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Home My WebLink AboutX2021-0996 - Permits��rry City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 t fi Inspection Requ°esTs Phone (949)644-3255 Combination Type - BLDG PLUM IIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIII II COMB Permit: X2021-0996 Project No : 0910-2021 Issued Date : 04/27/2021 Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0412712024 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: 4801 SURREY DR NB Description: SFR DEMO (E) SFR W/GARAGE 3,000 SF (4 BEDROOMS) Legal Desc.: N TR 3519 LOT 43 Owner: OUZOUNIAN NOUBARITRACY Contractor: NICHOLSON CONSTRUCTION CO Architect: TEALE MARK Address: 453 SEAWARD RD Address: 1 CORPORATE PLZ 9110 Address: 2900 BRISTOL ST BLDG A203 CORONA DEL MAR, CA 92625 NEWPORT BEACH CA 92660 COSTA MESA CA 92626 Phone: Phone: 949-872-6637 Phone: 949-975-0123 State Lic:CO22162 Applicant: GLASS NANCY Con State Lic: 660295 Engineer: ni Address: 1 CORPORATE PLAZA #203 Lic Expire: 1213112022 Address: NEWPORT BEACH CA 92660 Bus Lic: BT98032850 Phone: 714-865-4465 Lic Exp Date: 04130/2021 Phone: State Lic: �J Code Edit: 2019 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: STATE FUND Address: Occupancy Group: R311.1 Policy No: 9074255 Added /New sq.ft. Bldg: 0 Expire: 10101/2021 Phone: Added /New sq. ft. Garage: 0 .. No of Stories: 1 Building Setbacks Rear: / Special Conditions: HAULER: JD DEMO No of Units : 1 Front: 1 (3) CITY TREES ON SITE Bldg Height: 0 Left: I Bldg Sprinklers: N Right: I Flood Zone: X Use Zane: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $12,000.00 Building Permit Fee: $120.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $227.50 Additional Fee : $0.00 Plan check Fee : $92.50 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 $26.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $219.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $1,692.00 Disabled Access : $0.00 P/W 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 %: $10.80 $0.00 TOTAL FEE : $2,392.80 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $2,392.80 PROCESSED BY: PUCLIC VIO:RK3 APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: �\ - - AFPRO'"AL TJ 13SUE ! 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.isauarbe, also requires the applicant for ie 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 'rofessions 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 of more than five hundred dollars ($500). 1, 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, lusiness 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 nprovements 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 nproved 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 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). I am exempt from Iicensure 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 legall) 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.htm]. Iignature 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 ) of Division 3 of the Business and Prof sl s Cod a license is in full force nd effect. License Class License No Date `Contractor Signatures VORKERS' COMPENSATION DECLARATION 'ARNING: 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 DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: I h ve 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 th, erfmance of the work for which this permit is issued. Policy No. have and will ¢p�Intain 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' rance carrier akdlsolicv, number,a n w 1 Date of Agent JI certify that, in the performance of thhwork 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 19t, if I shouldecome sub to workers' tion p2 r��ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature ofApplicant to �� ECLARATION REGAR IN—TCONSTRDCTION 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 y 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 ordinances and state laws relating to building construction. I authorize representatives of this city or county toAnter the above -identified property for inspection purposes. n _ ��— ACTION DATE BY RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY R%GU- TIONS PART 61 OF TITLE 40 AND AOM D RULE 1403 PERMIT EXPIREDUISLIBNkTTED ASBESTOS NOT I FICATION YO PERMIT CANCELLED UEPA ' PERMIT EXTENDED qM PERMITFINAL ASSES S NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF PROPOS DEMO N� OCCUPANCYISSUED SIGN RE:I`S�(�X._ 69E2 0922 0000 Oh20 6TOL 25E2 09L2 0000 Oh4O 62OL