HomeMy WebLinkAboutX2022-1556 - Permitsy'S1?rpry4, City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
�. Permit Counter Phone (949)644-3288
ct.. Inspection Requests Phone (949)644-3255
razYrraa'a Combination Type - CIP MECH ELEC PLUM
aX2022-1556`
COMB Permit: X2022-1556
Project No : 3025-2021
Issued Date : 0610312022
Inspection Area : 7
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY OR PERMIT WILJ BEr�IINi
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 tl F
Job Address: 4450 MACARTHUR BLVD NB I �' ,
Description: DELTA 1 ADDL SCOPE COMM (3) NEW OFFICES FROM PHONE ROOMS "MARK CAPITAL" 96 SF (X2021-3451)
Legal Desc.:
Owner: M4 MACARTHUR LLC Contractor: SMITH & SEVERSON BLDRS Architect: DWYER SUSAN M
Address: 4450 MACARTHUR BLVD Address: 21072 BAKE PKWY #106 Address: 4770 CAMPUS DR
NEWPORT BEACH, CA 92660 LAKE FOREST CA 92630 NEWPORT BEACH CA 92660
Phone: Phone: 949-232-1222 Phone: 949-851-3080 State Lic:C033724
Applicant:
SMARKER JESSICA
Address:
4770 CAMPUS DR STE 100
NEWPORT BEACH, CA 92660
Phone:
949-851-3080
Code Edit : 2019
Type of Construction: I-B-SPR
Occupancy Group: B/S2
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 0
Bldg Height: 0
Bldg Sprinklers: Y
Building Permit Fee: $249.00
Plan Check Fee: $216.63
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$40.00
Energy Compliance:
$61.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $826.45
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Con State Lic:
989943
Lic Expire:
0113112024
Bus Lic:
BT30061129
Lic Exp Date:
11130/2022
Worker's Compensation Insurance
Carrier: ZURICH INSURANCE
Policy No: WC456733002
Expire: 0910112022
Building Setbacks
Zone:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: /
Front: /
Left: /
Right: I
irking Spa
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$65.19
$51.22
$41.91
0
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
State Lic:
Special Conditions: SEE X2021-3451 FOR
FULL TI SF
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
Plan Check Fee : $0.00
Fire Department
$52.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
999a
09••
$0.00
$48.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Fee Due at Permit Issuance : $826.45
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
i
• a
oJG939
,
a
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
ie 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).
1 1, as owner of the property, or my employees with wages as their sole compensation, will do U 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).
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
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).
I am exempt from licensure under the Contractors' State License Law for the following reason:
;y 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
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.html.
signature of Propollj Vv%ner or Authorized Agent Date
.`CENSF,D CONTRACTOR'S DECLARATION
1drEBy Virm und£Iper alty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 711 0) of (7ivision 3 of the Business and Profess" ode and my license is in full force
nd effect. License Gless License No Date C O. Z2 Contractor Signature .5
1LORKERS' COMPENSATION DECLARATION
IAfF�LNING: FAILURE TQ 5L RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,000I, IN ADDITION TO T
_ .0F'CBMPENSATJJ46QAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
IfereVaffirm under penalty of perjury one of the following declarations:
I ha.ve and veiM 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 rbance of the work for which this permit is issued. Policy No.
and wiu fiajr%in 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 • i none Is
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 agree
if I should become subject to the wort ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Date /Q;� ��
lature of Applicant �, o� 2z
hereby 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)
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 owners 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 county to 1 above -identified property for inspection purposes.
signature of Property Owner or Authorized Agee Print Property Owner's or Authorized Agent's Name ——
ACTION DATE BY - DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
I SUBMITTED ASBESTOS
PERMITEXTENDED L IAQMD
PERMITRIVAL � ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF PROPOSED DEMOLITION
OCCUPANCYISSUED SIGNATURE: