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HomeMy WebLinkAboutX2021-0565 - Permits�1xer City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 w.. Inspection Requests Phone (949)644-3255 Combination Type - SFP GRAD MECH ELEC PLUM *X2021-0565* ISF."LC 9 COMB Permit: X2021-0565 Project No : 0517-2021 Issued Date : 05/1812021 Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 05/18/2024 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: 4801 SURREY DR NB Description: NEW SFR W/ATT GARAGE 4,3661653 SF Legal Desc.: N TR 3519 LOT 43 • ®• Owner: NOUBAR OUZOUNIAN Contractor: NICHOLSON CONSTRUCTION CO Architect: TEALE MARK Address: 453 SEAWARD RD Address: 1 CORPORATE PLZ #110 Address: 2900 BRISTOL ST BLDG A203 NEWPORT BEACH CA 92625 NEWPORT BEACH CA 92660 COSTA MESA CA 92626 Phone: Phone: 949-872-6637 Phone: 949-975-0123 State Lic:CO22162 Applicant: GLASS NANCI Con State Lic: 660295 Engineer: HAKIM FADY Address: 2900 BRISTOL ST #A1203 Lic Expire: 1213112022 Address: 124 PEONY COSTA MESA CA 92626 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: V-B-SPR Occupancy Group: R31U Added /New sq.ft. Bldg: 4366 Added /New sq. ft. Garage: 653 No of Stories: 1 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Y Flood Zone: X Building Permit Fee: $6,416.00 Plan Check Fee: $4,367.50 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $62.00 Energy Compliance: $303.00 CA Seismic Safety: $117.44 Disabled Access, $0.00 Hazardous Mat $0.00 Building Green Fee : $37.00 TOTAL FEE: $22,097.26 PROCESSED BY: ZONING APPROVAL: Workers Compensation Insurance Carrier: STATE FUND Policy No: 9074255 Expire: 10/0112021 Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: 6' Front: 30' Left: 6' Right: 6' $1,063.99 $0.00 $0.00 $2,066.40 $1,440.00 $1,464.54 $120.00 $449.12 $266.64 $577.44 Designer: Address: Phone: Special Conditions: 4 BEDRMS TO 4 BEDRMS Fire Planning Department - Plan check Fee: Fair Share SJH Trans In -lieu Housing Fee: Public Works Department - Park Dedication : $0.00 PAN Plan Check : $344.00 San Dist: $0.00 NMUSD Fee: $2,513.44 Plan Check Fee : $6,190.19 Fire Department $508.75 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: 0 • •o• aoaoo• •• • • •• •• • • • ....• oa000• .• • • • . ®ao• .000 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $15,907.07 PUBLIC WORKS APPROVAL: PLAN CHECK BY: L GRADING APPROVAL: s �TI APPROVAL TO ISSUE: ✓lV \z_ 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 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 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 not more than five hundred dollars ($500). i I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throul improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of cc improved for the purpose of sale). I, as owner of fft property, am exclusively contracting with licensed Contractors to construct the project (Section 70, apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra( 00* M exemgjtrpm,licensure under the Contractors' State License Law for the following reason: By my signature belo w i acknowledge that, except for my personal residence in which I must have resided for at least or s911 a structure That shave built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I ;roTe„sglbns Code,ls available upon request when this application is submitted or at the following Web site:http://Www.le Si9nature of Pro eP yaNner or Authorized Agent hIQENSED CONTRACTOR'S DECLARATION rheretiy affirm unde►penalty of perjurythat I am licensed under provisions of Chapter 9 (commencing with SectionZOYC 2rk &ftt. Licaase,Glass License No Date g COMPENSATION DECLARATION the work, and the structure is not intended or offered for sale (Section 7044, employees' or personal effort, builds or improves the property, provided that the pletion, the Owner -Builder will have the burden of proving that it was not built or Business and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). year prior to completion of the improvements covered by this permit, I cannot )derstand that a copy of the applicable law, Section 7044 of the Business and ifo.ca.gov/calaw.html. Date ,ision 3 of the Business and Prgf�S ons Code, and license is in full force Contractor Signature ��Q , Q l� VWIINObFAILURE 50 SECYRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($10D,000), IN ADDITION TO THE )ST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. le":rffirm under penalty of perjury one of the following declarations: P We and wlrmai stain 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, �rfo manse of the work for which this permit is issued. Policy No. 1-fiave and 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' compensatior prance carrier and policy number are Policy Number of Agent I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any ms )at, if I should become su ect to thp-workers' compensation prp\ma�Ip�¢a-/qf Section 3700 of the Labor Code, I shall fol signature of Applicant )ECLARATION REGAPJ6ING CONSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for .Ender's Name Lender's Address ly 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 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 tr/gnter the above-idisHtjf4 property for inspection purposes. of PfoOertv Owner or Authorized ACTION I DATE I PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED PART 61 OF TITLE 40 AND AQMD RULE ASBESTOS IS NOTAPPLICABLE TO Date so as to become subject to the workerscompensation laws of California, and agre h comply with those provisions. Date— ID—� i this permit is issued (Section 3097, Civil Code). or FOR OFFICE USE ONLY Name 1 \_ PIT'C ) v VQ5i Dad S`