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Home My WebLink AboutX2021-3366 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - BLDG 11 111111 3 3 6 6 COMB Permit : X2021-3366 Project No : 1764-2021 Issued Date : 12/23/2021 Inspection Area : 7 Job Address: Description: Legal Desc.: Owner: Address: Phone: Applicant: Address: Phone: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 12/23/2024 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 11 HOAG DR NB RETAINING WALL 5' X 30' W/ GUARD RAIL HOAG MEMORIAL HOSPITAL 510 SUPERIOR AV STE 290 NEWPORT BEACH CA 92663 949-355-9268 DIONNE CHRISTOPHER 10 EDELMAN IRVINE CA 92603 949-660-9128 X 1157 Code Edit : Type of Construction: Occupancy Group: U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: No of Units : Bldg Height: Bldg Sprinklers: Flood Zone: 0 0 0 Construction Valuation: $7,500.00 Building Permit Fee: $215.00 Plan Check Fee: $187.05 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 : $455.05 Contractor: Address: Phone: Con State Lic: Lic Expire: Bus Lic: Lic Exp Date: SLATER BUILDERS INC 3100 - B PULLMAN STREET COSTA MESA CA 92626 714-615-6108 675832 08/31/2023 BT30025319 02/28/2022 2019 Worker's Compensation Insurance Carrier: Policy No: Expire: Building Setbacks Use Zone: Excise Tax: Additional Fee : Grading Bonds Fee: Grading PC Consultant : Grading Permit Fee: Grading PC Fee: WQ Insp. Fee : Electrical %: Mechanical %: Plumbing %: CYPRESS INS COMPANY SLWC245302 02/16/2022 Rear: / Front: / Left: / Right: / Parking Spaces: PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Architect: Address: NOUIZILI ILYES M 10 EDELMAN IRVINE CA 92618 Phone: 949-788-4054 State Lic:C032135 Engineer: BISHOFF RYAN WILLIAM Address: 3300 IRVINE AVE #245 NEWPORT BEACH CA 92660 Phone: 949-862-8510 State Lic:S-006250 Designer: Address: Phone: Special Conditions: Fire Hazard Zone : N $0.00 Planning Department - $0.00 Plan check Fee : $0.00 Fair Share : $0.00 SJH Trans : $0.00 In -lieu Housing Fee : $0.00 Public Works Department - $0.00 Park Dedication : $0.00 P/W Plan Check : $0.00 San Dist : $0.00 NMUSD Fee: $0.00 $0.00 $0.00 $0.00 Plan Check Fee : c $52.00 $0.00 $0.00 $0.00 Fire 'Department Fire Inspection: Fire Plan Rev Demolition Fee Building DeptAdm General Service Refund Deposit Grading Bond: $0.00 Fee Due at Permit Issuance : 771 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $455.05 PUBLIC WORKS APPROVAL: PLAN CHECK BY: 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 L) all of or L) 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). ❑ 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 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 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury at I am licensed under provisions of Ch pter 9 commencing with Section 7000) of rivision c of the Business and Profession ode, a y license is in full force and effect. License Class v License No 6 / _S 3 Date _ Contractor Signatu ,67/L WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLA 5 ($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. I 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 the p ormance of the work for which this permit is issued. Policy No. 1:11 have 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 i issued. My workers' compensation ins ance car ier apolicy berfpre: S!� mer ( / ! L r Policy Number L -c /4/G �, / . 3 a,2— Date Name of Agent ❑ I certify that, in the performance of the work f r which this per Expiration Date .2-lIJ.,-)-- Phone # 9/9" ``'//4/ 6 it is issued, I shall not employ any person in any manner so as to become subject to the worker's' compensat o laws of alifornia, and agree that, if I should become subject to the worke s' ompensatio rovisio of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant --14-‘. /02- 02 3 W.:/ DECLARATION REGARDINCONS UCTION LEN NG AG CY I hereby affirm under penalty of perjury that there is a constru Lender's Name Ion lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). 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 corr I agree to comply with all applicable city and county ordina 'ces a ate laws relating to building construction. I authorize representatives of this city or county to ente) e ab dentified property for inspection purposes. Signature of Property Owner or Authorized Agent ///L-- Print Property Owner's or Authorized Agent's Name ACTION DATE BY DECLARATION OF OMPLIANCE WITH CODE OF FEDERAL PERMIT EXPIRED REGULATIONS CART 610F TITLE 40 AND AQMD RULE 1403 ❑ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED DEPA PERMIT EXTENDED ❑AQMD PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED 0-14 El ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION SIGNATURE: FOR OFFICE USE ONLY