HomeMy WebLinkAboutX2021-3394 - Permitsatxr,� City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIII�IIIIIIII�IIII II COMB Permit: X2021-3394
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 3 3 9 4
Permit Counter Phone (949)644-3288 Project No: 2965-2021
Inspection Requests Phone (949)644-3255
`"rrsn5a�"` Combination Type - CIP ELEC MECH PLUM Issued Date: 05/1712022
Inspection Area : 7
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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: 3901 E COAST HWY NB
Description: COMM TI 991 SF "WATERMARK CROWN COVE MEMORY CARE"
Legal Desc.: PARCEL MAP PM. 294-24 PAR. 3 AND FOR. OF ABAND. STREET.
Owner: NEWPORT BEACH CA PROP OWNER LLC Contractor:
Address: 3901 E COAST HWY Address:
CORONA DEL MAR CA 92625
Phone:
Applicant:
SU NANCY
Address:
115 22ND ST
NEWPORT BEACH CA 92663
Phone:
9491675-6442
Code Edit : 2019
Type of Construction: V-A- SPR
Occupancy Group: B
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
_ No, of Stories: 5
No of Units : 0
Bldg Hecht:. 0
Bldg Sprinklers: Y
Flood Zone: X
Building Permit Fee:
$1,594.00
Plan Check Fee: $1,386.78
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$70.00
Energy Compliance:
$108.50
CA Seismic Safety:
$0.00
Disabled Access :
$155.00
Hazardous Mat
$0.00
Building Green Fee :
$7.00
TOTAL FEE : $5,244.25
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Phone
Con State Lic:
Lic Expire:
Bus Lic:
Lic Exp Date:
MARQUIS CONSTRUCTION INC
5595 DANIELS ST STE E
CHINO CA 91710
398448
01/31/2024
BT30078616
04/30/2023
Worker's Compensation Insurance
Carrier: INS CO OF THE WEST
Policy No: WSD506146800
Expire: 0712112022
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical W
Plumbing %:
Rear: /
Front: /
Left: I
Right: /
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$417.31
$327.89
$268.27
0
Architect: GAUNCE MEGAN C)
Address: 115 22ND ST
NEWPO64EACH CA 63
Phone: 9491675-Stai :C034807
Engineer:
Address:
Phone: State Lic:
Designer:
Address:
Phone: �+g
Special Conditions: HIGH DENSITY
CWS TO HAUL DEIS
Planning Department -
Plan check Fee
Fair Share
SJH Trans
In -lieu Housing Fee
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check :
$0.00
San Dist :
$0.00
NMUSD Fee:
$0.00
Fire Department
$52.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$48.50
$0.00
Demolition Fee
$0.00
Building Dept Adm
$26.00
General Service
$219.00
Refund Deposit
$564.00
Grading Bond:
$0.00
$0.00
$0.00
Plan Check Fee : $2,067.29 Fee Due at Permit Issuance : $3,176.96
PUBLIC WORKS°w4R+PPOVAL`;
PLAN CHECK BY: if- Gam( inn
APPROVAL TO ISSUE: Q °°° °°° °°
AM
OWNhK-bSUILUCK U=1-1 a1w1 lull
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
he 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
Drofessions 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 peney of
iot 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,
3usiness 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
mprovements 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
mproved 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).
❑ 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 legall)
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. Date
Signature of Property Owner or Authorized Agent .-
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Pr si ns Code,Z04and I y "cense is i Il�orce
and effect. License Class License No Da '1 2Z Contractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED O SAND DOLLARS (E100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
❑ khave 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 th
armance of the work for which this permit is issued. Policy No.
01 ve 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' compensatio
ipsura e carrier and policy number are:
Carrie Expiration Date
Policy Number
S�, of Agent
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 become subject to the workers' cgatgensation fgrTisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
IECLARATION REGARDrNG QONSTRUCTION LENDING AGENCY
hereby affirm under penalty of berjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097
.ender's Name Lender's Address
ly 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 Telin to building construction.
I authorize re resentatives of this city or county zo�antgr the above-ide d prope or inspection purposes.
p .. __ __ -:_ •,..,.,. X/I O n n A,^A �Md Print Prooertv Owner's or Authorized Agent's Name
By D RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
ULATIONS PART 61 OF TITLE 40 AND AQMD RULE
• 4403. ••• •••
• I UBMITTE SBE4F S NOTIFICATION TO
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PERMIT EXTENDED I� Ivies
PERMITFINAL �'(�i ASBESTOS NOTIFICATION IS NOT APPLICABLE
CERTIFICATE OF •�• ••: PQftQD U 1141
OCCUPANCY ISSUED • S A U E:• �/v"""
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