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HomeMy WebLinkAboutX2018-1550 - Permits (2)wtoo City of Newport Beach - Building Division %. Type of Construction: Carrier: OLD REPUBLIC GENERAL INS. 100 Civic Center Drive, Newport Beach, CA 92660 r+ Permit Counter Phone (949)644-3288 .. - Inspection Requests Phone (949)644-3255 Expire: 0511612019 Combination Type - BLDG ELEC COMB Permit: X2018-1550 IIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Project No : 1192-2018 Issued Date : 07103/2018 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: 3333 W COAST HWY NB - Description: COMM CELL SITE "AT&T" Legal Desc.: IRVINE SUB LOT BILK 2 POR OF BLK Owner: HARBOR MARINA LLC Contractor: METRO RF SERVICES INC Architect: Address: FOUNTAIN AIN VALLEY, E S7 STE H Address: 2320 S IOARCHIBALD 91761 AVE Address: FOUNTAIN VALLEY, CA 92708 ONTARIO CA 917fi1 Phone: Phone: 909-230-4920 Phone: State Lie: Applicant: SHIH STELLA Con State Lie: 895236 Engineer: LEE CHRIS SHIUH-GUANG . Address: 1746 W. ORANGEWOOD AVE STE 103 Lie Expire: 04/30/2019 Address: 27758 SANTA MARGARITA PKWY 238 ORANGE, CA 92686 Bus Lie: BT30061751 MISSION VIEJO CA 92691 Phone: 602-527-3592 Lie Exp Date: 0113112019 Phone: 949-468-9702 State Lic:C-061054 Code Edit: 2016 Worker's Compensation Insurance Designer: Type of Construction: Carrier: OLD REPUBLIC GENERAL INS. Address: Occupancy Group: U Policy No: AlCW12301700 Construction Valuation: $25.000.00 Added /New sq.ft. Bldg: 0 Expire: 0511612019 Phone: Added /New sq. ft. Garage: 0 _ .- No of Stories: 0 Building Setbacks Rear: / Special Conditions: No of Units : 0 Front: / Planning Department - Bldg Height: 0 Left: / Fire Department Bldg Sprinklers: Right: I Additional Fee: mooc cone: Use Lone: Parkin spaces 0 Fire Hazard Zone : N Construction Valuation: $25.000.00 Building Permit Fee: $442.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $384.54 Additional Fee: $0.00 Plan check Fee : $37.50 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share: $0.00 Fire Plan Rev $179.00 Investigation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Record Management : $28.00 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 WO Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access: $0.00 PAN Plan Check°.._ $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $57.86 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $1,129.90 Plan Check Fee : $1,129.90 Fee Due at Permit Issuance : $0.00 PROCESSED BY: ZONING APPROVAL: PUBLIC WORKS 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 placed next to the applicable items) '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 :he 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 the applicant to a civil penalty of lot 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, 3usiness 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 mprovemenls 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 m 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 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: 3y my signatureibelow 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 ;ell a structure that 1:11lave. 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 3rofessions-Code;-is'a`vailable 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 Date LICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No Date Contractor Signature NORKERS' COMPENSATION DECLARATION YARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE :OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 1 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( )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 1e of Agent Pnone 0 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 , if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant uace_ CLARATION REGARDING CONSTRUCTION LENDING AGENCY areby 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). 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 owners 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 county to enter the above -identified property for inspection purposes. nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE 1403 PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED DEPA PERMIT EXTENDED/� OMD PERMITFINAL 7-/�ll-EIMTESTIBS{NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: