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Home My WebLink AboutX2021-3100 - PermitsCity of Newport Beach - Building Division 8 G 100 Civic Center Drive, Newport Beach, CA 92660 H, Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 �,zjyj�ys.* Combination Type - BLDG 1111111111111111111p111111111111111111111111111111 COMB Permit: X2021-3100 _ x 2 6 2 1 3 1 0 0 Project No : 1994-2021 Issued Date : Inspection Area : 2 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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: 1015 DOLPHIN TER NB Description: SFR RETAINING WALL 5' X 90' W/ PERMANENT SHORING. 4' X 100' RETAINING WALL Legal Desc.: N TR 5130 LOT 4 Owner: POLOS PETER Address: 2 HERMITAGE LN NEWPORT BEACH CA 92660 Phone: Applicant: HEASON JEANELLE Address: 2279 EAGLE GLEN PKWY ##112-421 CORONA CA 92883 Phone: 909-633-4094 Code Edit : 2019 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 : 0 Bldg Height: 0 Contractor: LEGACY CUSTOM HOMES INC Address: 1000 QUAIL ST, STE 220 NEWPORT BEACH CA 92660 Phone: 949-887-4750 Con State Lic: 986194 Lic Expire: 0813112023 Bus Lic: BT30045036 Lic Exp Date: 1013112022 Worker's Compensation Insurance Carrier: OAK RIVER INSURANCE CO Policy No: LEWC219928 Expire: 12/02/2022 Building Setbacks Rear: 10' Front: T STREET Left: 4' Architect: TOBLESKY KENNETH Address: 1450 W 6TH ST CORONA CA 92882 Phone: 909-217-1866 State Lic:CO23571 Engineer: DEIHIMI AMIR HOSSEIN Address: 23172 PLAZA POINTE DR STE 145 LAGUNA HILLS CA 92653 Phone: 949.954-7244 State Lic:C-078194 Designer: Address: Phone: Special Conditions: Bldg Sprinklers: Flood Zone: Use Zone: R-1 Kignt: a' Parkin Spaces: 0 ;«-^ Fire Hazaid1 e . 14 Construction Valuation: $42,500.00 Building Permit Fee: $715.00 Excise Tax: $0.00 Planning Department ' Fire Department Plan Check Fee: $622.05 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: $0.00 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 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 PNV Plan Check : $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist : $0.00 Building Green Fee : $2.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $1,339.05 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $1,339.05 4V, \ PROCESSED BY: " �Uo ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: fhw APPROVAL TO ISSUE: 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, 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). 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 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). ❑ 1 am exempt from Iicensure 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 legally 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, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. 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 Sec0 of Division 3 of the Business and Profession "ode, an Icense is u11 force and effect. License Class License No a 2Z Contractor Signat re WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HU 4 RE THOUSAND DOLLAR (100,000), IN ADDITION TO THE COST OF COMPENSATION, 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: ❑ I have 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 tht Tformanceof the work for which 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' compensatior ura ce carrier and policy number are: ¢fir Policy Number Expiration Date me of Agent Phone # I certify that, in the pertormance "e work for which this permit is issued, I shall not employ any person in any manner so as to become subject t0 the workers' compensation laws of California, and agree t, if I should became subject he workers' - ensation isions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions. nature of Applican � DStei `Z,_Zg Z Z CLARATION REGA CONSTRUCTION L DING AGENCY UC— areby affirm under penalty of perjury that therqvrs a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ider'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 0rdma ces and state laws relatin to building construction. I authorize representatives of this city or county to en ,a abo tified for inspection purposes. Signature of Property Owner or Authorized Age Print Property Owner's or Authorized Agent's Name Date _ ZZ. ACTION DATE BY V I DECLARATION OF COMKIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PAR 61 OFTITLE 40 AND AQMD RULE 1403 PERMITEXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO " PERMITCANCELLED OEPA PERMIT EXTENDED QM D PERMIT FINAL 1� ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF '��%� Y'� PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: