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Home My WebLink AboutX2021-2613 - PermitsCity of Newport Beach - Building Division *X2021-2613* COMB Permit: X2021-2613 100 Civic Center Drive, Newport Beach, CA 92660 Counter Phone (949)644-32B8''� o. ,� � � �"'j Y-'j Project No : 2274-2021 Permit Inspection Requests Phone (949)644-3255 Issued Date : 03/16/2022 µ,> Combination Type - BLDG ELEC PLUM GRAD Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 03/16/2025 OR PERMII wILL do INVA" 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: 4515 SURREY DR NB Description: SFR 5'6" HIGH X 152 LF & THIGH X 40 LF RETAINING WALLS INSIDE P/L, GAS/ELEC TO BBQ/FIREPIT AND DRAIN Legal Desc.: N TR 3519 LOT 73 , Contractor: HOBSON HOMES Architect: - Owner: SMITH JEREMY & DINA Address: 6462 ACACIA LN .Address: Address: 4515 SURREY DR YORBA LINDA CA 92886 ' CORONA DEL MAR, CA 92625 Phone: 714-225-6365 Phone: 949-351.6383 State Lic: Phone: HOBSON JEREMY Con State Lic: 930528 Engineer: Address: SALEM YASSER 4500 CAMPUS DRM #220 - ... , Applicant: Address: 6462 ACACIA LN Lic Expire: 10/3112022 NEWPORT BEACH CA 92660 YORBA LINDA, CA 92886 Bus Lic: Lic Exp Date: BT31120229 10131 /2022 Phone: 9491955-1345 State Lic:C-060678 . Phone: 714.225-6366 Designer: LEE STUDIO DESIGNS , Code Edit : 2019 Worker's Compensation Insurance INS. CO. OF THE WEST Address: 27756 SANTA MARGARITA PKWY Type of Construction: Carrier: Policy No: WSD505598801 MISSION VIEJO, CA 92691 , Occupancy Group: U Expire: 06/14/2022 Phone: 949-916-5964 Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 Building Setbacks Rear: / Special Conditions: No of Stories: 0 Front: / No of Units: 0 Left: / Bldg Height: 0 Bldg Sprinklers: Use Zone: Right: / Parking Spaces: 0 Fire Hazard Zone : N Flood Zone: X Construction Valuation: $140 000.00 Fire Department Building Permit Fee: $1,477.00 Excise Tax: $0.00 $0.00 Planning Department - Plan check Fee : $0.00 Fireinspection: $0.00 Plan Check Fee: $1,284.99 Additional Fee: Grading Bonds Fee: $0.00 Fair Share : $0 00 Fire Plan Rev Fee DeBuildingnDept Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Grading PC Consultant: $0.00 SJ Trans Housing Fee : $0.00 Adm $0.00 Record Management: $0.00 Grading Permit Fee: Grading PC Fee: $237.00 $199.00 Public Works Department - General Service Refund Deposit $0.00 $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 WO Insp. Fee : $0.00 00 PNV l PlanCheck: $304.50 Grading Bond: $0.00 Disabled Access : $0.00 $0.00 Electrical %: $103.39 San Dist: $0.00 $0.00 $0 00 Hazardous Mat $6.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Building Green Fee : Plumbing %: $132.93 Plan Check Fee : $1,5B5.49 Fee Due at Permit Issuance : $2,159.32 TOTAL FEE : $3,744.81 ftr Q1 PUBLIC WORKS APPROVAL: PROCESSED BY: L�T m V_ `q PLAN CHECK BY: ZONING APPROVAL: C f{ G J' 1 APPROVAL TO ISSUE: GRADING APPROVAL: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) i (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State Licen Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of S not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throu improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of cc improved for the purpose of sale). ff I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 70, apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contrac ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below; acknowledge that, except for my personal residence in which I must have resided for at least or cell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I Profess-ons Code, is available upon request when this application is submitted or at the following Web site: ontr/www.le Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm ul,der penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 and effect. License Class License No Date WORKERS' COMPENSATION DECLARATION NARNING. FAILUR-70 SECURE WORKERS' COMPENSATION COVERAGE Is UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN cu5 r Or COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I,ertLy affirm under oenalty of perjury one of the following declarations: icated below by the checkmark(s) I have placed next to the applicable item(s) molish, or repair any structure, prior to its issuance, also requires the applicant for Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and :tion 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of the work, and the structure is not intended or offered for sale (Section 7044, employees' or personal effort, builds or improves the property, provided that the pletion, the Owner -Builder will have the burden of proving that it was not built or , Business and Professions Code: The Contractors' State License Law does not r pursuant to the Contractors' State License Law). year prior to completion Of the Improvements covered by this permit, I cannot legall iderstand that a copy of the applicable law, Section 7044 of the Business and ifo.ca.gov/calaw.htm[. Date If Division 3 of the Business and Professi Code, and my license is in full force I Contractor Signature TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE have and wil' ma'ntain a certificate of consent to self -insure for workers' compensation, issued by the Director I Industrial Relations as provided for by Section 3700 of the Labor Code, for rmance of the wnrk for which this permit is issued. Policy No. have and wil; ,nain:ain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the ranee carrier and policy number are: of Agent Policy Number certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any t, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall nature of Applicant areby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for w Ider's Name Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinan s and state laws relating to building construction. I authorize representatives of this city or county to enter a ve-identified property for inspection purposes. nature of Property Owner or Authorized Agent Print Property Owner's or DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED � . PERMIT FINAL y$ Z� Z ` SBESTOS N111:1 1 ATI NO PPLICABLE TO CERTIFICATE OF •I ROPOSED DEMOLITIO OCCUPANCY ISSUED of the work for which this permit is issued. My workers' Date o as to become subject to the workerscompensation laws of California, and comply with those provisions. Date_ 24(. h 7 this permit is issued (Section 3097, Civil Code). USE ONLY