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HomeMy WebLinkAboutX2021-1464 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 u Inspection Requests Phone (949)644-3255 Combination Type - BLDG �12_IV7,3 -0344� *X2021-1464* IN1 S COMB Permit: X2021-1464 Project No : 0517-2021 Issued Date : 0610812021 Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0610812024 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 ptm. No work on Sundays or Holidays Job Address: 4801 SURREY DR NB Description: SFR *ADDITIONAL SCOPE* RETAINING WALL FOR BID PLANTER 8' HIGH X 30 LF 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 4110 Address: 2900 BRISTOL ST BLDG A203 NEWPORT BEACH CA 92626 NEWPORT BEACH CA 92660 COSTA MESA CA 92626 Phone: Phone: 949-872-6637 Phone: 949-975-0123 State Lic:CO22162 - Applicant: GLASS NANCI Can State Lic: 660295 Engineer: HAKIM FADY Address: 2900 BRISTOL ST #A/203 Lic Expire: 1213112022 Address: 124 PEONY COSTA MESA CA 92626 Bus Lic: BT98032850 IRVINE CA 92618 " Phone: 714-865-4465 Lic Exp Date: 04/3012022 Phone: 310-422-1536 State Lic:C-075736 Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: Carrier: STATE FUND Address: Occupancy Group: U Policy No: 9074255 - Added /New sq.ft. Bldg: 0 Expire: 10101/2021 Phone: Added /New sq. ft. Garage: 0 _ No of Stories: 0 Building Setbacks Rear: 6 Special Conditions: No of Units : 0 Front: 30 Bldg Height: 0 Left: 6 Bldg Sprinklers: Right: 6 Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $15,000.00 Building Permit Fee: $331.00 Excise Tax: $0.00 Planning Department- Fire Department Plan Check Fee: $287.97 Additional Fee : $0.00 Plan check Fee : $0.00 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Investigation Fee: $0.00 Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Record Management : $4.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WO Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access: $0.00 PAN Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist : $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $623.97 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $623.97 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE:i -A 1 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). 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) 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 owner of property 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). 1, 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). I 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 legall, sell 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 Professions Code. 's available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Plonerfy Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION hereb; affirm JnL;er penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0) of Division 3 of the Business and Prof ons Code, and m license is in full force and effect. License Class License No Date - 2l Contractor Signature NO:Y:(ERS' COMPENSATION DECLARATION N1RNIVG: FAILUR= TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THO SAND DOLLARS I$100,0001, IN ADDITION TO THE .AST OF COMPENS,0 IUN, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: Five and will maintain 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 mnnce of the work for which this permit is issued. Policy No. and will mair.iain 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' carder and policy number are: Policy Number of Agent Date I certify that, in the performance 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' compensation laws of California, and agre iat, if I should become ubcile''ct to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of Applican �''1�%l.- ham/ DatXivVil IECLARATION REG CONSTRUCTION LENDING AGENCY hereby affirm under p alty o perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097,ode). enders Name Lender's Address Iy 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 conqty ordinances and state laws relating to building construction. % I authorize representatives of this city or courf*)b epter the abovytidentified property for inspection purposes. i�/ r, _ _ O ACTION PERMITEXPIRED PERMITCANCELLED PERMIT EMENDED PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED DATE I BY - DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL R ULATIONS PART 61 OF TITLE 40 AND AQMD RULE I SUBMITTED EPA IS NOTAPPLICABLE TO FOR OFFICE USE ONLY Name Date