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Home My WebLink AboutX2019-1914 - PermitsCYf�ry�A. City of Newport Beach - Building Division IIIIIII IIII II IIIIIIIIIIII VIII III COMB Permit: X2019-1914 varKing a aces: u II Construction Valuation: $100,000.00 II $1,113.00 s4' ' 100 Civic Center Drive, Newport Beach, CA 92660 '" $0.00 X 2 0 1 9. 1 9 1 4 Fire Department - Project No: 1390-2019 -. F Permit Counter Phone (949)644-3288 Additional Fee : $324.00 Plan check Fee `. F $ Inspection Requests Phone (949)644-3255 Fire Inspection: $0.00 Overtime Plan Ck: enc v,+,> ` Combination Type- CIP ELEC MECH PLUM rv., Grading Bonds Fee: $0.00 Issued Date : 0912512019 $0.00 Fire Plan Rev $0.00 _ 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, to 6:00 p.m. No work on Sundays or Holidays Job Address: 100 BAYVIEW CIR NB St: 1 FI: 1 Unit: 1200 SJH Trans : $0.00 Demolition Fee Description: COMM TI "STEREOSCOPE COFFEE" 672 SF (CHANGE OF USE) Record Management: $72.00 .Legal Desc.: N TR 12528 LOT 2 $0.00 In -lieu Housing Fee: $0.00 Owner: GPI BAYVIEW. LLC Contractor: < PACIFIC CONTRACTING GRP INC Architect: WICK DAVID Address: 5601 GRANITE PKWY #1200 Address: 15431 RED HILL AVE #F Address: 830 TRACTION AVENUE 0A PLANO, TX 75024 - TUSTIN, CA 92780 $0.00 LOS ANGELES, CA 90013 Phone: Phone: 714-834-0911 Phone: 323-644-9867 State Lic:CO29199 Applicant: VERMEULEN SHANNON Con State Lia 947272 Engineer: LAM HOWARD Address:. 830 TRACTION AVENUE #3A Lic Expire: .05/3112020 - Address: 18831 VON KARMAN AVE #240 LOS ANGELES, CA 90013 Bus Lia BT30054951 $0.00 IRVINE CA 92612 - Phone: 323-644-9867. Lic Exp Date: 09/30/2020. Phone: 949-862.-8500 State Lic:S-002717 Code Edit : 2016 Worker's Compensation Insurance Designer. $4.00. Type of Construction: B SPR Carrier. Occupancy Group: 8 Policy No: BENCHMARK CST5014882 Address: $0.00 � E T OR Added /New sq.ft. Bldg: 672 Expire: 1213112019 Phone: Plumbing %: $187.32 Added /New sq. ft. Garage: 0 $0.00 No of Stories: fi Building Setbacks Rear: I Special Conditions: !RWD Fee Due at Permit Issuance : No of Units : 0 Front: / ��3 Bldg Height: 0 -Left: / Bldg. Sprinklers: Y Right: / ,.,, m,. F., 8� . nooa cone: ilL UU4 use cone: varKing a aces: u rare nazara Lone: N Construction Valuation: $100,000.00 Building Permit Fee: $1,113.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee:. $968.31 Additional Fee : $324.00 Plan check Fee `. $240.00 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share: $0.00 Fire Plan Rev $0.00 Investigation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $72.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance: $70.00 Grading PC Fee: $0.00. Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00. Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access t $100.00 PMI Plan Check: $0.00.. Grading Bond: $0.00 Hazardous Mat. $0.00 Electrical %: $291,38 San Dist: .$0.00 Building Green Fee : $4.00. Mechanical %: .$228.94 NMUSD Fee:. $0.00 $0.00 Plumbing %: $187.32 $0.00 TOTAL FEE : $3 .95 Plan Check Fee: $1,831.53 Fee Due at Permit Issuance : $1,767.42 ear co:. ,.,, m,. F., 8� . ZONING APPROVAL: APPROVAL: PLAN CHECK BY: GRADING APPROVAL: �APPF;OVU TO ISSUE: c. c goo 00o w oo0 00 oe� 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 (_) 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 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.htmi. 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 7 0) of !via f the Business and Professions n y license is in full force and effect. License Class License No Dat / Contractor Signatures% WORKERS' COMPENSATION DECLARATION 1_-1 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 THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 7706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: 11 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 th Ra rmance of the work for which this permit is issued. Policy No. e 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 auran a carrier and policy number are: // - Carrier �E]n1CklMAQK- �AtSo.P11a.7f.0-GD• Policy Number Expiration Date Name of Agent Phone # I certify that, in the performance 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' compensation laws of California, and agre that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / q Signature of Applican�E� Dafen! / / DECLARATION REG X NG CONSTRUCTION LENDING AGENCY V� I hereby 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). 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 [.D �, ,5'7) N/a I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county to en r t -I n ified property for inspection purposes. q ` Si nature of Property Owner or Authorized Age - Print Property Owner's or Authorized Agent's Nam Date / a ACTION DATE B DECLARATIOITZIF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED IT SUBMITTED ASBESTOSN01IFI4110N TO • • �a• •` PERMIT CANCELLED- EPA • • � • • •• • ••i PERMIT EXTENDEDQMD • • °' PERMITFINAL LJ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF PROPOSED DEMOLITION ••• OCCUPANCYISSUED SIGNATURE: • ° • °�• •• e••