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Home My WebLink AboutXR2023-0349 - PermitsQ a�Wpo"r City of Newport Beach p , 0 Community Development Department - Building Division > �y 100 Civic Center Drive, Newport Beach, CA 92660 n Permit Counter Phone: (949) 644-3288 U T Inspection Requests Phone: (949) 644-3255 cq<rcoaN`P newportbeachca.govfinspections Combination Type - SFP Work Class - Other COMB Permit : XR2023-0349 Plan Check No : 0517-2021 Issued Date : 02/09/2023 Inspection Area : 5 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 4801 SURREY DR Legal Desc : N TR 3519 BILK LOT 43 Description: DELTA 2 -ADD'L SCOPE. RETAINING WALL 8' X 147' BELOW GRADE. (REV2023-0230) Owner: NOUBAR OUZOUNIAN Address : 453 SEAWARD RD CORONA DEL MAR, CA 92625 Phone Applicant: NICHOLSON CONSTRUCTION CO Address : 1 CORPORATE PLZ #110 NEWPORT BEACH, CA 92660 Phone : (949) 756-8393 Owner/Builder : Address : Phone Contractor: NICHOLSON CONSTRUCTION CO Address : 1 CORPORATE PLZ #110 NEWPORT BEACH, CA 92660 Phone : (949) 756-8393 Con State Lie : 660295 Lie Expire : 12/31/2024 Bus Lie: BT98032850 Bus Lie Expire : 04/30/2023 Workers' Compensation Insurance Carrier: STATE FUND Policy No: 9074255 W. C. Expire: 10/1/2023 Code Edition : 2019 Fire Sprinklers : NO Type of Construction : V-B Fire Hazard Zone : NO Occupancy Groups : U No of Units : 0 Bldg Height: No of Stories : 0 Building Setbacks : Front: 30, Side: 6, Side: 6, Rear: 6 Flood Zone : X Use Zone: R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area) PROCESSED BY: J SPECIAL CONDITIONS: Architect: MARK TEALE Address : 2900 BRISTOL ST BLDG A203 COSTA MESA, CA 92626 Phone : (949) 975-0123 State Lie : Engineer: HAKIMFADY Address : 124 PEONY IRVINE, CA 92618 Phone : (310) 422-1536 Designer: Address : Phone : Construction Valuation : $20,000.00 Added/New/TI sq. ft. Bldg: 0 Alteration sq. ft. Bldg: Added/New sq. ft. Garage : 0 TOTAL sq. ft. : 0 OWNER -BUILDER DECLARATION i hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the mRson(s) indicated below by the checkmark(s) I have placed next to the applicable-ftem(s) Section 7031.5, Business and Professions Code: Any city or county that requiresa permit to construct, alter, improve, demolish, or repair any structure, poor toits issuance, also requires the applicant for ie permit to file a signed statement that lie 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 Yofessions Code) or that he or she is exempt from licensors and the basis. for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of of more than five hundred dollars ($500). 3 I, as owner of the property, or my employees with wages as their sole compensation, will do C_) all of or U portions of the work; and the structure is not Intended or offered for sale (Section 7044, iusiness 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 nprovemenls 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 p ly 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 acensure under the Contractors' State License Law for the following reason _ y 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 bythis permit, 1 cannot legall! oil 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 Brat the following Web site:http:Jiwww.leginfo.ca.govlcalaw.html. Sgnature 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 7000) of Division 3 of the Business and P fe Ions CBd�r anrj�r y iaense is In full force nd effect. License Class License No Defeo ContractorSignatur -E-o �X 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),314 ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations U 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 th errormance 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 of Agent Dale 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 . If I should become subiect to the workers�Lomoensstlon provisions of Section 3700of the Labor Code, I shall forthwith comply with those provisions. of zreby affirm Linder penalty of perjury that theta is a construction lending agency forlhe performance of the work for which this permit Is issued (Section 3097, Civil Code) Nara Name Lender's Address 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 applicationand 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 reps esentatives of this city or county ja enter the aooveideptl(led property for inspection purposes. r. S,gnalul o of Property Owner or Authorized Agent II�l Print Propem AC90N DATE BY i DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 _ K ItT&MIRED I SUBMITTED ASBESTOS NOTIFICATION TO PFPANTCANCE11E0 IDEPA P`P?<YT 4XTENOEO _ _ LJAQMO P`ph9`',NAL WESTOS NOTIFICATION IS NOT APPLICABLE TO CCRTIRCATEOF Ok fifON � OCftrpANCYISSUEU - L� ATURE: 11a 0 ` I FOR OFFICE USE ONLY Name tom' �TJ� C