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Home My WebLink AboutX2019-0858 - Permits= , . •• city�fel$QW?Qrt Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIillllllllllllllllllllllllll COMB Permit: X2019-0858 $ 10%,CgIr teeter Deivel Newport. Beach CA 92660 X 2 0 1 9 0 8 5 8 Project No : 0580-2019 h • Peyrrh tcoan�o�:Pho ��(949)644-3288 Inspection Regdesfs Phone (949)644-3255 Combination Type - CIP Issued Date: 0 311 512 01 9 m Inspection Area :VI mm a em em• 1eo ® e . • • `e • i `® ' PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. - e° °Coilstrucfl;pl 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: :.1601 AVOCADO AVE NB Description: "COMM - INT DEMO PRIOR TO TI 12600 SF Legal Desc.: P SK 192 PG 1 PAR 2 Owner. CITY OF HOPE MEDICAL FDN Contractor: CON - AM INC Architect: Address: 1605 AVOCADO AVE -Address: 903 CALLE AMANCEER#210 Address: NEWPORT BEACH, CA 92660 SAN CLEMENTECA 92673 Phone Phone: 909-498-1003 Phone: ' State Lie: Applicant: RIDDLE RYAN- Con State Lie: 698311 ': Engineer: - -Address: 903 CALLE AMANECER#210 Lie. Expire: 10/31/2019 Address: SAN CLEMENTE CA 92673`. : Bus Lie BT30066464 Phone: 949-498-1003 Lie Exp Date 03/31/2020 Phone: `. State Lic:'' Code Edd 2016 Worker's. Compensation Insurance. Designer: BOULDER ASSOCIATES Type of Construction V -B - .Carrier: TRUMBULL INS CO Address: 300 SPECTRUM CENTER DR STE 730 - Occupancy Group: B Policy No. 72WEAAB4SZQ IRVINE CA 92618 Added /New sq.ft.Bldg: - 0 :Expire: 04/2112019 Phone: Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: / Special Conditions: IRS TO HAUL DEBRIS No of Units : 0 Front: I e Bldg Height 0 ' : Left. I ` Bldg Sprinklers: Right I Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N - P -' Construction Valuation $200.000.00 Building Permit Fee: $1,768.00 Excise Tax. %` $0.00 Planning Department - Fire Department <Plan Check Fee: $1,538.16' :.Additional Fee, $0.00 Plan check Fee:- .'$40.00 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: :$2.00 Grading Permit Fee: .;$0.00 In -lieu Housing Fee $0.00 Building Dept Adm $24.00 'Energy Compliance: -: $0.00 Grading PC Fee: $0.00 Public Works Department- General Service -$197.00 CA Seismic Safety: :$0.00 WQ Insp. Fee: ; $0.00 : Park Dedication : $0.00 -. Refund Deposit". - $664.00 1Jisabla Access: $0.00 PAN Plan Check: $0.00 Grading Bond: - $0.00 Hazardous. Mat $0.00 Electrical %: ". .:'.$0.00 San Dist: $0.00 .Building Green Fee ; -.; $8.00 Mechanical %: :::$0.00 NMUSD Fee: $0.00 :$0.00 Plumbing %:`. $0.00 $0.00 TOTALFEE : $4,141.16 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $4,141.16 PROCESSED BY: PUBLIC WORKS' APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: 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 ala*d r41 tie applicatil : iterm(s) ction 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 }ssoarlc��alSq Tegbjf€s the app6nt for 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`%00) of Division 3 of the Business and fessions 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 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 intend8d br o6ledfor sale (Section 7044, e o ;iness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improvI the pfj)perty, provided ttrat4 he, rovements 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 tiurdenodproving thatolroas notbullt or roved for the purpose of sale). 1, 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 Iy 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: 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) 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 fessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. nature of Property Owner or Authorized Agent Date :ENSED CONTRACTOR'S DECLARATION reby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 of Div' ion 3 of the Business and Profess ons Code, and license is in full force effect. License Class License No Date Contractor Signature Ls s )RKERS' COMPENSATION DECLARATION '.NING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100 000), IN ADDITION TO THE T OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. reby affirm under penalty of perjury one of the following declarations: ,ave 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 'drmance 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 Date 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 agre if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. F IatureofApplican - Date 1 \� )LARATION RE A DING CON CTION LENDING AGENCY reby 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). ier s Name Lender's Address ny 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 counlylo enter the above -identified property for inspection purposes. Iature of Prooertv Owner or AuthorizedADent%'l—-'-_ Print Property Owner's or Authorized Agent's Name Date1 DATE I BY rICLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE TO L, $,` ` \ PPR POSED DEMOLITASBESTOS ION, NIS NOT APPLICA� B LE TO OF