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Home My WebLink AboutX2019-3882 - PermitsCity of Newport Beach - Building Division *X2019-3882' COMB Permit: X2019-3882 r�' 100 Civic Center Drive, Newport Beach, CA 92660 PtOJ@Ct No: 26$2-2019 `y '� Permit Counter Phone (949)644-3288 'u.. n Inspection Requests Phone (949)644-3255 rq=rrafari` Combination Type - CIP MECH ELEC PLUM Issued Date : 02/25/2021 0 Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 02/26/2024 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: 5020 CAMPUS DR NB Description: COMM TI "NEWPORT CAMPUS MEDICAL PLAZA" BLDG #2 11,458 SF Legal Desc.: N TR 9626 LOT 9 t� Ire PORT LLC yVON Contractor: COLUMN P � E200N WILLIAM � �� Opt Address: 4701 KARMAN AVE #100 Address:: 4701 ONKARMAN AVE STE 100 Address14 : 13 N BIRCH ST, SUITE NEWPORT BEACH CA 92660 NEWPORT BEACH, CA 92660 SANTA ANA CA 92701 Phone: Phone: 949.420-1601 Phone: 714-716-5042 State Lic:C-031793 Applicant: ITZEN WILLIAM Con State Lic: 992770 Engineer: CROSS KIRK -- - Address: 313 N BIRCH ST, SUITE 200 Lic Expire: 05/31/2022 Address: 3198-D AIRPORT LOOP DR SANTA ANA CA 92701 Bus Lic: BT30067756 COSTA MESA CA 92626 ...... Phone: 714-716-6042 Lic Exp Date: 0613012021 Phone: 714-556-5475 State Lic:S-003886 Code Edit : 2016 Worker's Compensation Insurance Designer: Type of Construction: V -B -SPR Carrier: STATE COMP Address: Occupancy Group: B Policy No: 9099527 Added /New sq.ft. Bldg: 0 Expire: 05/14/2021 Phone: Added /New sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: I Special Conditions: ° ° ° ° ° No of Units : 0 Front: I ° ° ° ...... Bldg Height: 0 Left: / Bldg Sprinklers: Y Right: I o°°oo Flood Zone: X Use Zone: Parkin S aces: 0 Fire Hazard Zone : N Construction Valuation: $277.888.00 o°0000 °°oo Building Permit Fee: $2,305.00 Excise Tax: $0.00 Planning Department - Fire Department ° Plan Check Fee: $2,071.35 Additional Fee : $66.00 Plan check Fee: $0.00 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $39,592.74 Fire Plan Rev $0.00 Investigation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $94.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $26.00 Energy Compliance: $194.52 Grading PC Fee: $0.00 Public Works Department - General Service $219.00 CA Seismic Safety: $77.81 WO Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $564.00 Disabled Access: $0.00 PAN Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical W $603.45 San Dist: $0.00 Building Green Fee : $12.00 Mechanical %: $474.14 NMUSD Fee: $0.00 $0.00 Plumbing %: $387.93 $0.00 TOTAL FEE : $46,687.94 Plan Check Fee: $2,801.25 Fee Due at Permit Issuance: $43,886.69 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: PUBLIC WORKS APPROVAL: OPI PLAN CHECK BY: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION 1 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 items) lection 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 (_) 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, thebuilding 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). 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 only 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 legall) 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.htm . signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perju that I am licensed under provisions of Chapter 9 (commencing with Se on 0) f Divlsi n 3 of th siness and Professiony de, and my license is in full farce and effect. Lice- rags License No LIQ iJ�_ D Co tr for Signature /A1 VORKMS' COWNSATION DECLARATION IARNING: NA1LURE 90 SaCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE 'O%T OFF OMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. IterEl;jy affirm under penalty of perjury one of the following declarations: ]d have and Will mairriain 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 d4 slice of thilfPaorkYor which this permit is issued. Policy No. ,,, , .hays and wiN 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' compensatiol reaae came jan�d/pp' o�licy number(�re: ;eMlei • , %7 J".R.i .! n.fil ' Policy Number �I —t —1 � Expiration Date ,-mss in Ztle pe!•formance 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, an bEedMa Subject 10 the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. i I I V TI VINISLVI"II�✓��v,.v..-vv.. .. :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 o e). 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 an ounty ordina ces and state laws relating to building construction. I authorize representatives of this city unty to an r t above -identified property for inspection purposes. nature of Property Owner or Authorized nt Print Property Owner's or Authorized Agent' ame ZZOVa TION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMITEXPIRED PERMITCANCELLED PERMIT EMENDED PERMIT FINAL CERTIFICATEOF OCCUPANCY ISSUED !— 747 NOTIFICATION TO ISNOTAPPLICABLE TO