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Home My WebLink AboutX2018-3852 - Permits19� City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII it COMB Permit: X2018-3852 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 8 3 8 5 2 Project No : 2972-2018 iw Permit Counter Phone (949)644-3288 u Inspection Requests Phone (949)644-3255 y'l�rr �1t Combination Type - CIP MECH ELEC PLUM. Issued Date: 1 212 012 01 9 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: 4631 TELLER AVE NB St: 1 FI: 1 Unit: 140 Description: COMM ALTERATION PRIOR TO TI (DEMO INTERIOR NON BEARING WALLS) Legal Desc.:. N TR 9626 LOT fi Owner:. 12B NEWPORT BEACH LLC Contractor: PACIFIC ORCA CORPORATION Architect: LUX TIMOTHY J Address: 4631 TELLER AVE Address: 1307 E ST GERTRUDE PLACE 'Address: 3001 CAPRI LN �. NEWPORT BEACH, CA 92660 BUILDING A COSTA MESA CA 92626 - Phone: 949-500-4868 Phone: 714-647-1791 Phone: 949-581-2255 State Uc:C019769 Applicant: LUX TIMOTHY.J Con State Lie: 644807 Engineer: Address: 3001 CAPRI LN Lie Expire: 0613112020 . Address: COSTA MESA CA 92626 Bus Lie: BT3006543 Phone: 949.581-2255. Lie Exp Date: 12/3112019 Phone: State Lie: Code Edit : 2016 Worker's Compensation Insurance Designer:. Type of Construction: V-BSPR Carrier: NO EMPLOYEES Address: Occupancy Group: B Policy No: Added /New sq.ft:. Bldg: 3200 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: / Special Conditions: No of Units : 0 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: Y Right: I Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $64.000.00 Building Permit Fee: $861.00 Excise Tax: $0.00 Planning Department - Fire Department Plan. Check Fee: $749.07 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: $6.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00. Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access: $87.00 PAN Plan Check: $0:00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $120.54 San Dist: $0.00 Building Green Fee ; $3.00 Mechanical %: $94.71 NMUSD Fee: $0.00 $0.00 Plumbing %:. $77.49 $0.00 TOTAL FEE : $2,038.81 Plan Check Fee: $172.24 . Fee Due at Permit Issuance : $1,866.57 PROCESSED BY: - ° `+ • ttUBLIC WORKS APPROVAL: ,_ o • ` - - ZONING APPROVAL - o c PLAN CHECK BY: GRADING APPROVAL:. _ • o e� c APPROVAL TO ISSUE: uea o0 0o u c cuo ac OWNER -BUILDER I hereby affirm under penally 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 acivil penalty of not more than five hundred dollars ($500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I. acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of per y(Y that I am licensed under provisions of hap r9 (commencing with Section 00 of Division 3 of the Business and and effect.. License Class (5 License No t��`TY Yt� Date -2D-I$ Contractor Signa WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUII COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm underpenalty of perjury one of the following declarations: my license is in full force THOUSAND DOLIiARA($100,000), IN ADDITION TO 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 formance of the work for which this permit is issued. Policy No. have 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' compensatioi urance carrier and policy number are: mer Policy Number Expiration Date me of Agent Phone # certify that, in the performanc th or or 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 It,, if I should become S bject t w r r ' mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant Dat I Z-Zu-1y CLARATION RE RDING CO STRUCTION LE ING AGENCY areby affirm and penalty of perjury that there is a nstruction lending agency for the performance of the work for which this permit is issued (Section" 097, Civil Code). 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 ord' ces nd state laws relating to building construction. I authorize representatives of this city or c unty enter�ypr,'�@/ ab,'t7�av��Id�entified property for inspection purposes. nature of Prooerty Owner or Authorized Aoen \'i"^� Y Print Property Owner's or Authorized Agent's Nam Daffi� ACTION I DATE RY r �GGtNTION t F l OMPLIANCE. WITH CODE OF FEDERAL I FOR OFFICE USE ONLY R6GlLLA IONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED ❑ I suBNkTTED ASBESTOS NOTIFICATIOMTP - • • s "• e a • • • • •• _ PERMIT CANCELLED EJEPA • PERMIT EXTENDED0AQMJ ` PERMITFINAL lj.�-`"� ASBESTOS NOIFICATI SNO APPLICABLE TO CERTIFICATE OF PROPOS EM ITIO OCCUPANCYISSUED SIGN RE: