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Home My WebLink AboutX2021-3167 - PermitsCity of Newport Beach - Building Division fit' 7+T=a 100 Civic Center Drive, Newport Beach, CA 92660 4 Permit Counter Phone (949)644-3288 a ' . Inspection Requests Phone (949)644-3255 tk i® `L:;,r„wv`• Combination Type - BLDG GRAD V IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2021-3167 x 2 0 2 1 3 1 6 7 Project No : 2392-2020 Issued Date : 11/22/2021 Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE C0VF1b9'=D BY 1112212024 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: 217 LARKSPUR AVE NB ^� L� Description: SITE RETAINING WALL (INSIDE P/L) 113' X T (MAX) W/ TEMP SHORIN I V THE WEEKEND VD Legal Desc.: RESUB OF CORONA DEL MAR LOT 15 BLK 137(AND NELY 5 FT LOT 13(AND SW LY Owner: 217 LARKSPUR LLC Contractor: NICHOLSON CONSTRUCTION CO Architect: Address: 217 LARKSPUR Address: 1 CORPORATE PLZ 9110 Address: CORONA DEL MAR CA 92625 NEWPORT BEACH CA 92660 Phone: Phone: 949-872-6637 Phone: State Lic: Applicant: GLASS NANCY Con State Lic: 660295 Engineer: HAKIM FADY Address: 1 CORPORATE PLAZA STE 110 Lic Expire: 1213112022 Address: 124 PEONY NEWPORT BEACH, CA 92660 Bus Lic: BT98032850 IRVINE CA 92618 Phone: 714-865-4465 Lic Exp Date: 04/30/2022 Phone: 310-422-1536 State Lic:C-075736 Code Edit: 2019 Type of Construction: Occupancy Group: U Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 0 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Flood Zone: Construction Building Permit Fee: $484.00 Plan Check Fee: $421.08 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: $906.08 PROCESSED BY: ZONING APPROVAL: Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9074255 Expire: 1010112022 Building Setbacks Use Zone: Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WO Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: 5' Front: 15' Left: 3' Right: 3' $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Designer: Address: Phone: Special Conditions: Fire Hazard Zone Planning Department - Plan check Fee Fair Share : SJH Trans : In -lieu Housing Fee: Public Works Department - Park Dedication : $0.00 PAN Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department $0.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: Plan Check Fee : $0.00 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: r PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: U I OR $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $906.08 I OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indica ad 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, demc ish, or repair any structure, priorto 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 Lz w (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 Sectio 17031,5 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 (_) all of or I_) portions of th I 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 er iployees' 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 COMPIE tion, the Owner-Builderwill 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, E usiness 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 r ursuant to the Contractors' State License Law). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: ar prior to completion of the improvements covered by this permit, I cannot legal) By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one ye sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I and )rstand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfc.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION 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, �zgd,rty (isepse is in full force and effect. License Class License No Dat \t-aT,. Contractor Signature `/ WORKERS' COMPENSATION DECLARATION mil, WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTI S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,000I, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 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 idustrial Relations as provided for by Section 3700 of the Labor Code, for the pe�ormance of the work for which this permit is issued. Policy No. UlhayeAncl will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the per ormance of the work for which this permit is issued. My workers' compensation rance carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # as to become subject to the workers' compensation laws of California, and agree ❑I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner si that, if I should become subjectto the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant Dat DECLARATION RE DING CONSTIRUCTICNILE19MNG AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which is permit is issued (Section 309 Civil Cade). Lender's Name Lender's Address By my signature below, I 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 ordinances and state laws relating to building construction. I authorize representatives of this city or county to nter the above-i tified property for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Auth rized Agent's Name Date ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE I. SE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO - PERMITCANCELLED LJEPA PERMIT EXTENDED aQMD PERMIT FINAL I- 12,23 '2,i_ ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: