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Home My WebLink AboutX2019-3993 - Permits�,ara4 City of Newport Beach - Building Division f 100 Civic Center Drive, Newport Beach, CA 92660 ' Permit Counter Phone (949)644-3288 v Inspection Requests Phone (949)644-3255 Combination Type - CIP IIIIII'IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2019-3993 X 2 0 1 9 3 9 9 3 Project No: 2748-2019 Issued Date : 01/2912020 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: 4242 CAMPUS DR NB Description: COMM INSTALL 250 GALLON ABOVE GROUND FUEL TANK Legal Desc.: TR. 3201 LOT 25 AND LOT 26 Owner: AVIS RENT A CAR SYSTEMS INC Contractor: JONES COVEY GROUP INCORP. Address: 6 SYLVAN WAY Address: 9595 LUCAS RANCH RD #100 CA Seismic Safety: PARSIPPANY, NJ 07054 Disabled Access : RANCHO CUCAMONGA CA 91730 Phone: 610.430-8151 Phone: 888-972-7581 Applicant: SILLS ROBERT Con State Lie: 804431 Address: 9595 LUCAS RANCH RD # 100 Lie Expire: 0813112021 RANCHO CUCAMONGA, CA 91730 Bus Lie: ' - .. BT30070218 Phone: 888-972-7581 - Lie Exp Date: 12/31/2020 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: Construction Valuation: Building Permit Fee: $120.00 Plan Check Fee: $104.40 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management : $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 Worker's Compensation Insurance Carrier: EVEREST NAT'L INS CO Policy No: CA100002046191 Expire: 05/01/2020 Building Setbacks Zone: 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 king Spa $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 II TOTAL FEE : $322.40 Plan Check Fee: o Ir Of0 g PROCESSED BY:�`' ° ZONING APPROVAL: GRADING APPROVAL: ° n v co u° ou 0 Architect: Address: Phone: Engineer: Address: State Lie: Phone: - State Lie: Designer: SILLS ROBERT Address: 9595 LUCAey, # 100 RANCHO CY Phone: 888-972-7581 Special Conditions: 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 : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 $201.40 Fee Due at Permit Issuance : $121.00 PUBLIC WORKS APPROVAL:TZA PLAN CHECK BY: APPROVAL TO ISSUE: 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 $201.40 Fee Due at Permit Issuance : $121.00 PUBLIC WORKS APPROVAL:TZA PLAN CHECK BY: 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 U 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). ❑ 1, 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 legally 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 7000) of Division of the Business and Profession Code, and my license is in full force and effect. License Class License No Date Contractor SignatutK_ 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 THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 IN Onformance of the work for which this permit is issued. Policy No. 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' carrier and policy number are: Policy Number of Agent Date 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( I, if I should become subject two thhe/yorkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. \ ' nature of Applicant I D , �i4'/Z.0 CLARATION REGAAADING CbNIS RUCTI LENDI AGENCY :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, CI 1 1 Code). lder'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. �OR�,� 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�tq enter tt"_ ove-idofied property for inspection purposes. ,_ fin - ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY t REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO • • • • •' ' • • • • • •' PERMIT CANCELLED UEPA PERMIT EXTENDED .. QUID PERMITFINAL // J� "I // ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO CERTIFICATE OF r [�j PROPOSED DEMOLITION • ••a •• OCCUPANCYISSUED SIGNATURE: •�• •�• •�'_ i