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Home My WebLink AboutX2017-3657 - 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 - GRAD IIIIIIIIIIIIIIIIII IIIII111 IIIIIIIIIiv III II COMB Permit : X2017-3657 Project No : 2555-2017 Issued Date : 11/15/2017 Inspection Area : 7 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. 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: 1 HOAG DR NB Description: COMM - DRAINAGE ONLY (ALL OTHER WORK TO BE APPROVED AND INSPECTED BY OSHPD) Legal Desc.: IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172 POR OF LOT Owner: Address: Phone: Applicant: Address: Phone: HOAG MEMORIAL HOSPITAL 1 HOAG DR NEWPORT BEACH CA 92663 ALIGN BUILDERS INC 6872 EMBARCADERO LN CARLSBAD CA 92011 858-800-2531 Code Edit : 2016 Type of Construction: Occupancy Group: U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 0 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Flood Zone: Construction Valuation: $0.00 Building Permit Fee: $0.00 Plan Check Fee: $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management : $40.00 Energy Compliance: $0.00 CA Seismic Safety : $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $0.00 TOTAL FEE : $626.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: Address: Phone: Con State Lic: Lic Expire: Bus Lic: Lic Exp Date: ALIGN BUILDERS INC 6872 EMBARCADERO LN CARLSBAD CA 92011 858-800-2531 989507 01/31/2018 BT30047235 05/31/2018 Worker's Compensation Insurance Carrier: EVEREST NATL INS CO Policy No: 7600016195 Expire: 03/18/2018 Phone: Architect: Address: Phone: Engineer: Address: 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 %: Rear: / Front: / Left: I Right: I Parking Spaces: $0.00 $0.00 $0.00 $0.00 $293.00 $293.06 $0.00 $0.00 $0.00 $0.00 Plan Check Fee : Phone: Designer: Address: State Lic: State Lic: HERMAN DANIEL W 833 DOVER DR STE 9 NEWPORT BEACH CA 92663 949-548-3459 Special Conditions: Fire Hazard Zone : N Planning Department - Plan check Fee : Fair Share : SJH Trans : In -lieu Housing Fee : Public Works Department - Park Dedication : P/W Plan Check : $0.00 $0.00 San Dist: $0.00 NMUSD Fee: $0.00 $0.00 $0.00 $0.00 $0.00 Fire Department Fire Inspection: Fire Plan Rev Demolition Fee Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 Fee Due at Permit Issuance : PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: O 000 C c C QC C C OC fC C $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $626.00 e o0eeoce e e 00 O CC C m 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 (_) all of or (_) 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 imUroved 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 Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm Ot>L1d4116italty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 60 o Divisi 2.3 of the Business and Profession R a I -force a.nd effegt. License Class License No Dat I A5 )7 Contractor Signature 16/biRlRS' CQMBENSATION DECLARATION WAFNINO; FAILURE TO SECARE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P NAL ES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF SOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. rl hhereb' affirm under penalty of perjury one of the following declarations: ICJ r tee and will malhtain 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 name of the:Ncecs for which this permit is issued. Policy No. ve 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' compensation arm carrier aild policy number are: C;arner Nerve &.Agent Phone • ••• t I ify that, On,the performance of ork for which this ermit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subje, tto rkers' compensaf .ovisions-of-Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant DECLARATION REGA*DIN G7CONS TRUCTION LENDING AGENCY I 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 Lender's Name 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 correct. I agree to comply with all applicab e city and county rdinan and state I s relating to building construction. I authorize representatives of this city or county enter abov party for inspection purposes. Signature of Pro ert Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name, Policy Number Expiration Date Date i7 ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 610F TITLE 40 AND AQMD RULE 1403 FOR OFFICE USE ONLY RY,4a Sarni PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED ❑EPA PERMIT EXTENDED ❑AQMD PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED 0 ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO PROPOSED DEMOLITION SIGNATURE: