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Home My WebLink AboutX2019-2568 - Permitsxno City of Newport Beach - Building Division Address: 1400 SUNKIST#190 Record Management : 100 Civic Center Drive, Newport Beach, CA 92660 N . Permit Counter Phone (949)644-3288 c,.. Inspection Requests Phone (949)644-3255 'fl''aaar,a`A Combination Type - BLDG PLUM ELEC III �XI�I� I 0 Ilu� II�VIII II I I I I I�I II COMB Permit: X2019-2568 Project No: 1579-2019 Issued Date : 0811412019 Inspection Area; 5 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: 4701 SURREY DR NB Description: DELTA 1, INSTALL SUBTERRANEAN VAULT TO ASSIST (E) SPA (52019-0122) Legal Desc.: N TR 3519 LOT 67 Owner: PLEASANTVILLE RD PTRS Address: 1 CORPORATE PLAZA DR #110 NEWPORT BEACH IIA 92660 Phone Applicant: PAULIMITCHELL PARKS Address: 1400 SUNKIST#190 Record Management : ANAHEIM, CA 92806 Phone: 949.228-1953 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: Contractor: MITCHELL PARKS Address: 1400 S SUNKIST ST #190 Record Management : ANAHEIM CA 92806 Phone: 949-279-7193 Con State Lic: 838091 Lie Expire: 05/31/2020 Bus Lie: BT30058994 Lie Exp Date: 05/3112020 Worker's Compensation Insurance Carrier: NO EMPLOYEES Policy No: Record Management : Expire: Energy Compliance: Building Setbacks Rear: I $0.00 Front: I $0.00 Left: I $0.00 Right: I Use Zone: Parkina SDaces: 0 Construction Valuation: $8,000.00 Building Permit Fee: $200.00 Plan Check Fee: $174.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management : $4.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green Fee: $1.00 TOTAL FEE: $451.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Architect Address: Phone: State Lie Engineer: LACHER TODD Address: 1201 N TUSTIN AVE Additional Fee : ANAHEIM CA 92807 Phone: 714.630-6100 State Lic:C-067656 Designer: $0.00 Address: Phone: $0.00 Special Conditions: Excise Tax: .$0.00 Planning Department - $40.00 Additional Fee : $0.00 Plan check Fee Fire Plan Rev Grading Bonds Fee: $0.00 Fair Share Grading PC Consultant : $0.00 SJH Trans Grading Permit Fee: $0.00 In -lieu Housing Fee: Refund Deposit Grading PC Fee: $0.00 Public Works Department - WQ Insp. Fee: $0.00 Park Dedication : $0.00 PAN Plan Check: $0.00 Electrical %: $14.00. San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: ' $10.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $451.00 PUBLIC 06RKSIAPPROVAL: ° ELAN CHC- CK f Y® 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 : $0.00 Fee Due at Permit Issuance : $451.00 PUBLIC 06RKSIAPPROVAL: ° ELAN CHC- CK f Y® 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 (_) all of or L) 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). U '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 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 licensure under 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 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 Professions Code, 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 Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 ) ' ' f f the Business and P ofed an icense is in full force and effect. License Class License No Date Contractor Signal 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 )$100,000), IN ADDITION TO THI COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: I 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 Code, for t1 9pe rmance of the work for which this permit is issued. Policy No. 1 have and willImain 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' compensatic insurance carrier ADd Wicv number are: ^ "N \ J'1 Tier Y P Expiration Date Tie of Agent Phone # certify that, in the perf=ters' t ' permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compens on law of California, and agree I. if I should become su tion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisionsnature of Applicant CLARATION REGA D AGENCY rreby affirm under p aonstruction 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, 1 certify to each of the following: I am the property owner or authorized to act on the property owners behalf. I have read this application and the information I have pro a Iscome I agree to comply with all applicable city and county ordi nc s to I s Ing to building construction. I authorize representatives of this city or countAo rioter h b e-il n ' e r arty for inspection purposes. Signature of Property Owner or Authorized A entPrint Property Owner's or Authorized Agent's Na c " pEte ACTION DATE BY DECLAATItFITOFC PLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGU TIONS PART61 OF TITLE 40AND AQMD RULE 1403 PERMIT EXPIRED 0 I SUBMITTED ASBESTOS NOTIFICATION TO, • • " • •• PERMIT CANCELLED Epp •" �i •�• • """ i PERMIT EXTENDEDA3AQMD �" • • • • • • • " " PERMITFINAL/p ASBESTOS NOTIFICATION IS AOT APPLICABLE TO CERTIFICATE OF ll �� C� PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: • • •s•