HomeMy WebLinkAboutX2017-1801 - PermitswaoQ City of Newport Beach - Building Division
04* 100 Civic Center Drive, Newport Beach, CA 92660
`i Permit Counter Phone (949)644-3288
v. Inspection Requests Phone (949)644-3255
""arva,try'. Combination Type - CIP
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2017-1801
x 2 6 1 7 1 6 0 1 Project No: 0300-2017
Issued Date : 06/07/2017
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: 401 NEWPORT CENTER DR NB
Description: PRECISE GRADING FOR ADA IMPROVEMENTS "PHASE 3"
Legal Desc.: P BK 221 PG 30 PAR 2 1A �� A /�
Owner: IRVINE CO Contractor: CUESTA CONSTRUCTION CO Architect: 19/ N��
Address: 550 NEWPORT CENTER DR Address: 3195A AIRPORT LOOP DR Address: ®�
NEWPORT BEACH, CA 92660 COSTA MESA CA 92626
Phone: Phone: 714-557-5877 Phone: State Lic:
Applicant: HOLLAND ROB
Con State Lic:
568466
Address: 38 TECHNOLOGY STE 100
Lic Expire:
0 5131 /201 9
IRVINE, CA 92618
Bus Lic:
BT20012806
Phone: 949-923-6260
Lic Exp Date:
12131/2017
Code Edit : 2016
Worker's Compensation Insurance
Type of Construction:
Carrier:
SENTINEL INS
Occupancy Group: U
Policy No:
72WEQ10610
Added /New sq.ft. Bldg: 0
Expire:
1 210112 01 7
Added /New sq. ft. Garage: 0
Phone:
Grading Bonds Fee:
No of Stories: 0
Building Setbacks
Rear: I
No of Units : 0
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Front: I
Bldg Height: 0
o 0
°
Left: I
Bldg Sprinklers:
$0.00
Right: /
Engineer: THIESSEN MITCHELL
Address:
38 TECHNOLOGY
IRVINE CA 92618
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Phone:
949-923.6293 State Lic:C-056967
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$0.00
Designer:
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Address:
Additional Fee :
$0.00
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$0.00
Fire Inspection:
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Phone:
Grading Bonds Fee:
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Special Conditions: SEE X2017-0429 FOR ADDL
Fire Plan Rev
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Investigation Fee:
FEES AND GRADING
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0
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SJH Trans :
$0.00
Demolition Fee
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Construction Valuation:
$312.506.00
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Building Permit Fee:
$2,160.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $1,879.20
Additional Fee :
$0.00
Plan check Fee :
$0.00
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:
$0.00
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 :
$312.51
PAN Plan Check: $0.00
Grading Bond:
$0.00
Hazardous Mat
$0.00
Electrical %:
$0.00
San Dist : $0.00
Building Green Fee :
$13.00
Mechanical %:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $4,364.71
Plan Check Fee
: $0.00 Fee Due at Permit Issuance :
$4,364.71
PROCESSED BY:
PUBLIC WORKS APPROVAL:
ZONING 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 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
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
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
of more than five hundred dollars ($500).
7 I, 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,
Iusiness 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
nprovements 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
nproved for the purpose of sale).
1 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).
7 1 am exempt from licensure under the Contractors' State License Law for the following reason:
Iy 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.htm].
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 Division 3 of the Business and Professlo Code, and m license is in full force
nd effect. License Class License No Date 7 Contractor Signature .., / J ..�t.....�
YORKERS' OOMPErNSATION DECLARATION CC
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
:OMPEN�SR7IOM 4AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
affirm Ondef penalty of perjury one of the following declarations:
4have and MIT 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
umance of4ITeM8rk, for which this permit is issued. Policy No.
Lave and yill 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' compensa
vice carrier mn policy number are:
el. * Policy Number Expiration Date
Agent
certify that, in Ne 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 agre,
f," hould becgplg,s jec tQ the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. `
natureof Applicant L/ I&L-7 Date f'7
CLARATION REGARDING CONSTRUCTIO ENDING AGENCY
:reby 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 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.
I authorize representatives of this city or cou y to enter the ab9ve-identified property for inspection purposes.
nature Of PMDerty Owner or Authorized AOet �,.r�C/ 1 IN AM a . i Print Propertv Owner's or Authorized Agent's Name
DATE BY DECLARATION OF I I REGULATIONS PATQ61 OF TITLE 40 AND AQMD RULEITH CODE OF RAL FOR OFFICE USE ONLY
PERMIT EXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED
OEPA
PERMIT EXTENDED
0AQMD
PERMITFINAL
CERTIFICATE OF
OCCUPANCY ISSUED
r L
0 ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION
SIGNATURE:
Date