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Home My WebLink AboutXR2024-0998 - Permits (3)EWF,o?T City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit XR2024-0998 e ,,.'i e'.. Community Development Department- Building Division : �r 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2024-0549 u . z, Permit Counter Phone: (949) 718-1888 Issued Date : 04/16/2024 newportbeachca.gov/civic Final Date: Combination Type - ' Permit Status: Issued Work Class - Other. 1GG gg =4 Inspection Area : 3 v d,W� � l PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELA URDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS S-3-Zo?zl r lcli»it?I Job Address: 1681 PEGASUS ST Legal Desc : N TR 4146 BLK LOT 26 Description: SFR RETAINING BLOCK WALL 52 LF X U HIGH ON P/L Owner: KLODIANGJOKA Contractor: OWNER/BUILDER Architect: Address : 1681 PEGASUS ST Address : Address NEWPORT BEACH, CA 92660 Phone: (317)448-5203 Phone: Phone: Con State Lic : OWNER/BUILDER State Lie Lie Expire Applicant : KLODIAN GJOKA Bus Lie : Engineer: MOKSUDUR RAHMAN Address : 1681 PEGASUS ST Bus Lie Expire : Address : 13611 12TH ST, STE B NEWPORT BEACH, CA 92660 CHINO, CA 91710 Phone : (317) 448-5203 Workers' Compensation Insurance Phone : (213) 400-8078 Carrier: EXEMPT Owner/Builder : Policy No : 0000 Designer: Address : W. C. Expire: Address Phone: Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $4,500.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 Occupancy Groups : U No of Units : 0 Alteration sq. ft. Bldg : , 1. , Bldg Height: No of Stories : 0 Added/New sq. ft. Garage: 0 TOTAL sq. ft. 0 , Building Setbacks : Front: 20, Side: 5, Side: 5, Rear: 25 Flood Zone: X Use Zone : SP-7 - Santa Ana Heights Specific Plan PROCESSED BY: SPECIAL CONDITIONS: STANDARD PLAN ��Zoty-d892 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate 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 Prafessions Code) or that he or she is exempt from ficensure and the basis for the alleged exemption. Any violation of Section 7031..5 by any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). FI, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7G44, usinass 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. 11, 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 of improved for the purpose of sate). 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 ficensure under the Contractors' Stale 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 feast one year prior to comp) ion of the Improvements covered by this permit, I cannot legally sell a structure that I have built as an ewner builder if it has riot been constructed in its entirety by licensed contractors. I understand that a cop O sable taw Section 7044 of [ha Business and Professions Code, is available upon request when this application>submitted or at the following Web site:http:llwww,leginfo.ca,govtcalaw.html, Signature of Property Owner or Authorized Agent ,_______,_ > Date - LICENSED CONTRACTOR'S DECLARATION I hereby affirm udder 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, and 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 if100,0001,1N ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION $706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the fallowing 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 lh 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' compensatio insurance carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # 1 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 agre that, if I Should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. , Signature of Applicant __-�Date,-„ �l L DECLARATION REGARDING CONSTRUCTION LENDING AGENCY I 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),. Lenders Name _ _ Lenders Address _ By my signahue oalow. I certify to each of the following: I am the pwpeny owner or authorized to act on the property owner's behalf. ;;lave re.,G fats application and the information I have provided is Correct. I agree to conplywith all applicable city and county ordinances and state laws relating to building construction. 1 authorize r^presentatives of this city or county to enter the above -identified property for inspection purposes. Signature of PrioMy Owner or Authorized Agent Print PropertyOwner's or Authorized Agent's NameJ' Date ACTION DATE BY i DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY ' REGULATIONS PART et OF TITTLE 40 AND AOMD RULE 1403 P[h)MIT ENPRED i 0 1 SUBMITTED ASBESTOS NOTIFICATION TO cHMITCAIVCEILED j--1IEPA PfRMl7 EXTENf1FD /�� pI��r� t_WOMD PEW 4IT FINAL W�Z�I�ZrI4 L.L tot- i& ASBESTOS NOTIFICATION IS NOT APPLICABfE TU Ceni1FICATE OF I f1,,1 PROPOSED DEMOUTIO OCCUPANCY [,SUED i j ! SIGNATURE: