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Home My WebLink AboutX2019-0786 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIII� II COMB Permit X2019-0786 100 Civic Center Drive, Newport ort Beach, CA 92660 X 2 0 1 9 0 7 8 6 p Project No : 0528-2019 ,Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - BLDG. Issued Date : 03112/2019 Inspection Area : 8 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. 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: 2864 ALTA VISTA DR NB Description: SFR RETAINING WALL 10' HIGH MAX X 50 LF INSIDE P/L & BLOCK WALL 5' HIGH X 25 LF ON P/L AND STAIRS ON GRADE WI DRAINAGE Legal Desc.: N TR 5018 LOT 15 - Owner:. LOUCKSMATTHEW Contractor: H D R CONSTRUCTION Architect Address: 2854 ALTA VISTA DR Address: 21800 VERNE AVENUE Address: NEWPORT BEACH, CA 92660 HAWAIIAN GARDENS CA 90716 Phone: Phone: 562-233-5671 Phone: State Lie: �- - Applicant: AHMADI MANSOUR Address: 32262 VIA DEL SOL Record Management: TRABUCO CANYON CA 92679 Phone: 949-715.9990 Code Edit: 2016 Type of Construction: Occupancy Group: U Added /New sq.ft.. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 0 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Building Permit Fee: $412.00 Plan Check Fee: $365.00 Overtime Plan Ck: $0.00 Investigation Fee: .$0.00 Record Management: $18.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access :. $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $1,460.00 PROCESSED BY: ZONING APPROVAL: Con State Lie: 923536 Lie Expire: X10131/2020 Bus Lie: BT30064002 Lie Exp Date: 07/31/2019 Worker's Compensation Insurance Carrier: NATIONAL LIABILITY FIRE Policy No: A9WC960063 Expire: 02103/2020 Building Setbacks Rear: 6' $0.00 Front: 6' $0.00 Left: 6' Address: ..Right:. 6'. Excise Tax: $0.00 Additional Fee: $0.00 Grading Bonds Fee: $0.00 Grading PC Consultant: $0.00 Grading Permit Fee: $312.00 Grading PC Fee: $312.00. WQ Insp. Fee : $0.00 Electrical %: $0.00 Mechanical %: $0.00 Plumbing %: $0.00 Planning Department - Plan check Fee .Fire Department Fair Share : Engineer: AHMADI MANSOUR •t m ° �..5 Sr ':S Address: 32262 VIA DEL SOL • �- . Park Dedication : TRABUCO CANYON CA 92679 00 ,< • • m Phone: 949-716-9990 ..State LIC:C-076370 $0.00 NMUSD Fee: $0.00 • mr �. • o Designer use r t• •m a Address: e c • o ® • I o Phone: mo °o 0 • t ,j • � ° 00000 rr o Special Conditions: PIL AGREEMENT ATTACHED 00000 SURVEY WAIVER ATTACHED ama000 000000 ° ® 0 c o c oo oomdc0 - ri- W -M 7....e . u Planning Department - Plan check Fee .Fire Department Fair Share : Fire Inspection: SJH Trans: Fire Plan Rev In -lieu Housing Fee: Demolition Fee - Public Works Department- . Park Dedication : $0.00 PAN Plan Check: $0.00 ' San Dist: $0.00 NMUSD Fee: $0.00 Plan Check Fee: $717.00 Fee Due at Permit Issuance : PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $743.00 .Fire Department $40.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 - Building Dept Adm General Service Refund Deposit - Grading Bond: Fee Due at Permit Issuance : PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $743.00 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 require€ the applicant for is 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 'rofessions 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 of more than five hundred dollars ($500). 7 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 nprovements 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 n roved 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 pply 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). 7 I am exempt from licensure under the Contractors' State License Law for the following reason: Iymy 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 legall) ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/colaw.html. ',ignature of Property Owner or Authorized Agent Date .ICENSED,COlOYRACTOR'S DECLARATION hereby affirm%*dgr penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 ) of Division 3 of the Business and Prof sions Code license ism full force pdeifect. Licens@Flass License No Date /�� Contractor Signature VOAERS•COMPENSATION DECLARATION 'ARNING: FAILURERO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN PENALTIES AND CIVIL FINES UP TO ONE HUND ED THOUSAND DOLLARS (5700,0001, IN ADDITION TO THE 09AOF COMPENOATIOM DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirrrf Mcre'r penalty of perjury one of the following declarations: 3 i have an JWi%ft$intain 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 &fb%ance o7 kre work for which this permit is issued. Policy No. ave and wilPmaintain 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' compensatiol Seam w e carrie Cggd,dolicy number are: anner� Policy Number Expiration Date ameame rF Agent," _ Phone # 9... .... 1 certify that, in the pe ormance 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' ompensation laws of California, and ogre Iat, if I should become ubject to the workers' compensation provisions of Section Labor Code, I shall forthwith comply with those provisions. ignature of Applicant—� Dat— 7 / DECLARATION REG DIN STRUCTION LENDING AGENCY hereby affirm under nalty 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, I certify to each of the following: I am the property owner or authorized to act on the property owners behalf. I have read this application and the information I he provided is correct. I agree to comply with all applicable city and coup ordinances and state laws relating to building construction. I authorize representatives of this city or county tenter the above -identified pro a ins ection purposes. ignature of Property Owner or Authorized Agent Print PropertyOwners or Authorized Agent's Nameleup"Z \CTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE I SUBMITTED ASBESTOS PERMITEXTENDED - QMD SBESTOS OTIFICATION IS NOT APPLICABLE TO ROP MOLITION SIGNATURE PERMITFINAL CERTIFICATE OF �\ r'J r q\ r /, t OCCUPANCYISSUEO (�A/�-�j-�