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Home My WebLink AboutX2018-3768 - PermitsI+q City of Newport Beach - Building Division C +� 100 Civic Center Drive, Newport Beach, CA 92660 Address: Energy Compliance: COSTA MESA, CA 92626 Permit Counter Phone (949)644-3288 Phone: Disabled Access: Phone: Inspection Requests Phone (949)644-3255 JACOBSEN BRENT Con State Lie: Combination Type - CIP GRAD ELEC COMB Permit: X2018-3768 IIIIIIIIIIIIIIIIIIIIIIIIII�llllillllllllllllllu II Project No : 2917-2018 Issued Date: 05/08/2019 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. t0 6:00 p.m. No work on Sundays or Holidays Job Address: 1500 QUAIL ST NB Description: COMM EXTERIOR LANDSCAPE IMPROVEMENTS WI (2) LATTICE/FABRIC CANOPY STRUCTURES 450 SF & 190 SF Legal Desc.: P BK 120 PG 27 PAR 2 Owner: 1500 QUAIL LLC Contractor: Address: 150 PAULARINO AVE #D182 Address: Energy Compliance: COSTA MESA, CA 92626 CA Seismic Safety: Phone: Disabled Access: Phone: Applicant: JACOBSEN BRENT Con State Lie: Address: 3101 IN EXPOSITION PL Lie Expire: 949-892-3510 LOS ANGELES CDA 90018 Bus Lic: Phone: 323-785-1800 Lie Exp Date: Code Edit: 2016 Type of Construction: Occupancy Group: U 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: Building Permit Fee: $5,577.00 Plan Check Fee: $4,851.99 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $56.00 Energy Compliance: $0.00 CA Seismic Safety: $252.00 Disabled Access: $885.00. Hazardous Mat $0.00 Building Green Fee : $36.00 TOTAL FEE: $15,803.30 PROCESSED BY: C D G BUILDERS INC Architect: Additional Fee : $0.00 Grading Bonds Fee: $0.00 24 EXECUTIVE PARK #150 Address: Grading Permit Fee: ) '� '^ �'•. $169.92 IRVINE CA 92614 $0.00 $41.25 � � $0.00 NMUSD Fee: 949-892-3510 Phone: ;i State W . d `. ` • o o • ° o 0 n.>.y IA• , 921615 Engineer:. GAVAZZA, JEFFREY BRYAN a •° a°e 0913012020 Address: 472 35TH .... oe o BT30044670 MANHATTAN BEACH CA 90266 ° • e m 09130/2019 Phone: 213.416-0201 sees State Li¢C-059894 e a o °O ° Worker's Compensation Insurance Carrier: LIBERTY MUTUAL FIRE INS Policy No: WC2Z914701010 Expire: 01120/2020 Building Setbacks Rear: / Front: / Left: / Right: I Excise Tax: $0.00 Additional Fee : $0.00 Grading Bonds Fee: $0.00 Grading PC Consultant: $774.08 Grading Permit Fee: $875.00 Grading PC Fee: $169.92 WQ Insp. Fee: $0.00 Electrical %: $1,460.06 Mechanical %: $0.00 Plumbing %: $0.00 ZONING APPROVAL:7yv GRADING APPROVAL: Plan Check Fee Designer: Address: Phone: Special Conditions: ob�cks �Wa eke Planning Department - Fire Department Plan check Fee Fire Inspection: Fair Share Fire Plan Rev SJH Trans Demolition Fee In -lieu Housing Fee Building Dept Adm Public Works Department - Park Dedication : $0.00 PAN Plan Check: $41.25 San Dist: $0.00 NMUSD Fee: $0.00 o m mmo•oo m o mm o m o oomm $0.00 $0.00 $24.00 $197.00 $564.00 $0.00 $0.00 $0.00 $6,444.99 Fee Due at Permit Issuance : $9,358.31 PUBLIC WORKS APPROVAL: PLAN CHECK BY: JA, � ,, v�4, APPROVAL TO ISSUE: - ✓ U X/y mm•oo e mmmoo mmmmoo m o 0 m o omoe,o m mmoe Fire Department $40.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: o m mmo•oo m o mm o m o oomm $0.00 $0.00 $24.00 $197.00 $564.00 $0.00 $0.00 $0.00 $6,444.99 Fee Due at Permit Issuance : $9,358.31 PUBLIC WORKS APPROVAL: PLAN CHECK BY: JA, � ,, v�4, APPROVAL TO ISSUE: - ✓ U X/y mm•oo e mmmoo mmmmoo m o 0 m o omoe,o m mmoe 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 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). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) 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). ❑ 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 �I 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 from licensure under the Contractors' State License Law for the following reason: By my signature befoVi 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 legal) s@II a strycture thAt1 T18ve 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 F':8IB39idns 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 Properiy0wner or Authorized Agent Date I.ICEWSED CONTRACTOR'S DECLARATION l hereby affirm underpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0 of Division 3 of the Business and Professio Is Cod A license is in full force %p efMl;t. Lic(%s. Class License No Date 5'�"' )� Contractor Signature *OVERS' CQMljjNSATION DECLARATION VTA*RW45;.FAILURE•TJfT,90RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI L PENALTIES AND CIVIL FINES UP TO ONE HUNDRED HOUSAND DOLLARS ($100,000), IN ADDITION TO THE Mei OR COMPENSATIOAA, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Iherebyeffirm undgr penalty of perjury one of the following declarations: I ha0e and 6utll•R19il1tain a certificate of consent to self-insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th rmance of he work for which this permit is issued. Policy No. I.11Eve and Alk V$Intain 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' compensatio s ante carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # I certify that, in the pert rmance 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 w/Das--9 mpensation laws of California, and agre that, if 1 should become bject to the works ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.(lSignature of Applicant % /DECLARATIONREG DINGCONST CTION LENDING AGENCY I hereby affirm under enalty of perjury that there is a construction lending agencyforthe performance of the work forwhich this permit is issued (Section 30Code). Lender's Name Lender's Address By 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 coLtty ordinances and state laws relating to building construction. I authorize representatives of this city or count h -identified property for inspection purposes. Signature of Property Owner or Authorized Age Print Property Owner's or Authorized Agent's Na �c1G- Da ACTION VDATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMIT EXTENDED QMD PERMIT FINAL SBESTOS OTIFICATION LICABLE TO CERTIFICATEOF RO DMO OCCUPANCYISSUED SIGNATUR