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Home My WebLink AboutXR2024-0998 - Permits�E "9T. City of Newport Beach II IIIII I IIII IIIII IIIIIIIIIIII IIIII II� III jj COMB Permit : XR2024-0998 D� 6 Community Development Department- Building Division X R 2 0 2 4 0 9 9 8 a t G w 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2024-0549 Permit Counter Phone: (949) 718-1888 Issued Date: 04116/2024 newportbeachca.gov/civic Final Date: q��FoaN�P Combination Type - Permit Status: Issued ,cur Work Class - Other Inspection Area : 3 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 1681 PEGASUS ST Legal Desc : N TR 4146 BLK LOT 26 Description: SFR BLOCK WALL 52 LF X 6' HIGH ON P/L Owner: KLODIAN GJOKA Contractor: OWNER/BUILDER Architect Address : 1681 PEGASUS ST Address : Address NEWPORT BEACH, CA 92660 Phone: (317)448-5203 Phone: Phone: Con State Lie: OWNER/BUILDER State Lie: c Lie Expire Applicant: KLODIAN GJOKA Bus Lie: Engineer: Address : 1681 PEGASUS ST Bus Lie Expire : Address NEWPORT BEACH, CA 92660 Phone : (317) 448-5203 Workers' Compensation Insurance Phone : y' Carrier : E^ Owner/Builder : Policy No: Designer: Address : W. C. Expire: Address Phone: Phone: yy 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 : . , Bldg Height: No of Stories : 0 Added/New sq. ft. Garage: 0 TOTAL sq. ft.: 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 OWNER -BUILDER DECLARATION I hereby affinn 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 items) (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 Contractor; 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 n more than five hundred dollars (S500). as owner of the property, or my employees with wages as their sale compensation, will do II 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 owne f p party 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). 111, 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 legal) sell a structure that I have built as an owner-build-r 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 Bu 'ness and Professions Code., is available upon request whe. s a cation is submitted or at the following Web site:htip:livA=,w.leginfe.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent m Date "I,_ LAI LICENSED CONTRACTOR'S DECLARATI Q N 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, ad 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 EMPLDYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1S100,0001.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: I have and will maintain a certificate of consent to sell -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. DI 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 # ❑I certify that, inthe performance of the work for which {tits permit is issued, I shall not employ any person in any manner so as to become subject to the workers comps sation laws of California, and agre that, if I should becomeNippect to the workers compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant _ _ __ Date DECLARATION RE:OA ISIN ONSTRUCTION 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, C 1€ Code). Lender's Name Lender's Address By my signature below, I certify to each of the following: I am the propert, niter or authorized to act on the property owner's behalf. I yn"f read this application and the information I have provided is correct. I agree to comply with all applicable city and u Ay ordinances and state laws relating to building construction. I authorize representatives of this city or count o enter th _hove -identified property for inspection purposes. /� Z 51 nature of Pro. e y Owner or Authorized A em Print Property Owner's or Authorized Agent's Name �L. 4) A-TION I DATE. BY I DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY [, REGULATIONS PART 51 OF TITLE 40 AND AOMD RULE 1403 FE&VO EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO t"TWI)(AN'CELLED EPA P€RNilT fXTFNDED /�n l�((� IJAOMD ," ERPAIT I`rNA! OS 1124 UL TOIN [ 56E5T05 N TIFICA11ON 15 NOT APPLICABLE 10 CERTIFICA7F Of w I € PRO ZED OLI OCCUPANCY ISSUED JM SIGNATURE: