HomeMy WebLinkAboutX2019-2167 - Permitsw1'c�
City of Newport Beach - Building Division
Contractor:
100 Civic Center Drive, Newport Beach, CA 92660
Architect:
Permit Counter Phone (949)644-3288
v
Inspection Requests Phone (949)644-3255
Address:
Combination Type - BLDG GRAD ELEC
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2019-2167
x 2 0 1 9 2 1 6 7 Project No: 1572-2019
Issued Date : 02/06/2020
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: 1 HOAG DR NB
Description: COMM LANDSCAPE IMPROVEMENTS, WOOD FENCE WI STEEL FRAMES 5' HIGH X 41 LF & GRADINGIDRAINAGE, 4 -FOOT CMU WALL (WATER FEATURE) AND RAISED FLOOR
Legal Desc.: IRVINE SUB BILK 1 LOT 172 POR OF LOT
Owner:
HOAG MEMORIAL HOSPITAL
Contractor:
C D G BUILDERS INC
Architect:
$48.00
Address:
301 N NEWPORT BLVD
Address:
24 EXECUTIVE PARK #150
Address:
$400.00
Hazardous Mat
NEWPORT BEACH, CA 92669
Building Green Fee :
IRVINE CA 92614
$0.00
NMUSD Fee:
Phone:
Refund Deposit
Phone:
949-892-3510
Phone:
State Lic:
Applicant:
RABBEN BILL
Con State Lic:
921615
Engineer:
WELTON JEREMY
Address:
833 DOVER DR #9
Lic Expire:
0913012020
Address:
26461 RANCHO PARKWAY SOUTH
NEWPORT BEACH, CA 92663
Bus Lic:
BT30044670
LAKE FOREST CA 92620
Phone:
949-548-3459
Lic Exp Date:
0913012020
Phone:
949.916.3440 State Lic:S-004614
Code Edit : 2016
Type of Construction: VB
Occupancy Group: U
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 0
No of Units: 0
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation: $400.000.00
Building Permit Fee: $2,968.00
Plan Check Fee: $2,643.16
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management :
$48.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$400.00
Hazardous Mat
$0.00
Building Green Fee :
$16.00
TOTAL FEE: $8,238.17
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Worker's Compensation Insurance
Carrier: LIBERTY MUTUAL FIRE INS
Policy No: WC2Z91470101020
Expire: 01/2012021
Building Setbacks
Excise Tax:
Additional Fee:
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: I
Front: I
Left: I
Right: I
larking Spa
$0.00
$0.00
$0.00
$0.00
$875.00
$761.25
$0.00
$388.51
$0.00
$0.00
Designer:
HERMAN DANIEL
Address:
8333 DOVER DR #9
Fair Share
NEWPORT BEACH CA 92663
Phone:
949-548-3459
Special Conditions
Fire Hazard
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
PAN Plan Check:
$41.25
San Dist:
$0.00
NMUSD Fee:
$0.00
Plan Check Fee: $3,524.16 Fee Due at Permit Issuance : $4,714.01
PURiLIE WOht(S APPROVAL:
m °PLAIti t;HECI* BYE
o m ° APPROVAL TO ISSUE:
o m mo mm m ° moo co°
Fire Department
$40.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$57.00
$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: $3,524.16 Fee Due at Permit Issuance : $4,714.01
PURiLIE WOht(S APPROVAL:
m °PLAIti t;HECI* BYE
o m ° APPROVAL TO ISSUE:
o m mo mm m ° moo co°
OWN
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 Vern(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).
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,
iusiness 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
n roved 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 legally
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.govlcalaw.htm].
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 Section 0 f 's' of the Business and Profs cense ' .�RI force
nd effect. License Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
DOLLARS ($100,000), IN ADDITION TO THE
have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
rmance of the,M(ork for which this permit is issued. Policy No.
have and willa tarn workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
rance carrier an licv numbel$am:
Date
of Agent
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' compens tion 116s of California, and agree
becomet, if I should subject to the como>
pens3ti n prtion 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant�T
CLARATION RE A I COf CTION LE II/NG AGENCY •i`�'S-(P�/
:reby 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).
tder'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 ordinances and at to laws relating to building construction.
I authorize representatives of this city or countXto en.* -the above'nnVi0 r9Rerty,f2pJApection purposes.
or Autnonzea Agent rant vropeny owner s or Aumonzea Ag
DATE BY bEcLARATicA OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED U i suBMITTED ASBL•STO3 NQTIFICpiI®N i0 •
PERMITCANCELLED OEPA • • • • ••
PERMIT EXTENDED QMD
PERMITFINAL-7 / C� ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
CERTIFICATE OF !/•(� PROPOSED DEMOLITION • • ••
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