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Home My WebLink AboutX2019-3770 - PermitsCity of Newport Beach - Building Division off` 100 Civic Center Drive, Newport Beach, CA 92660 h+ Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 x,irs u4'y Combination Type - CIP ELEC MECH IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2019-3770 x 2 0 1 9 3 7 7 0 Project No: 2606-2019 Issued Date : 03/16/2020 Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY ERMIT WILL BE INVALID Construction Hours: Monday - Friday 7.00 a.m, to 6:30 p.m. and Saturday from 6:00 a.m. to 6:00 o Sundays or Holidays Job Address: 510 SUPERIOR AVE NB Description: COMM TI - R/R IMAGING EQUIPMENT/RECEPTION AREA FOR HOAG RADIOLOGY, ADD C IILh' SF. Legal Desc.: IRVINE SUB LOT 169 BLK 2 PORS OF LOT mm�� Owner: NEWPORT HEALTHCARE CENTER Address: PO BOX 6100 NEWPORT BEACH. CA92656�" Phone: Applicant: LIEBKE Address: 1340 RI IRVINE Phone: 949.752 50$2 Code Edit: Type of Construction 4-A Occupancy Group: 'iB Added /New sq.ft. Bldg ` Added /New sq. ft. Garage, - No of Stories: 2+ No of Units Bldg Height: 0 - Bldg Sprinklers: Y.., Flood Zone: N=; 11 Construction Valuation:_ A 05 Building Permit Fee: $2,968,00 Plan Check Fee: $2,582.16 1'' Overtime Plan Ck: $Q;00 Investigation Fee: $040 Record Management : $136.60 Energy Compliance: $280.00 CA Seismic Safety: $0.00: Disabled Access: $400.00, Hazardous Mat $0.00.. Building Green Fee : $16.00:,. PROCESSED BY: f 'J Aamholt't: STE C A d s: 13Q0/0 0% '�i.1 f0 YYNO DS AV IRVINE CA 92614 1k Phone: 949-752.505 a-'- to VkAAAddress: 21008 SYLVANWOOD LAKEWOOD AV 90715 Phone: 562-860-7896 S Designer: Address: Phone: Address: 6677 WEST THDERBIR[ AZ 85306 Con StatLicxp12 t'213�f� awataff GUTHRIE GEN. OF CA INCI c C3OO4 �rI�t orr's Compensation Insurance Carrier Pollcront: I Special ConRgh: I� #115 f CIS ^ 6 L'Ic:CO25341Lic:C-02311000oo 000000 c' > $0.00 Planning Department- Fire e+ eA ditional Fi�eej,taded) $0.00 Plan check Fee : $40.00 Eti� sp'� ion: $0.00 Grayf111$i�i d�sTee: $0.00 _Fair�ha Q.U(f1 Fire P .Re4'$647.00 Grading PC Consultant : $0.00 _�'--SJH Trans �� $0.00 emu... ^�l'1@"molith Fee Grading Permit Fee: --- �VIr In -lieu Ho 'ng-rea : d�Building Dept Adm $24.00 Grading�ee:-"`— $0.00--P-ubl' orks parE General Service $197.00 NC O - W nsp. Fee: _,$11A0 ,Bafk (cation : $0.00 Refund Deposit $564.00 PM Plan Check: $0.00 Grading Bond: $0.00 $77.02 San Dist: $0.00 g$610.52 NMUSD Fee: $0.00 $0.00 lubinq %: $0.00 $0.00 TOTAL FEE: $9,141.70 ZONING APPROVAL: GRADING APPROVAL: Plan Check Fee : $3,775.70 Fee Due at Permit Issuance : $5,366.00 _ PUBLIC WORKS APPROVAL: _ PLAN CHECK BY: APPROVAL TO ISSUE:y v L12A OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) 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 `) 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). 1 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 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). 1 am exempt from licensure under the Contractors' State License Law for the following reason: ly my signatureteli 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 legal ell a structurelli j 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 'jq[gsAbrs Cgfle, isavailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. - :ignatufe of PrWr Owner or Authorized Agent Dat 10ENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 ) of li of the Business and Pr ofe si Code, a my licesys is ' ull pdeffect. Ligpheb Ciass License No Date O Contractor Signature .d 16RARS' COMPENSATION DECLARATION - THING: FAILURE TO SEDURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNtlRED THOUSA DOLLARS I$100,000), IN ADDITION TO THE • i OFCOMPENSATIOM, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'$ FEES. / .r: � .affirm under penalty of perjury one of the following declarations: i have nd.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 th ,p ce of MewoA for which this permit is issued. Policy No. •••• •Fa✓e and willmairRain 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' compensatior trance camer ann policy number are: Tier Policy Number Expiration Date re of Agent Phone # certify that, in the pert rma tae of the k for which this permit is issued, I shall employ any person in any manner so as to become subject to the workAco'nsation laws of California, and agree t, if should becomes bject tot orker ' compensation p�Lovisions of Sectio 00 oft Laber Code, I shall forthwith comply with those provisions.nature of Applicant - DaCLARATION REG DING CONSTR TION LENDING AGENCY :reby affirm under natty of perju at there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097). Ider's Name Lender's Address my signature belo , I certify to 6ach 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 i proved is correct. 1 agree to comply with all applicable city and county rdi ce and state laws rel to building construction. I authorize representatives of this city or county to the a ove-identif" d pr ert*v�tu—unspection purposes. .® q nature of Property Owner or Authorized Agent N Print Property Owner's or Authorized Agent's Na �', L, e TION DATE BY DEC TION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY RE LXA NS PART 61 OF TITLE 40 AND AQMD RULE PERMITC4NCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATEOF OCCUPANCY ISSUED I SUBMITTED ASBESTOS NOTIFICATION TO NOT APPLICABLE