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Home My WebLink AboutX2022-1026 - Permits's�rrov City of Newport Beach - Building Division r 100 Civic Center Drive, Newport Beach, CA 92660 4 n Permit Counter Phone (949)644-3288 Yam..._ Inspection Requests Phone (949)644-3255 Combination Type - BLDG 11IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2022-1026 x 2 0 2 2 1 e 2 6 Project No: 0278-2022 Issued Date : 0410712022 Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTERISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0410712025 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: 526 RIVERSIDE AVE NB Description: SFR (2) CMU RETAINING WALLS W/ RETURNS T15" X 2'4" Legal Desc.: FIRST ADD TO NEWPORT HEIGHTS LOT 7 ELK 35 Owner: SAMEN EDWARD Contractor: OWNER/BLDR Address: 526 RIVERSIDE AVE Address: SAMEN MICHAEL NEWPORT BEACH, CA 92660 Phone: 949-629-8263 Phone: Applicant: SAMEN EDWARD Con State Lic: O/B Address: 526 RIVERSIDE AVE Lic Expire: NEWPORT BEACH, CA 92660 Bus Lic: Phone: 949-629-8263 Lic Exp Date: Code Edit : 2019 Worker's Compensation Insurance Type of Construction: Carrier: Occupancy Group: U Policy No: Added /New sq.ft. Bldg: 0 Expire: Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: 5 No of Units : 1 Front: 20 Bldg Height: 0 Left: 4 Bldg Sprinklers: Right: 4 Flood Zone: X Use Zone: Parking Spaces: 0 Construction Valuation: $360.00 Building Permit Fee: $110.00 Plan Check Fee: $95.70 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management : $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $258.70 PROCESSED BY: ZONING APPROVAL: Architect: Address: Phone: State Lic: Engineer: THOMPSON MATTHEW Address: 12021 N TUSTIN AVE ANAHEIM CA 92807 Phone: 714-630-6100 State Lic:C-086051 Designer: Address: Phone: Special Conditions: •�, _ .A,. d 'id 4: Fire Excise Tax: $0.00 Planning Department - Fire Department Additional Fee : $0.00 Plan check Fee : $52.00 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 PNV 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 : $258.70 PUBLIC WORKS APPROVAL: 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(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 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 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 ap 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). 50 IV exempt from licensure under the Contractors' State License Law for the following reason: By my ignature 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 legal) sell a ructure that have built as an owner -builder if it has not be��eII,, constructed in its erllire by licensed contractors. I understand that a copy of the applicable law, Section 704q+of he Business and Prole sions Code, is available upon request when this application ";rGBmitted o at t http://www.leginfo.ca.gov/calaw.html. GCS' ' ature of Property Owner or Authorized Agent �/y��Cy��//�� -- Date LICENSED CONTRACTOR'S DECLARATI06V � I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, an my license is in full force and effect. License Class License No Date Contractor Signature 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 3T06 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S 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 the performance of the work for which this permit is issued. Policy No. ❑I 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' compensation insurance carrier and policy number are: Policy Number Agent Date Ify that, in the performance of the work for which this permi Issued, shall not employ any person in any manner so as to become subject to the workers' compen ation laws of California, and agree tat, i should become subject t �Wo ers' compensation Ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of ApplicantC�eeJJJJ�cc i �ZvJ�'— e �- IECLARATION REG ItIRSNNSTRLTCTION 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 'y my signature below,=1 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 o dances and state laws ng to building construction. I authorize representatives of this city or county toe lgXabove-idgntifie y for inspection purposes. of ACTION DATE BY - DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED II I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED DEPA PERMIT EXTENDED UAQM D PERMITFINAL ^(�•ZY _ ASBESTOS NOTIFICATION IS NOT APPLICABLY TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: