HomeMy WebLinkAboutX2019-3781 - Permits�vtY, City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2019-3781
a. 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 3 7 8 1
p Project No :2602-2019
r. Permit Counter Phone (949)644-3288
v,. Inspection Requests Phone (949)644-3255
r'ar,�ru�*°' Combination Type - MFP MECH ELEC PLUM Issued Date: 0710812020
Inspection Area : 8
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 07109/2023 OR PERMIT WILL BE INVALID
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: 1561 MESA DR NIS `
Description: MFR BLDG R12 (UNITS 57-70) REMODEL 8,860 SF -
Legal Desc.: '
� 5
Owner: PALM MESA LTD Contractor: REFINO INC Architect: WINTERS PATRICK F'
Address: 12121 WILSHIRE BLVD #700 Address: 9706 4TH AVE N E #401 Address: 1990 S BUNDY 9400 3 tr\
LOS ANGLES CA 90025 SEATTLE, WA 98116 LOS ANGELES CA 90067
Phone: Phone: 206-260-1509 Phone: 310-626-2100 State Lic:CO22032 -'
Applicant:
PADDOCK STEVE
Address:
1990 S BUNDY #400
Record Management:
LOS ANGELES CA 90067
Phone:
310-626-2100
Code Edit : 2016
Type of Construction: VB
Occupancy Group: R21U
Added /New sq.ft. Bldg:
Added/New sq. ft. Garage:
No of Stories: 2
No of Units : 14
Bldg Height: 0
Bldg Sprinklers: N
Building Permit Fee: $2,035.00
Plan Check Fee: $1,770.45
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 :
$10.00
TOTAL FEE: $5,007.45
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Con State Lic:
787509
Engineer:
Lic Expire:
06/30/2021
Address:
Bus Lic:
BT30072366
In -lieu Housing Fee:
Lic Exp Date:
0713112021
Phone:
Worker's Compensation Insurance
Designer:
Carrier:
STATE FUND
Address:
Policy No:
9161474
Refund Deposit
Expire:
0612512021
Phone:
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: /
Front: /
Left: /
Right: /
Parkinc Soaces
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$142.45
$81.40
$183.15
Plan Check Fee
VARELA BEN
6007 WASHINGTON BLVD
CULVER CITY CA 90232
424-208-4764 State Lic:5-005714
Special Conditions:
Planning Department -
Fire Department
Plan check Fee
$0.00
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
$1,736.52 Fee Due at Permit Issuance : $3,270.93
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
Fire Department
$0.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$24.00
General Service
$197.00
Refund Deposit
$564.00
Grading Bond:
$0.00
$0.00
-.. -
$0.00
$1,736.52 Fee Due at Permit Issuance : $3,270.93
PUBLIC WORKS APPROVAL:
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
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 (_) all of or U 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
�ly 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 legaill
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 Section 000) of 4jyision 3 of the Busin and Professions C : L;^; en i n is in full force
nd effect. License Class License No •�—�_/- Z J Contractor S gnature 71
VORKERS' COMPENSATION DECLARATION
IARNING: 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 ($700,000), IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a
'ormance of the work for wh
of Agent
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
nit is issued. Policy No.
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'
are:
Policy Number
Date
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 to the w ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. -/
nature of cant /L �§te 7
CLARATI REGARDING NSTR TI LENDING AGENCY -`
Ireby affirm under penalty of perjury t at there is a construction 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, 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 st f I Ing to building construction.
I authorize representatives of this city or county to e�f the ove' p y for inspection purposes. ��,//'
sf„re �f or�..va„ nm,r,er . r A,dh�6A An.nt / / _ Print Prooertv Owner's r Authorized ADent's Wme l�/L vV.�ff.'"O _ to
ACTION DATE I - BY ' I DE TION TIONS PART0MWACE WITH CODE OF 61 OF TNTLE 40 AND AOMD RULERAL I FOR IFICE USE ONLY
PERMIT EXPIRED I I I YJ I SUBMITTED ASBESTOS NOTIFICATION
PERMIT EXTENDED
PERMIT FINAL 5 r. ' 12,1
CERTIFICATE OF (tet'
OCCUPANCY ISSUED