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Home My WebLink AboutX2018-3458 - Permits (2)W1fi f City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII� II COMB Permit X2018-3458 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 8 3 4 5 6 Project No: 2680-2018 E. a Permit Counter Phone (949)644-3288 9 Inspection Requests Phone (949)644-3255. °u1e Combination Type - CIP ELEC MECH Issued Date : 03/2012019 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: 1600 W BALBOA BLVD NB - Description". ; PUBLIC-USE TI - 153 SF OFFICE SPACE @ MARINA PARK - Legal Desc.: Owner CITY OF NEWPORT BEACH Contractor:. T L.VETERANS CONSTRUCTION INC Architect: BUNDY TIM • e ° e " Address: 100 CIVIC CENTER DR Address: 18345 SIERRA HIGHWAY 7 Address: 20331 IRVINE AVE #7 ° .... NEWPORT BEACH CA 92660 SANTA CLARITA, CA 91351 ` SANTA ANA CA 92673 os Phone; - Phone: (661) 299.6782 Phone: State Lic:CO25503 • e • ° e a^ ,.}��® Applicant: TSE FONG Con State Lie: 1000483 Engineer: TSE FONG WAI • "� ° Address. 100 CIVIC CENTER OR Lie Expire: 01/31/2021 Address: 1102 DORSETSHIRE LN ee se.. ° NEWPORT BEACH CA 92660 Bus LIC Phone: 949-644-3321 Lie Exp Date: BT30062121 1213112019 Phone: SANTA ANA CA 92705 949-644-3321 State Li¢C-056980 e ° e e • ° Code Edit: 2016 Worker's Compensation Insurance Designer: .... Type of Construction:. V-BSPR Carrier: STATE COMP Address: e"9129563 Occupancy Group: B Policy No: °°°m°° m ° Added /New sq.ft. Bldg: 153 Expire: 04/0412019 Phone: Added /New sq. ft. Garage: 0 No of Stories: 2. : ' Building Setbacks Rear: I Special Conditions: CITY PROJECT No of Units : 0 Front: Bldg Height: 0 Left:. / - Bldg Sprinklers:. Right: /. - Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $35.000.00. Building Permit Fee: $581.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $505.47 Additional Fee : ($1,313.72) 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: $26.00 Grading Permit Fee: $0.00 In-lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy. Compliance:. $56.00 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: $0.00 : - P/W Plan Check: $0.00 .Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $81.34 San Dist: $0.00 Building Green Fee ; $2.00. Mechanical %: $63.91 NMUSD Fee: , $0.00 - $0.00 Plumbing %:.. $0.00 ..$0.00. TOTAL FEE: $2.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $2.00 PROCESSED BY: - PUBLIC WORKS APPROVAL: p ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE:',/ v\ z 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, altffr, 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 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 mprovements 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 nnt' 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). I am exempt frgm 11 censure under the Contractors' State License Law for the following reason: 3y 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 legalll Lei a str}Icture th&f rifave 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 :MfessiQns Cole, 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 7 Date AERSED CON.TRACTOR'S DECLARATION Other fby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00) f Di is' n 3 of the Business and P fessions CAde,dynyIke Bis in full force UMaf fait. LicatrysgCllss License No Date ntractor Signatu a NORItERS' COMPENSATION DECLARATION /]�yZ� ftAR1GyFAILURE?T,WP1!1RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES A D CIVIL FI S UP TO ONE HUP DRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE "16 pGCOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 7706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. bawby affirm under penalty of perjury one of the following declarations: :211 havB and $411I1fiAiQtain 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 leguran ce of the work for which this permit is issued. Policy No. He and willdvaiotain 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' compensatiol carrier and policy number are: Policy Number Date 1e of Agent r'none 9 certify that, in the perform ce 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 work s' compensation laws of California, and , if I should become subjetto the„workers' gpmWgsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. y signature of Applicant IECLARATION REGARDI G CONSTRUCTION LENDING AGENCY hereby affirm under penlity of perjury that thereis a construction lending agency for the performance of the work for which this permit is issued (Section ender's Name Lender's Address ly my signature below, I certify to each of the following 1 am the property owner or authorized to act on the property owner's behalf. I have read this application and the informationyyI have provided is correct. I agree to comply with all applicable city and cqunty ordinances and state laws relating to building construction. I authorize representatives of this city or country to an er t above-' tified roperty for inspection purposes. .�....�r..— ..f o...,. , n..,e,� — A„IHnriovA Ancn/ 7�'7 � Print Pronartv Owner's or Authorized Aaent's Name DATE BY REGULATIONS COMPLIANCE PART61OF II TLE 40 AND AQMD RULE PERMIT CANCELLED UEPA PERMITEXTENDED EIAQMD PERMITFINAL BESTOS NIQTIFICATION IS NOTAPPLICABLE TO. CERTIFICATE OF \ PROPOSED DEtyiOLITION, OCCUPANCYISSUED SIGNATURE: .FOR OFFICE USE ONLY �O Civil Code).