HomeMy WebLinkAboutX2019-2559 - Permitsr rr City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
o 100 Civic Center Drive, Newport Beach, CA 92660 X 2 8 1 7 9
['�, .z Permit Counter Phone (949)644-3288
.Inspection Requests Phone (949)644-3255
''*yxr�,v`r Combination Type - BLDG MECH
2 5 5 9 y II
COMB Permits X2019-2559
project No: 1824-2019
Issued Date : 08/28/2019
Inspection Area : 7
$0.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION,
$8.00
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: 4343 VON KARMAN AVE NB.
CA Seismic Safety:
$0.00
Disabled Access :
Description: COMM REMOVEIREPLACE (2) EXISTING ROOFTOP AIR COOLER CHILLERS W/ SAME SIZE EQUIPMENT
Hazardous Mat
$0.00
Legal Desc.; N TR 8063 LOT 2.
$3.00
Public Works Department-
$0.00
Owner: MIZAN LLC
Contractor: MESA ENERGY SYSTEMS INC
Architect:
P/W Plan Check:
Address: 4343 YQe.KARMAN AVE
Address: 2 CROMWELL
Address:
$0.00
c ., c NEWPORT -BEACH, CA 92660
IRVINE CA 82618
$0.00
$0.00
PhfRe;oo-
Phone ..949-460-4601
Phone:
State Lie: _
Apklic6nt THAed'airtl6
Con State Lie: 611215
Engineer: FERINI JARED
AddrG6`O 2 CROMWELL
Lie Expire: 0113112021
Address: 28124 MURRI ETA CREEK
. a,... IRVINF, J;# 92618
Bus Lie: BT98039750;
MURRIETS CA
92562
Phctinoe : o 949-603-5$98
Lie Exp Date: 12/3112019
Phone:
State Li¢S-005922
Cod; E&V � = ° 2016
Type of Construction ^ c
Worker's Compensation Insurance
Designer:
Carrier: AMERICAN CASUALTY
Address:
OccLip@r?c%.Group: o U
Policy. No: WC6072336019
Adds(] INEw sq.ft. Bldg:,, 0
Expire: 1 0/0112 01 9
Phone:
Addod /New sq. ft. Galsor.` 0
No QV.Slone`G: , 0
Building Setbacks Rear: /
Special Conditions:
No of Units :0
Bldg Height: �. o c o c0
Front: I
Left: I
{p -
1 �
Bldg Sprinklers:
Right:. /
..�
Flood Zone:
Use Zone: Parkina Snaces: 0
Firm Hwerd 7nno - M
Building Permit Fee: $833.00
Plan Check Fee: $724.71
Overtime Plan Ck:
$0.00
Investigation Feer
$0.00
Record Management:
$8.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$3.00
TOTAL FEE: $1,671.02
PROCESSED BY: Arw
ZONING APPROVAL:
GRADING APPROVAL:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant:
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
$0.00
Planning Department -
$0.00
Plan check Fee
:$0.00
$0.00
Fair Share
$0.00
$0.00
SJH Trans
$0.00
In -lieu Housing Fee :.
$0.00
$0.00
Public Works Department-
$0.00
Park Dedication :
$0.00
$0.00
P/W Plan Check:
$0.00
$0.00.
San Dist:
$0.00
$62.31
NMUSD Fee:
$0.00
$0.00
Plan Check Fee : $793.70 Fee Due at Permit Issuance : $877.32
PUBLIC WORKS APPROVAL: / f�.�.
PLAN CHECK BY: � Gr i
APPROVAL TO ISSUE:
Fire Department
$40.00
Fire Inspection:
:$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
-. Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00.
Plan Check Fee : $793.70 Fee Due at Permit Issuance : $877.32
PUBLIC WORKS APPROVAL: / f�.�.
PLAN CHECK BY: � Gr i
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
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 `) 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 Coder 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 licensureunder 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 of the improvements covered by this permit, I cannot legal)
sell a structure that 1 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 JIIj Qusiness 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. ; 6.0 a••^•`
Signature of Property Owner or Authorized Agent Date - -
LICENSED CONTRACTOR'S DECLARATION •" +
I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 of ivision 3 of the Business and Professions o license is in fQlj �°o eco
and effect. License Class License No BefE i Contractor Signature
WORKERS' COMPENSATION DECLARATION • +••
WARNING: 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 ($10(r.0001, IN ADDITI ONeTO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. • • • • + +
I hereby affirm under penalty of perjury one of the following declarations: "+
9-1 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 Cede dor°the
p, �rformance of the work for which this permit is issued. Policy No. . ' -
I i 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. Mj Wdtkers' co:VI§AE9gon
...•
ance carrier and policy number are: J/ /1
Tier AMR41f1AAl YURCTY &AvIOA fZ Policy Number �1 33 lot) Expiration Date 30 9
ne of Agent Phone #
certify that, 1n the performance h rk for ch 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 agree
I, if I should become subject t e e mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /
Date
nature of Applicant
CLARATION REGAADING taWRKTION LENDING AGENCY
Ireby 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 ordina s d state relating to building construction.
I authorize representatives of this city or county to enter a a- Ified property for inspection purposes. �7� ®P /79
nature of Property Owner or Authorized A ant Print Property Owner's or Authorized Agent's Name l.i (� yl Date L
TION DATE BY D TION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
PERMIT EXPIRED
CERTIFICATE OF
I SUBMITTED
TO
' ` ` I ��/ I PROPOSED DEMOLITION ION ISNOT APPLICABLE TO