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Home My WebLink AboutX2019-0301 - PermitsCity of �d,�p®r$•Baach.;13uiiding Division COMB Permit: X2019-0301 b. F 100 Civic CeYiter Drive, Mey✓p�irt each, C:A $2660 ��Illllllllllllllllll�llllllllllllllllllllllllllllu X 2 0. 1 9 H 3 0 1 �� Project No : 2111-2017 ti Permit Co rmar Prone ($4T)G44.32A8 ' ° Grading PC Consultant : CA Seismic Safety: Inspection Requests Phone (9$9)644-9295 ° Grading Bond:. 'e"rzrx+rv'• Combipatiog Type - CIP PLUM ELEC MECH Issued Date : 01/2612019 Hazardous Mat ° • . ° ° ®®® Inspection Area : 7 Building Green Fee-: $2.00 $0.00 Park Dedication : 1502MITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Construction t%urs: Monda; .Agdhy 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: 2933 E COAST HWY NB $93.66 Description: COMM TI" REBORN COFFEE" 1,200 SF (Replaces expired permit) Mechanical W Legal Desc.: TR 323 LOT 3 BLK G(AND LOTS 4 AND.5(AND ALL-LYINGSELY OF A LINE WH $0.00 Owner: SIBLING ASSOC LLC Contractor: Z ELITE CONSTRUCTION Architect: CHILI PATRICK Address: 2699 WHITE RD #150 Address: PO BOX 6020 Address: 320 W CLARY AVE IRVINE, CA 92614 MORENO VALLEY, CA 92554 SAN GABRIEL CA 91776 Phone: Phone: 951-258-0871 - Phone: State Lic:C012852 Applicant: CASKEY BILL Con State Lie: 976064 Engineer. Address:: 630 CAMEO HIGHLANDS DR Lie Expire: .08131/2020 Address: CORONA DEL MAR CA 92625 - Bus Lia BT30065099 Phone: 714.624-7086 'Lie Exp Date: 1113012019 Phone: State Lic: .Code Edit: 2016 Workers Compensation Insurance Designer:, Type of Construction: VB Carrier: EXEMPT Address: Yr;° 11 Occupancy Group: B Policy No: Added /New sq.ft. Bldg: 0 Expire: _, A .t;.. :,. a >. Phone n �j Vie% r• Added /New sq: ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: / Special Conditiopsj No of Units : 0 Front: / . _ Bldg Height: 0 Lek: / ` Bldg Sprinklers: Right: / Flood Zone: X " Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Building Permit Fee: $669.00 Plan Check Fee: $0.00 TOTAL FEE $449.24 PROCESSED BY: ZONING APPROVAL: Excise Tax: Overtime Plan Ck $0.00. Fire inspection: Investigation Fee: $0.00 Plan check Fee Record Management: $0.00 $0.00 Energy Compliance: $0.00 Grading PC Consultant : CA Seismic Safety: $0.00 Grading Bond:. Disabled Access : $0.00 In -lieu Housing Fee: Hazardous Mat $0.00 $0.00 Building Green Fee-: $2.00 TOTAL FEE $449.24 PROCESSED BY: ZONING APPROVAL: Excise Tax: $0.00 Planning Department - Fire inspection: Additional Fee : ($449.22) Plan check Fee Demolition Fee Grading Bonds Fee: $0.00 Fair Share .General Service Grading PC Consultant : $0.00 SJH Trans : Grading Bond:. Grading Permit Fee: $0.00 In -lieu Housing Fee: Grading. PC Fee: $0.00 Public Works Department - WQ Insp. Fee: $0.00 Park Dedication : $0.00 PAN Plan Check: $0.00 Electrical %: $93.66 San Dist: $0.00 Mechanical W $73.59 NMUSD Fee: $0.00 Plumbing %: $60.21 Plan Check Fee : $0.00 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: $0.00 $0.00 $0.00 $0.00 $0.00 '.. $0.00 '... $0.00 $0.00 $449.24 Fire Department $0.00 Fire inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm .General Service Refund Deposit Grading Bond:. Plan Check Fee : $0.00 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: $0.00 $0.00 $0.00 $0.00 $0.00 '.. $0.00 '... $0.00 $0.00 $449.24 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 chDckmark`) 1th*epikera ne xt Jo 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 sJuq(WS, prior to its isslfance, also requires the applicant for is 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 'rofessions 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 Vie applicant to a civil penalty of 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 sytr*turo is not rEndW or offergd f4 sile (Section 7044, lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, buiidsor "j roves this property, provided that the nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-tuilderwtll haveihe burden of proving that it was not built or n roved 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 pply 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: ly 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 ell 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 or at the following Web site:http://www.leginfo.ca.gov/calaw.html. signature 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) f ivis'on 3 of the Business and Profe ions Cade, and license is in full force nd effect. License Class IJ License No �) 76 0,6q Da' Contractor Signatur IIORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 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 the erformance 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' rance carrier and policy number are: Policy Number Date �e of Agent Phone # ertify 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 agree If I should become subject to the workers' cooTpy�nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. < / iature of Applica4 �i�—"�!� Date -i— A) X5)1 tLARATION REGI6RNTNG GMS TION LENDING AGENCY GI eby 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). Per's Name Lender's Address Ty 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. A I authorize representatives of this city or counjXtp enter the ab ve-ide d property for inspection purposes. Date iature of Prooertv Owner or Authorized Aaent x Print Prooertv Owner's or Authorized Aaent's Name rn ACTION DATE BY V `DE66VATI019 OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIREDRE SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMITFINAL VA 5.,VAT-11l U ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: