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Home My WebLink AboutX2022-0762 - PermitsrW roq City of Newport Beach - Building Division .. ;� 100 Civic Center Drive, Newport Beach, CA 9266C Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - BLDG COMB Permit: X20 Project No . 0677-2022 Issued Date : 03/16/2022 Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0311612025 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: 119 SHORECLIFF RD NB Description: SFR BLOCK WALL 36" X 30 LF (INSIDE P/L, MARKERS ON SITE) Legal Desc.: N TR 1116 LOT 116 , Owner: BENTLEY GREG & DONELLE Contractor: PATTERSON CONSTRUCTION Architect: Address: 119 SHORECLIFF RD Address: 15 CORPORATE PLAZA STEA 50 Address: COM CA 92625 NEWPORT BEACH CA 92660 Phone: Phone: 949-723-1800 Phone: State Lic: Applicant: CULLER SHAWN Con State Lic: 802367 Engineer: Address: 15 CORPORATE PLAZA #150 Lic Expire: 07/3112022 Address: NEWPORT BEACH CA 92660 Bus Lic: BT02110534 Phone: 949-5301-8629 Lic Exp Date: 09/3012022 Phone: State Lic: Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: STATE COMP Address: Occupancy Group: U Policy No: 9065406 Added /New sq.ft. Bldg: 0 Expire: 08/01/2022 Phone: Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: 6' Special Conditions: No of Units : 0 Front: 25' Bldg Height: 0 Left: 6' Bldg Sprinklers: Right: 6' Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $10,000.00 Building Permit Fee: $246.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $214.02 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 PNV 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: $461.02 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Plan Check Fee $461.02 Fee Due at Permit Issuance : $0.00 PU3LIC WQPKS APPROVAL: M Pf_AN 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 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 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 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 Iegalll 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 0 of Vision 3 of the Business and Professions and my license is in f erce and effect. License Class License No Date Contractor Signatur 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 HUNDR HOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I hereby affirm under penalty of perjury one of the following declarations: 111 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 th performance of the work for which this permit is issued. Policy No. ave and will a aI workers' co tion 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 ^ urance carrier an o number ar 1 Expiration Date le of Agent �f`IxE certify that, in the performance if I should become suLyEct to, of Applicant work A 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 rkers' co pensation provisions of 3700 of the Labor Code, I shall forthwith comply with those provisions. tin 9�'e, Z-w IECLARATION REG*DltR%ItONSTRUCTION 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 ly 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 I courLty j� n th bove-idenyfied propert ruction purposes. Jnnature of PmDsrtv Owner or Authorized Agent i( ./Lss-+ �A�/ Print Property Owner's or Authorized Agent's N ACTION DATE BY Pt"CLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED LIEPA PERMIT EXTENDED QMD _ PERMITFINAL p p j a4— ASBESTOS NOTIFICATION IS NOTAP-LICABLL TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: