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HomeMy WebLinkAboutX2019-2769 - Permits6tYrrq� City of Newport Beach - Building Division Overtime Plan Ck $0.00 100 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIII Investigation Fee: $0.00 Building Setbacks Record Management : $60.00 Front: I Energy Compliance: $56.00 Address: CA Seismic Safety: $0.00. COMB Permit :X2019-2769 Disabled Access : Civic Center Drive.,. Newport Beach, CA 92660 $0.00 Hazardous Mat $0.00 Phone: Building Green Fee : $1.00 $0.00 Special Conditions: I I Y ^11111g.���� S k trg1' Permit Counter Phone (949)644-3288 Project No : 1970-2019 Inspection Requests Phone (949)644-3255 xs�* Combination Type - CIP ELEC MECH Issued Date: 0 911 212 01 9 Inspection Area : 7 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Job Address: Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday 700 NEWPORT CENTER DR NB from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Description: COMM T1 376 SF'PACIFIC LIFE AUDIT' Legal Desc.: IRVINE SUB LOT BLK 55 FOR OF BLK - Owner. Address: PACIFIC MUTUAL LIFE - Contractor: ESPLANADE BUILDERS INC Architect: 700 NEWPORT CTR DR ° emmm WALTON JENNIFER • e m m ° m e Address: 23820 HAWTHORNE BLVD Address: NEWPORT BEACH, CA 92660 4770 CAMPUS DR #100 ° .... m m m a ° Phone: TORRANCE CA 90505 ° ° NEWPORT BEACH CA 92660 Phone:. 310-783-7664 Phone: o m • o 949-851-3080 State Lic:C033627 Applicant: BETHEL MEGAN Con State Lic: 831964 Engineer. . e m • • Address. 4770 CAMPUS DR STE 100 Lic Expire: 02/29/2020 Address: - NEWPORT BEACH CA 92660 Bus Lic: BT3 2 m ° • ° • • • m r a Phone: 949-851-3050 LIC Exp Date: 01/31/20201/2020 Phone o e • e Code Edit - 2016. Type of Construction: I -A -SPR Occupancy Group: B Added /New sq.ft. Bldg: 376 Added /New sq. ft. Garage: 0 No of Stories: 6 No of Units 0 Bldg Height:' 0 . Bldg Sprinklers: Y Building Permit Fee: $344.00 Plan Check Fee: $299.28 Worker's Compensation Insurance Carrier: Overtime Plan Ck $0.00 UBBJ8175291826G Investigation Fee: $0.00 Building Setbacks Record Management : $60.00 Front: I Energy Compliance: $56.00 Address: CA Seismic Safety: $0.00. Parking Spaces: 0 Disabled Access : $87.00 $0.00 Hazardous Mat $0.00 Phone: Building Green Fee : $1.00 Worker's Compensation Insurance Carrier: TRAVELERS Policy No: UBBJ8175291826G Expire: 09/27/2019 Building Setbacks Rear: / In -lieu Housing Fee.: Front: I Public Works Department-. Left: / Address: Right: / _ Use Zone: Parking Spaces: 0 14.00 omomc� TOTAL FEE: $973.28 PROCESSED BY:. 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 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $48.16 $37.84 $0.00' Plan Check Fee Planning Department - State Lic: Plan check Fee $40.00 Fair Share $0.00 Designer. Fire Plan Rev In -lieu Housing Fee.: $0.00 Public Works Department-. Park Dedication : Address: m $0.00 San Dist: $0.00 omomc� $0.00 m mo 0 Phone: meommlI°PPaa 000m $0.00 Special Conditions: I I Y ^11111g.���� S 1 ECI® �.e7m Planning Department - Fire Department Plan check Fee $40.00 Fair Share $0.00 SJH Trans Fire Plan Rev In -lieu Housing Fee.: $0.00 Public Works Department-. Park Dedication : $0.00 P/W Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 $482.28 Fee Due at Permit Issuance $491.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: - 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 $482.28 Fee Due at Permit Issuance $491.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: - APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION 1 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) 1 have placed next to the applicable item(s) action 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 B 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 ofessions 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 A 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 L) portions of the work, and the structure is not intended or offered for sale (Section 7044, usiness 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 Iprovements 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 I roved for the purpose of sale). I, as owner of fltICproperty, am exclusively contracting with licensed Contractors to construct the project (Section 7044,_Business and Professions Code: The Contractors' State License Law does not )ply to an own@( 9f.pj8perty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 1.1."exempt from Ijpensure under the Contractors' State License Law for the following reason: y my ENgnatur0 pglpvj1 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 legally NI a structure that 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 rolaselons Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm]. Date jgnatpre of Pr9d%V.(TNner or Authorized Agent ICUUSED CONTRACTOR'S DECLARATION bjie y affirm uRderpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0 of Division 3 of the tractor s and Prof d d li an a is in full force ndd Pact. License Cuss License No ' .... �Q�t�l�RS' COMPENSATION DECLARATION A.RNINO FAILURE CO SEGURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNG EO THOUSAND DOLLARS (E100,0001, IN ADDITION TO THE OST OFICOMPENSA MOW,, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. A&WtafFlrm ugler penalty of perjury one of the following declarations: n have and will Laointain 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 Coda, for lh rformance of the work for which this permit is issued. Policy No. 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. My workers' compensatio sui�nce ca(deLand policy number are: Expiration Date :arrier 1 Policy Number D1,— a ne of Agent certify that, in the perform�n/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 workers' cor9pensation laws of California, and ogre 1, if I should becom/ING to t s' compe s tion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /In Date `7 nature of Applicant CLARATION REGACONSTRUCTION LENDING AGENCYIreby affirm under pperjury that there is a construction lending agency fo erformance Address of the work for which this permit is issued (Section 3097 Civil Code). Ider's Name my signature below, 1 certify to each of the following: I am the property owner or authorizedto act on thepro arty owner's behalf. I have read this application and the information I hav provided is correct. I agree to comply with all applicable city and county rdinances and state laws relating to building construction. {{..L(�_ I authorize representatives of this city or county to er o -i entifi p p y for inspection purposes. L �� C ull, Lc U lDat '[ a (nature of Pro 2 arty Owner or Authorized Agent Print Pro arty Owner's or Authorized A ent's Name :TION DATE BY / DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY nFGOI A. &s PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED 1 SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED LJEPA ISNOTAPPLICABLE TO CERTIFICATE OF OCCUPANCYISSUED