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Home My WebLink AboutX2020-0888 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 ti y (x Permit Counter Phone (949)644-3288 C 4 Inspection Requests Phone (949)644-3255 �'�41yuL4�� Combination Type - BLDG ��IIIIIIIIilllllllllllllllllilllllllllllllllllllllll �� COMB Permit: X2020-0888 x 2 0 2 0 0 8 0 e Project No : 2795-2019 Issued Date: 09/2912020 Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 09130/2023 OR PERMIT WILL BE NVALID Construction Hours: Monday - Friday TOO 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: 4515 ORRINGTON RD NB Description: SITE RETAINING WALLS/BIOPLANTER 100 LF X 13' HIGH (INSIDE P/L) Legal Desc.: N TR 3357 LOT 76 Owner: ZIEMBA FAMILY TRUST Contractor: S C HOMES INC Architect: TEALE MARK Address: 4515 ORRINGTON RD Address: 3050 PULLMAN ST Address: 2900 BRISTOL ST BLDG A203 CORONA DEL MAR, CA 92625 COSTA MESA CA 92626 COSTA MESA CA 92626 Phone: Phone: 949-723-4243 Phone: 949-975-0123 State Lic:CO22162 Applicant: TEALE MARK Con State Lic: 828216 Engineer: HAKIM FADY Address: 2900 BRISTOL ST BLDG A 203 Lic Expire: 12/3112021 Address: 124 PEONY COSTA MESA CA 92626 Bus Lic: BT30002421 IRVINE CA 92618 Phone: 949-975-0123 Lic Exp Date: 02128/2021 Phone: 310-422-1536 State Lic:C-07573(• Code Edit: 2016 Worker's Compensation Insurance Designer: Type of Construction: Carrier: STATE FUND Address: Occupancy Group: U Policy No: 1763760 Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 Expire: 01107/2021 Phone: No of Stories: 0 Building Setbacks Rear: 30 Special Conditions: No of Units, 0 Front: 6 Im Bldg Height: 0 Left: 6 Bldg Sprinklers: Right: 6 Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: Building Permit Fee: $1,478.00 Plan Check Fee: $0.00 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: $2.00 TOTAL FEE: $1,480.00 PROCESSED BY: 'V ZONING APPROVAL: �jL AM GRADING APPROVAL: ✓ k Excise Tax: $0.00 Planning Department - Additional Fee: $0.00 Plan check Fee Grading Bonds Fee: $0.00 Fair Share : Grading PC Consultant: $0.00 SJH Trans: Grading Permit Fee: $0.00 In -lieu Housing Fee: Grading PC Fee: $0.00 Public Works Department - WQ Insp. Fee: $0.00 Park Dedication : $0.00 PAN Plan Check: $0.00 Electrical %: $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 Plan Check Fee : $0.00 Fire Department $0.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $1,480.00 aloa�tarr�ar� � aaNGIVI_ M PLAN CHECK BY: 'yYY y "'s PPPFUVAL TO ISSUE: DocuSign Envelope ID: 1460C'.23-5942-4B4A-BOOF-D8EB7AC6FB2E s 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 Items) (Section /031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, Improve, demolish, or repair any structure, prior o its issuance. also requires the applicant for the permu t0 file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter g (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from Reassure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects he applicant to a civil penalty of not more than five hundred dollars ($500). 131, as nwner of the property, or my employees with wages as their sole compensation, will do (, all of or (_) pomons of the work, and the structure Is not intended or offered for sale (Section 7044, Business and Professions Cade: The Contractors' State License taw does not apply to an owner of property who, through employees' or personal effort, builds or improves 'he property, provided that the improven cents 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 ;)roving that it was not built Or rovec. for the purpose of sale). LI 1, as )wner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractor State License Law does not apply to ..n 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 sit[ -nature below 1 acknowledge that, except for my personal residence In which I must have resided for at least one year prior to completion of the improvements cove, red by this permit I cannot legally sell a stn.clura that I have built as an owner-bultler l it has not been constructed in its entirety by licensed contractors. € understand that a copy of the applicable law, Section 7G" of the Business and Professic ns Code, Is available upon request when this application is submitted or at the following Web site:ht1pY/www.leginfo.cagov/calaw.html. Signature. of Property Owner orAuthonzed Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby :IfOrm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 "nf q g4jlu*ps��rjd Profes ns Cod,, and my license is in full force antl effec.. License Class License No Dal bontractoi Ignatu WORKERS' COMPENSATION DECLARATION He hereby r ffirrhP��.--,qMlty of perjury one of the following declarations: PENALTES AND ONIL FINES UPTD ONE HUNDRED THOUSAND Dr1L4RS f rID0,000), - i0114`r, Main a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Sector 3700 of the Labor Code, for thi e work forwhich this permit is issued. Policy No. 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' compensator carder and policy number are: ATE COMPENSATION INSURANCE FUNIiiiiicy Number 1763760 Expiration Date 01/07/2021 ofAgent igent N 877-405-4545 I certih? that, in the performance of the work for which this permit is Issued, I shall not employ any person in any manner se as to become subject to the workers' compen: ation laws of Canfomia, and ag t, if i would became ssubb ct to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions. nature of Applicant Dal¢9/z8/'0 2:03 PM PDT CLARATION RE INGcONsTRUCTION LENDING AGENCY areby emrm 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 Jame Lender's Address my sic nature below, I certify to each of the following: 1 am - he property owner or authorized to act on the property owner's behalf. I haw: read this application and the information 1 have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I autr:onze representatives of this city or county to eplbrthe above-iderdifred property for inspection purposes. j(Cott Cross %-R9/28/20 _ nature of Property Owner or Authorized Agent _ Print Property Owner's or Authorized Agent's Nalhe' DatLS REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 NOTIFICAT€ONTO PERMITF.NAL 2�3'r� ASBESTOS N&W(ATICN SNOT APnUCABLE TOy CERTIFIC, TE OF PROPOSED DEvOyVPInN OCCUPAACYISSUED iii[ `eL orunn,oc.'\/' FOR OFFICE USE ONLY