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Home My WebLink AboutX2018-0177 - PermitsiyoNewport Beach Building Division •s COMB •O•i M• Bm • Oa.errmom nittm : X2018-0177 4Civic Center Beach, CA IIIIIIIII Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 FIFIESD - Combination Type - SFP ELEC GRAD MECH PLUM ••• Issued Date : • •.. . Inspection Area : 5 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID VJS?EC iIOA. 'm ,•, • ® e % : •• ` • o • • Construction Hours: Monday -Friday 7.00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:30 pan, N$, o7or•k ajn Sin ;'oys r . 4 r { s • • • • • r1,�i xxijyy Job Address: 4701 SURREY OR NB Q' Description: NEW SFR & GARAGE - 5012 & 660 SF (f'J Legal Desc.: N TR 3519 LOT 67 111 Owner: PLEASANTVILLE ROAD PARTNERS LLC Contractor: NICHOLSON CONSTRUCTION CO Architect: TEALE MARK Address: 1 CORPORATE PLAZA DR STE 110 Address: 1 CORPORATE PLZ #110 Address: 2900 BRISTOL ST BLDG A203 NEWPORT BEACH CA 92660 NEWPORT BEACH CA 92660 COSTA MESA CA 92626 Phone: 949-756.8393 Phone: 949-872.6637 Phone: 949-975-0123 State Lic:CO22162 Applicant: TEALE MARK Address: 2900 BRISTOL ST STE 203 Record Management: COSTA MESA CA 92646 Phone: 949-975.0123 Code Edit: 2016 Type of Construction: V -B -SPR Occupancy Group: R311.1 Added /New sq.ft. Bldg: 5012 Added /New sq. ft. Garage: 660 No of Stories: 1 No of Units : 1 Bldg Height: 29 Bldg Sprinklers: Y Construction Building Permit Fee: $5,888.00 Plan Check Fee: $4,744.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $62.00 Energy Compliance: $268.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green Fee : $36.00 TOTAL FEE: $21,602.72 PROCESSED BY: ZONING APPROVAL: '9L Con State Lie: 660295 Engineer: Lie Expire: 1 2131 /201 8 Address: Bus Lie: BT98032850 - $0.00 Lie Exp Date: 04/30/2018 Phone: Worker's Compensation Insurance Designer: Carrier: STATE FUND Address: Policy No: 9074255 Refund Deposit Expire: 1 0101/2 01 8 Phone: 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: 25 Left: 6 Right: 6 $1,191.12 $0.00 $0.00 $1,161.12 $1,113.00 $254.88 $0.00 $412.16 $235.52 $529.92 HAKIM FADY 124 PEONY IRVINE CA 92618 310-422-1536 State Lic:C-075736 Special Conditions: Fire Hazard Zone : N Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PAN Plan Check: $532.00 San Dist: $0.00 NMUSD Fee: $4,784.00 Plan Check Fee : $21,602.72 Fee Due at Permit Issuance : $0.00 PUBLIC WORKS APPROVAL: A G PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: Fire Department $0.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev - $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 Plan Check Fee : $21,602.72 Fee Due at Permit Issuance : $0.00 PUBLIC WORKS APPROVAL: A G PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: OWN ER-BUI LDEftDEE .LFYRATIOM I hereby affirm under tlenaftl oApe;ju(,y'that l"am eljempt from the Contraicated below by the checkmark(s) I have placed next to the applicable item(s) � t molish, or repair any structure, prior to its issuance, also requires the applicant for Section 7031.5, Business and ProfessicnsCodq+Aryy;c�ty or county that rsqu IS permit to file a signe8•statement that he or she is licensed pursuant to the provisio 00=to 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 all tion of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of of more than five hundred dollars ($5,00). I, as owner of th&llrtperV, ogme e:np1oyDeSw11hwades:as their sola colnpensaJol,, vAl do Lyall of cr (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness and Professions Cede: The Cont_rarytors' Itajg Ucatse Law. doss nit applyta an owner of property who, through employees' or personal effort, builds or improves the property, provided that the nprovements are not intended or o�iarsd fPor sale. Ifi however, the bui'ding-or improvement is sold witkin onu year of completion, the Owner -Builder will have the burden of proving that it was not built or nproved for the purpose of sale). I, as owner of the property, am elmlusively 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 1 am exempt from licensure under the Contractors' State License Law for the following reason: ly 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 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/calaw.html. - signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 0) of Ivis' 3 of the Business and P f ions Code,r'and pay license is in full force nd effect. License Class License No Date — Contractor Signet Irk c� 1IORKERS' COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE Is UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE OST 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: 7 1 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 the ehforrpance,of 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' carrier and policy number are: Policy Number Expiration Date 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 manner so as to become subject to the workers' compensation laws of California, and agree tat, if I should become sub'to workers' comp(o�1g)ano(n�)pr(ow�slons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. X ignature of Applicant �o �/ �c✓" Date .l—q.-' b IECLARATION REG R iNG CONSTRUCTION LENDING AGENCY hereby affirm under penalty 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 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 county or ances and state laws relating to building construction. I authorize representatives of this city or county tj ant r the bove-idtiff d(�p y for inspection purposes. lionature of Propertv Owner or Authorized Agent Y f'D__X � Print Property Owner's or Authorized Agent's NajnW f�� C \ �71i/0 V Date ACTION DATE B1k DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMIT EXTENDED ! QMD ' PERMIT FINAL ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF5y� f(-�'� PROPOSED DEMOLITION OCCUPANCY ISSUED 1l " 1 SIGNATURE: gP ,.r. etfl dl► Permit No: X2018-0177 Code Year Edition :2016 Plan Check No: 0150-2018 Occupancy Group: R3/U Address: 4701 SURREY DR Suite No: - ConstructionType: V -B -SPR Owner: PLEASANTVILLE ROAD PARTNERS LLC Occupant Load : N/A 1 CORPORATE PLAZA DR STE 110 Fire Sprinklered: Y NEWPORT BEACH CA 92660 Work Description: NEW SFR & GARAGE - 5012 & 660 SF THIS CERTIFICATE ISSUED PURSUANT TO THE REQUIREMENTS OF SECTION I I I OF THE CITY OF NEWPORT BEACH ADMINISTRATIVE CODE ATTESTS THAT AT THE TIME OF ISSUANCE, THIS STRUCTURE WAS IN COMPLIANCE WITH THE VARIOUS ORDINANCES OF THE CITY OF NEWPORT BEACH REGULATING BUILDING CONSTRUCTION OR USE. Chief Building Official: Samir Ghosn, MS, PE, CBO. Signature: Date: !�� O