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Home My WebLink AboutX2019-0657 - PermitsCity of Newport Beach - Building DivisionIIIIIIIIIIIII��IIIIIIIIIIIIIIIIIIIIII�IIII II COMB Permit: X2019-0657 100 Civic Center Drive, Newport Beach, CA 92660 x 2 e" 9 Project NO : 0472-2019 >< Permit Counter Phone (949)644-3288 Phone Inspection Requests (949)644-3255 Issued Date: 2019 Combination Type - CIP ELEC MECH PLUM Inspection Arearea :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: 895 DOVE ST NB Description: COMM TI "FITNESS CENTER" (1788 SF) Legal Desc.: TRACT N07694 LOT 4 AND LOTS POR OF LOT Owner: NEWPORT PLAZA OFFICE LLC Contractor: CALIBER CONSTRUCTION INC Architect: KELLY LISA M Address: 6011 CONNECTION DR Address: 240 NORTH ORANGE AVE Address: 17877 VON KARMAN #200 IRVING TX 75039 BREA CA 92821. IRVINE CA 92612 - Phone: - Phone: 7141572.0700 Phone: 949-798.7300 State LiaC032528 Applicant: KELLY LISA M Con State Lia 635842 _ .Engineer: Address: 17877 VON KARMAN 4200 - Lic Expire:. 01/3112020 Address: IRVINE CA 92612 Bus Lia BT30062464 Phone: 949-798-7300 Lic Exp Date:. .03/31/2020 Phone: State Lia Code Edit: 2016 Worker's Compensation Insurance Designer: Type of Construction: I-BSPR Carrier: TRAVELERS PROPERTY Address: Occupancy Group:,. B Policy No: UBOK19760619 Added /New sq.ft. Bldg: 1788 .Expire: 02113/2020 Phone: Added /New sq. ft. Garage: - 0 Noo6Spries: °ems 5 Building Setbacks Rear: / Special Conditions: _ No�of jjnk2s : ° , 1 0 ` Front: / , Bldg Height 0 Left: I"" alg S r nklers:° � � ° °. ° Right: I loon Z.6ne. Use Zone: Parking Spaces: 0. Fire Hazard Z66P.. 14� °Qgns€ruction Va uation: $78.672.00 m j3biiding PerPn;tcFeee" $966.00 Excise Tax: $0.00 Planning Department - Fire Department Plan CheckFee:840.42 Additional Fee : $0.00 Plan check Fee : $40.00 Fire Inspection: $0.00 o Overtime PI`a„n C�. $0.00 Grading Bonds Fee: $0.00 Fair Share; $0.00 Fire Plan Rev $0.00 'IrVOstigation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $54.00 Grading Permit Fee: $0.00 in-lieu Housing Fee: $0.00 Building Dept Adm $0.00 ° 'Pnargy CompIishiCe: $56.00 Grading PC Fee: $0.00. Public Works Department - General Service $0.00 Cd Seismic Saf9ty :. $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled AoWdsis : $87.00 PAN Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mdto $0.00 Electrical %: $252.90 San Dist: $0.00 Building Green Fee : $4.00 Mechanical %: $198.71 NMUSD Fee: $0.00 $0.00 - - Plumbing %: $162.58 $0.00 TOTAL FEE: $2,661.61 Plan Check Fee: $1,309.17 Fee Due at Permit Issuance : $1,352.44 PROCESSED BY: PUBLIC WORKS APPROVAL: �n ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: - APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION 1 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). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U 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). ❑ 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 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 legall, sell a structure that I have built as an owner -builder if it has not been constructedin 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:hftp://www.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 f Divi ion 3 of the Business and Profe 'S! Code, and my license is in full force and effect. License Class License No D e Contractor Signatur WORKERS' COMPENSATION DECLARATION NARNING; FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUB.IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 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 mance 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' compelivatir rance carrier and policy number are: , • �• • , ° ° ° Policy Number Date lame of Agent Phone u - . • •� -� ]I 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 agvel tat, if I should become subj ct the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. •, . ' ° ° • :.: °° signature of TApplicant �� ItOL LQT! .= IECLARATION REG I S RUCTION LENDING AGENCY ��CC// • .6. ° 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). �,• • a ° ender's Name Lender's Address ° ,y 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. • �• • : o° 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 county enter a � i above -identified property for inspection purposes. T ' ionature of Propertv Owner or Authorized ADe/ItV _ / Print Property Owner's or Authorized Agent's Nam Vl V K) LM0 X t CA Date PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCY155UED •3- \5 1403 OF COMPLIANCE WITH CODE OF FEDERAL PART 61 OF TITLE 40 AND AOMD RULE NOTIFICATION TO ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO FOR OFFICE USE ONLY