HomeMy WebLinkAboutX2018-3677 - PermitsCity of Newport Beach - Building Division��IIIIIIIII�IIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIII� �� COMB Permit: X2018-3677
' 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone(949)644-3288 X 2 0 1 8 3 6 7 7 Project No :1384-2018
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Inspection Requests Phone (949)644-3255
er lxnt s, vombination Type - CIP ELEC MECH PLUM Issued Date :12106/2018
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: 5010CAMPUS DR NB
Description: COMM TI (4282 SF) INCLUDES RAMPS, SITE ACCESSIBLE WALKWAY 1 ;
Legal Desc.: NTR 9626 LOT 8 Rr-
BAILEY
Owner � � JL CAPITAL INVESTMENT LLC Contractor: RENAULT & MORAN CONSTRUCTION LLC Architect: S! 'E' C DAVID
Address: 5010 CAMPUS DR Address: 27302 JARDINES Address: 23183 LA CADENA DR #101
NEWPORT BEACH CA 92660 MISSION VIEJO CA 92692 LAGUNA HILLS CA 92653
Phone: Phone: 949.412-6600 Phone: 949-573-1050 State Lic:CO27404
Applicant: BAILEY DAVID Con State Lic: 1038156 Engineer:
Address: 23183 LA CADENA DR#101 Lic Expire: 04/3012020 Address:
LAGUNA HILLS CA 92653
Phone: 949-573-1050
Code Edit: 2016
Type of Construction: V -B -SPR
Occupancy Group: B
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units : 0
Bldg Height: 0
Bldg Sprinklers: Y
Flood Zone:
Building Permit Fee: $3,094.00
Plan Check Fee: $0.00
Overtime Plan Ck:
$0.00
Investigation Feer
$0.00
Record Management:
$48.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$17.00
TOTAL FEE: $5,078.46
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Bus Lic: BT30065288
Lic Exp Date: 1213112019
Worker's Compensation Insurance
Carrier: EXEMPT
Policy No:
Expire:
Building Setbacks
Excise Tax:
Additional Fee:
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: I
Front: /
Left: /
Right: /
0
Phone:
Designer:
Address:
Phone:
State Lic:
Special Conditions: CONTRACTOR AUTH ATTACHED
WASTE MANAGEMENT TO HAUL
$0.00
Planning Department -
$0.00
$0.00.
Plan check Fee
Fire Plan Rev
$0.00
Fair Share
$0.00
$0.00
SJH Trans `.
General Service
$0.00
In -lieu Housing Fee:
$0.00
Public Works Department -
$0.00
Park Dedication:
$0.00
PM Plan Check:
$82.50
$433.16
San Dist:
$0.00
$340.34
NMUSD Fee:
$0.00
$278.46
Plan Check Fee: $0.00
Fee Due at Permit Issuance
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0 0
0000
0 0 0
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$197.00
$564.00
$0.00
$5,078.46
PUBLIC WORKS APPROVAL:
PLAN CHECK BY: -
APPROVAL TO ISSUE:
0
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0
0000
0
0000
00°00
Qo
e0000
°
0000
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:
Fee Due at Permit Issuance
0 0
000000
Deco
0 0
0000
0 0 0
00 0
°
o sa.eo °
$197.00
$564.00
$0.00
$5,078.46
PUBLIC WORKS APPROVAL:
PLAN CHECK BY: -
APPROVAL TO ISSUE:
0
o0°°0a
0
0000
0
0000
00°00
Qo
e0000
°
0000
V YY IYCR'V V � V V LIQ vrvrr��+, ,v,•
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
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 a cfvitpenalty of
Tot 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,
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
'mproved 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 f the improvements covered by this permit, I cannot legally
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 he 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 Dale
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with S c i IT0 I I on 3 of the B and Profe I ns C e, and my license is in full force
and effect. License Class License No D�_ Co tra or Sig ure
WORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP O ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 7706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I 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
ante MR€&8fj( forwhich this permit is issued. Policy No.
• and IN mafljtain 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
u nce carrierand policy number are:
Ea r • • Policy Number Expiration Date
ice of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to
to this workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisir
:OLARATION REGARDING CONSTRUCTION LENDING AGENCY
areby affirm asderpenalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued
44WS Name ' Lender's Address
j7:Bignatur2tgb% I certify to each of the following:
I am the propeltpowner or authorized to act on the property owner's behalf.
I have read this application nd the information I have provided is correct.
I agree to comply with a plicable city and cou ordinances and state laws relating to building construction.
I authorize re resen
ti
of this cit or count o nter t above -identified property for inspection purposes.
mature of Pro arty wo r or Authoriz d Agent i �� �- Print Property Owner's or Authorized Agent' Nam
ACTION DATE BY I I DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 63 OF TITLE 40 AND ACMD RULE
1403
PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED I QEPA
TICERFICATE OF ITFINAL V SBESTOS POSED DEf�IOjATIONIQN IS NOTAPPLICABLE TO
OCCUPANCYISSUED 444444//////f�/%((//�� IIL"
workers' compensation laws of California, and
3097, Civil Code).
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