HomeMy WebLinkAboutX2021-1122 - Permits�w'rtx City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Y. .. :. Inspection Requests Phone (949)644-3255
r w Combination Type - MFP ELEC
COMB Permit: X2021-1122
IIXIIIIIIII0IIIIIIIIIIIIIIIIIIIIIIIIIIIII II
Project No : 1029-2021
Issued Date : 05/18/2021
Inspection Area : 4
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0511812024 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: 120 LAURENT NB
Description: MFR RUN FIBER FROM OF ROOM THROUGH THE ATTIC DOWN WALLS INTO UNITS (UNITS 120.127)
Legal Desc.: TR 12309 LOT 7 POR OF LOT n
Owner: IAC AT JAMBOREE LLC Contractor: CORBEL COMMUNICATIONS Architect: CARNEY CECIL
Address: PO BOX 2450 Address: 875 EAST 145TH ST Address: 9841 S DARON DR
NEWPORT BEACH, CA 92658 BRONX, NY 10455 ORANGE CA 92869�'�
Phone: Phone: 917-939.6140 Phone: 714-665-9500 State Lic: 11980 -
Applicant: FLORES PRINCESS
Con State Lic: 1047975
Engineer:
Address: 19520 JAMBOREE
Lic Expire:
1213112022
Address:
IRVINE CA 92656
Bus Lic:
BT30071633
Phone: 714.552-9316
Lic Exp Date:
04/30/2022
Phone:
State Lic:
Code Edit: 2019
Worker's Compensation Insurance
Designer:
Type of Construction: VB
Carrier:
BERKSHIRE INSURANCE
Address:
Occupancy Group: R21U
Policy No:
COWC141260
Added /New sq.ft. Bldg: 0
Expire:
06/25/2021
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 2
Building Setbacks
Rear: /
Special Conditions:
No of Units : 8
Front: I
Bldg Height: 0
Left: /
Bldg Sprinklers:
Right: /
Flood Zone: X
Use Zone:
Parking Spaces:
0
Fire Hazard Zone : N
Construction Valuation: $664.00
Building Permit Fee: $110.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $95.70
Additional Fee :
$0.00
Plan check Fee :
$0.00
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: $0.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
$0.00
Building Dept Adm
$0.00
Energy Compliance: $0.00
Grading PC Fee:
$0.00
Public Works Department -
General Service
$0.00
CA Seismic Safety: $0.00
WO Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
Disabled Access : $0.00
PIW Plan Check :
$0.00
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %:
$14.40
San Dist:
$0.00
Building Green Fee : $1.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing W
$0.00
$0.00
TOTAL FEE : $221.10
Plan Check Fee :
$102.40
Fee Due at Permit Issuance :
$118.70
V
PROCESSED BY:
CIV
PUBLIC WORKS APPROVAL:
'
ZONING APPROVAL:
�' v
PLAN CHECK BY:
l '
GRADING APPROVAL:
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 ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally
sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Professions Code, is available upon request when this application is submitted or at the following Web site:http://Www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 of Divj3 op of the Businees$ and Pr f s)ion Code, an ,pW lice 9e is in ful fo e
and effect. License Class License No D L Contracto',gignature E
COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO C
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
RIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNOREO HOUSAND DOLLARS ($100,000 , IN ADDITION TO THE
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
grmance 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
Date
ie of Agent Phone #
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
, if I should beccome §ryy,� j ct to the
�workers'
-compensation
-lo)mpens tioonn,p�rovviisiionss of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �"''
Iature of A�XHCant 4C i��l>'✓ ° � W V`L� D 7 1 1 �6 I
.1 APATIOTJ raFrARHINJr C11NRTRIICTION I FNDI G Gr;FNCV
)reby affirm under penally 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).
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 state laws relating to building construction.
I authorize representatives of this city o�rr oury t�oq enter the ove-i entifi�eod property for inspection purposes. �M� 1n r
nature of Prooertv Owner or Authorized/Atrentt I AVIV 0 N-' Print Prooertv Owner's or Authorized Acent's N -z r YY�1 Y 1cq�J �I �
ACTION DATE BY REGULATIONS PART 61 OF IITLE 40 AND QMD RULE FOR OFFICE USE ONLY
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I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED
PERMIT EXTENDED
PERMITFINAL V/'��/'7/ rvW_1 ASBESTOS NOTIFICATION IS NOT APPLICABLE
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