HomeMy WebLinkAboutX2021-3073 - PermitsCity of Newport Beach - Building Division
*X2021-3073*
COMB Permit • X2021-3073
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100 Civic Center Drive, Newport Beach, CA 92660
Project No : 2667-2021
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Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
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Issued Date : 11N6/2021
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Combination Type - MFP
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Inspection Area :4
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1111612024 OR PERMIT 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 p.m. No work on Sundays or Holidays
Job Address: 3000 COLONY PLZ NIS
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Description: MFR (BLDG 3) 2 NEW DOORS FOR
OF ACCESS
Legal Desc.: N TR 15935 LOT 69
Owner: IRVINE CO
Contractor:
NATIONAL RENOVATION INC
Architect: RANIERI RANDY
Address: 660 NEWPORT CENTER DR
Address:
15650 EL PRADO RD
Address: 3141 LIMERICK LN
NEWPORT BEACH, CA 92660
CHINO CA 91710
COSTA MESA, CA 92626
Phone:
Phone:
909-606-0370
Phone: 714-296-5502 State Lic:CO24225
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Applicant: TRUAX JAY
Con State Lic:
956793
Engineer:
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Address: 2061/2 ABALONE
Lic Expire:
01/31/2023
Address:
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NEWORT BEACH, CA 92662
Bus Lic:
ST30062023
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Phone: 949-285-5594
Lic Exp Date:
01/31/2022
Phone: State Lic:
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Code Edit: 2019
Worker's Compensation Insurance
Designer:
me®em•
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Type of Construction: V-A
Carrier:
INS CO OF THE WEST
Address:
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Occupancy Group: R2
Policy No:
WVE506190300
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Added/New sq.ft. Bldg: 0
Expire:
09/0112022
Phone:
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Added/New sq. ft. Garage: 0
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No of Stories: 6
Building Setbacks
Rear: /
Special Conditions:
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No of Units : 0
Front: /
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Bldg Height: 0
Left: 1
Bldg Sprinklers:
Right: /
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Flood Zone:
Use Zone:
Parking Spaces:
0
Fire Hazard Zone : N
Construction Valuation: $2,960.00
Building Permit Fee: $127.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $110.49
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
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
Disabled Access : $0.00
P/W Plan Check :
$0.00
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %:
$0.00
San Dist:
$0.00
Building Green Fee : $1.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE: $238.49
Plan Check Fee:
$110.49
Fee Due at Permit Issuance:
$128.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
65 CG PUBLIC WORKS APPROVAL:
S P PLAN CHECK BY:
APPROVAL TO ISSUE:
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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 ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
❑ 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
❑ I am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally
sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CCATft=TOR'S DECLARATION
I rgWpi,l Dffirm unrJer penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7030 of Ivisi n 3 of the Business and Professi0 ode, an�i,m$ license is in full force
and effect. License Class License No Date 1, t(a 21 Contractor Signature 2 r ;/Q
VVI%RK .RS' COP4PENSATION DECLARATION
NARNIAG: FAILURE Tp SECIy2E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E100,000), IN ADDITION TO THE
COST OF.COMPENSA610k DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Bendy affirm under penalty of perjury one of the following declarations:
2•1.11- g and fill Ry�irttain 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
oeliormence of the work for which this permit is issued. Policy No.
Zr gNand will maiQtain 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
Mura V carrier-i V-poacy number arej , ,
Vol Agent ""'
certify that, in the p,
if I should become
of Applicant
Policy Numberw Ur 5 NO I q Expiration Date
Phone #
of the work forwhich 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 agree
the workersrc/g, nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
\Tii-ii� Date �l(iG+-lZl
areby 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 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 or count '�ty�en he above ' entified property for inspection purposes.
nature of Pronertv Owner or Authorized ADent / � ^v'� Print Prooertv Owner's or Authorized Agent's Name
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF II REGULATIONS PART 61 OF TITLE 40 AND AQMD RULEFEDE
FOR OFFICE USE ONLY
PERMITEXPIRED I I I U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT EXTENDED L_IA.QM D
PERMIT FINAL ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
CERTIFICATE OF PROPOSED DEMOLIJ rJ�
OCCUPANCYISSU, SIGNATURE: glt•y�` `
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