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Home My WebLink AboutX2018-3024 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2018-3024 T 100 Civic Center Drive,. Newport Beach, CA 92660 X , 2 0 1 8 3 0 2 4 Project No: 2385-2018 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255. aLrrvxn ' Combination Type -.CIP ELEC MECH PLUM ' Issued Date r 0212012019 Inspection Area : 7 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.. Construction Hours: Monday - Friday 7:00 a.m, to 6:$0 p.m. and Saturday from 6:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 2865.E COAST HWYNB St: 1 FI: 3 Unit: 300 Description. COMM TI -1713 SF FOR OUTPATIENT SURGERY FACILITY FOR DR ZARRABI� Legal Desc.: TR.323 LOT 5 BLK F AND CORONA DEL MAR LOTS 1/315 BLK 534fir 7 Owner: OCEAN RIDGE PLAZA LLC Contractor: COZART CONSTRUCTION INC Architect: JORDAN STEPHEN C, Address: 2865 E COAST HWY Address: -2863 BROKEN ARROW STREET Address: 19600 FAIRCHILD RD #295 "CORONA DEL MAR CA 92625 NORCO CA 92860 IRVINE CA 92612 Phone: Phone. Phone: 949.679.6300 State Lic:C013586 Applicant: VARISCO ROBERT Con State Lic: 669871 Engineer: NAGARAJAN SIVARAM Address:19600 FAIRCHILD RD STE 295 Lic Expire: 0 413 012 01 9 ...Address:. 167 MATISSE CIRCLE IRVINE CA 92612 Bus Lic: BT30065451 ALISO VIEJO CA 92666. Phone: 949-679-6300 - Lic Exp Date:.: 12/3112019 Phone: 714.444-2422 State. Lic:S-006349 ammo Code Edit: 2016 Worker's Compensation Insurance. Designer. °,,,, ° Type of Construction: 111 -A -SPR Carrier HARTFORD Address: - • ®.. • �•, m m ° o Occupancy Group: B Policy No: 72WECDS3926 s m m m m Added /New sq.ft. Bldg:. 1713 - Expire 0 6/1 212 01 9 Phone: Added/New sq. ft. Garage:. 0 •. °mm�..o. No of Stories: 3 - Building Setbacks Rear / - - -Special Conditions: CR & R TO HAUL No of Units i. 1 Front: I e m °.m o • m e° Bldg Height: 0. Left:-. I.... o m m Bldg Sprinklers: Y... Right. I °••°mm ••m.�° > Flood Zone:' - Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation:- $214,125.00 ° m m ..... oommme m bm Building Permit' Fee:.. $1,858.00 Excise Tax: .$0.00 Planning Department- Fire Department ° •ammo° Plan Check Fee: $1,616.46 Additional Fee : $0.00 Plan check Fee ; $160.00 Fire Inspection:. ;' 41700 Overtime Plan Cki $0.00 Grading Bonds Fee: .$0.00 Fair Share $8,169.56 ` Fire Plan Rev $80.00 Investigation Fee $0.00 Grading PC Consultant: -$0.00 SJH Trans : $0.00 Demolition Fee Record Management.:. $112.00 Grading Permit Fee: - $0.00 In -lieu Housing Fee : ' $0.00 Building Dept Adm $24,00 Energy Compliance: $149.89 Grading PC Fee: $0.00 Public Works Department- General Service $197.00 CA Seismic Safety: $0.00 WQ Insp. Fee :$0.00 Park Dedication: $0.00 Refund Deposit $564.00 Disabled Access ; $214.13 - -PAN Plan Check: $0.00 Grading Bond: $0.00 - Hazardous Mat $0.00: Electrical %:' $486.42 San Dist: $0.00 Building Green Fee : : $9.00 - Mechanical %: $382.19 NMUSD Fee: $0.00 $0.00 Plumbing %: $312.70 $0.00 TOTAL FEE : $14,942.35 Plan Check Fee : $11,022.61 Fee Due at Permit Issuance : $3,919.74 PROCESSED BY: : PUBLIC WORKS APPROVAL: ZONING APPROVAL: Q PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjurythat 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 is 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 'rofessions 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 of more than five hundred dollars ($500). 1 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, lusiness 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 nprovements 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 nproved 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 pply 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: ly 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 legall,. ell 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 'rofessions 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 Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with SYe ?LTIESV!1`!D f the Bus' e s and Professio Cod�„and my lige-(s_in full force nd effect. License Class License No Contra to ignature�!VORKERS'COMPENSATION DECLARATIONDARNING: FAILURE TDSFftRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PECIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE OST OF COMPENSA'(IQTJ DAMAGES AS PROVIDED FOR IN SECTION 5705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. jar*L); affirm under pepalty of perjury one of the following declarations: .1 hive and ;IN 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 Cade, for th %ditmi nce of the work for which this permit is issued. Policy No. Aare and wijl•mgif pin 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 Va a carrier and policy number are: .... Policy Number Expiration Date W.4 -Agent • • • • Phone # Sent 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 6rkers' compensation laws of California, and agre .If I should hecprol ubject to thywork IS' cg ompensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions. U 'atal of App' a /7 y/ J/—`� Date lLARATION DING COVSTRUCTION LENDING AGENCY eby 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). ier's Name Lender's Address ny 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 ordinances and state laws relating ty.�]�� g construction. I authorize representatives of ity or county to eyR1�above-identified prop Qy for�lbsbaction purposes. iature of Prooertv Owner or A rized Anent ,ice 29' i Print Property Owner's or Authorized Agont's Name Qat ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE DAY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE J 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT EXTENDEDy�, LJAQMD PERMITFINAL \\."t,6 •�'{ Cd•4'^ BESTOSNOTIFICA NI NOT�APPLICABLE TO CERTIFICATEOF 05ED DEMOLIT �- !!. d4 i OCCUPANCYISSL S ATURE: