92831 Phone: 714-482-8296 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: Flood Zone: Building Permit Fee: $246.00 Plan Check Fee: $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $6.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE : $253.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: COSTA MESA CA 92627 FULLERTON, CA 92831 Phone: 714-612-7678 Phone: 714-482-8296 State Lic:CO29715 Con State Lic: 692383 Engineer: LOTHROP SHAWN DUANE " Lic Expire: 0813112022 Address: 29970 TECHNOLOGY DR, STE 212 Bus Lic: BT00003226 MURRIETA CA 92563 Lic Exp Date: 0413012021 Phone: 951-600-0032 x204 State LiaS-005627 Worker's Compensation Insurance Designer: Carrier: EXEMPT Address: .,.. , Policy No, Expire: Phone: Building Setbacks Rear: 20' CANYON Special Conditions: REV20-1336 Front: 6' Left: 6' Right: 6' ; Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Excise Tax: $0.00 Planning Department - Fire Department Additional Fee: $0.00 Plan check Fee : $0.00 Fire Inspection: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 WO Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 PAN Plan Check: $0.00 Grading Bond: $0.00 Electrical %: $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 Plan Check Fee $0.00 Fee Due at Permit Issuance : $253.00 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 ie 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 Irofessions 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 of more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 nprovements 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 nproved 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 pply 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 Iicensure under the Contractors' State License Law for the following reason: ly 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 legally ell 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 Irofessions 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 .ICENSED CONTRACTOR'S DECLARATION hereby affirm ur.ds: penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Se n 7 f Di ision 3 of the Business an Professions dE my license is in full force rd cf`==-:t. Licnrse Class License No D Contractor ture VORKERS' COU IPENSATION DECLARATION It IARNING. FAILURE TC SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE OST'O'r COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby, affirm unda, penalty of perjury one of the following declarations: I have and w l' maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for IN ertormnnce of the wort for which this permit is issued. Policy No. have and will ,naintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' "ants carrier and policy number are: Tier_ Policy Number Expiration Date ; o'Agent,Phone# /certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workerialcompensation laws of California, and agree t, if I should become subjecttor ers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Ay.( cant CLARATI EGARDING CO STRUCTION LENDING AGENCY^� Jreby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ider's Name Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances nd state laws relating to building construction. I authorize representatives of this city d%$unty to entey ordinances property for inspection purposes. e 17 le,. Signature of Property Owner or Authorize -Tent l�� — Print Property Owner's or Authorized A ent's a �..c.� /X ! I w w�/ ate 117 U 11 ACTION DATE BY DE RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY RE LATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED UEPA PERMIT EXTENDED UAQMD PERMITFINAL ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: