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Home My WebLink AboutX2021-3366 - PermitsCity of Newport Beach - Building Division A :.f100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 \d Combination Type - BLDG IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2021-3366 x 2 0 2 1 3 3 6 6 Project No: 1764-2021 Issued Date : 12/23/2021 Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1212312024 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: 11 HOAG DR NB Description: RETAINING WALL 5' X 30' W/ GUARD RAIL Legal Desc.: Owner: HOAG MEMORIAL HOSPITAL Contractor: SLATER BUILDERS INC Architect: NOUIZILI ILYES M Address: 510 SUPERIOR AV STE 290 Address: 3100 - B PULLMAN STREET Address: 10 EDELMAN NEWPORT BEACH CA 92663 COSTA MESA CA 92626 IRVINE CA 92618 Phone: 949-355-9268 Phone: 714-615-6108 Phone: 949-788-4054 State Lic: C032135 Applicant: DIONNE CHRISTOPHER Con State Lic: 675832 Engineer: BISHOFF RYAN WILLIAM Address: 10 EDELMAN Lic Expire: 08/3112023 Address: 3300 IRVINE AVE #245 IRVINE CA 92603 Bus Lic: BT30025319 NEWPORT BEACH CA 92660 Phone: 949-660-9128 X 1157 Lic Exp Date: 02/2812022 Phone: 949-862-8510 State Lic:S-006250 Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: Carrier: CYPRESS INS COMPANY Address: Occupancy Group: U Policy No: SLWC245302 Added /New sq.ft. Bldg: 0 Expire: 0211612022 Phone: Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: / Special Conditions: No of Units : 0 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: Right: / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $7 500.00�� Building Permit Fee: $215.00 Excise Tax: $0.00 Planning Department - Fire partment Plan Check Fee: $187.05 Additional Fee : $0.00 Plan check Fee : $52.00 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 PM/ 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 : $455.05 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $455.05 PROCESSED BY: _ PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: t'r 1 IN`4 C GRADING APPROVAL: u 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 Iicensure and the basis for the alleged exemption. Any violation of Section 7D31.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 111, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U 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). 111, 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 at I am licensed under provisions of Ch pter 9Scommencing with Section 7000) of ivision of the Business and Profession ode, a y license is in full force and effect. License Class ,� License No �Jij Date, / 4 Contractor Signatu WORKERS' COMPENSATION DECLARATION D NARNING: 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 ($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 thi ppWormance of the work for which this permit is issued. Policy No. �have and will maintain workerscompensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this rmit issued. My workers' compen -ance carer a policy -berf re: r �1 rier (/�� % Policy Number JAL �G �' %IJ 30� Expiration Date ie of Agent Phone # certify that, in the performance of the work f r which this per, 6it is issued, I shall not employ any person in any manner so as to become subject to the work rs' compensat o lawZo"�,,�) alifornia, and 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, lature of Applicant yM �3 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 y 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 cor t. I agree to comply with all applicable city and county o>dina ces a ate laws relating to building construction. I authorize representatives of this city or county to ante a ab dentified property for inspection purposes. ionature of ProDertv Owner or Authorized Anent Print Property Owner's or Authorized Agent's Name ACTION DATE BY 'DECLARATION OF OMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS RT 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO - PERMITCANCELLED OEPA PERMITEXTENDED ❑gQMD PERMITFINAL TFASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF I (G (J % PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: Date