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Home My WebLink AboutX2022-0778 - Permitsw.rYot City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 s' Permit Counter Phone (949)644-3288 r3. - Inspection Requests Phone (949)644-3255 Combination Type - CIP ELEC MECH COMB Permit: X2022-0778 IIIIIIIIIIIIIIIII�IIIIIilllllllllllllllllllllll Project No : 0689-2022 Issued Date : 04/2512022 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: 1 HOAG DR NB - Description: COMM - (2) 24'x40' MODULAR TRAILERS FOR TRAINING WORKROOMS. ADD POWER TO TRAILERS AND RAMP ENTRANCES. RE -STRIPE PARKING AREA, Legal Desc.: IRVINE SUB BILK 1 LOT 172 FOR OF LOT Owner: HOAG MEMORIAL HOSPITAL- Contractor: SOUTH COUNTY CONTRACTORS Architect: LIEBKE STEVEN S� R Address: 1 HOAG DR Address: 23639 RIDGEWAY Address: 1340 REYNOLDS AVE #115 d' NEWPORT BEACH, CA 92663 MISSON VIEJO CA 92692 IRVINE CA 92614 ' Phone: 949-764-4496 Phone: 949-205-6304 Phone: 949-400-5462 State Lic:CO28344,; Applicant: LIEBKE STEVEN Con State Lie: 988175 Engineer: NIEMAN ADAM Address: 1340 REYNOLDS AVE #115 Lie Expire: 11/30/2023 Address: 11624 N 151ST LANE IRVINE CA 92614 Bus Lie: BT30048035 SURPRISE AZ 85379q Phone: 949-752.5052 Lie Exp Date: 07/31/2022 Phone: 81-571-9877 State Lic:C-091181. �1 Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: V-B Carrier: WC EXEMPT Address: Occupancy Group: B Policy No: (NO EMPLOYEES)' Added /New sq.ft. Bldg: 1780 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: I Special Conditions: No of Units : 0 Front: / LANDSLIDE & LIQUEFACTION Bldg Height: 0 Left: / Bldg Sprinklers: N Right: / Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N -- Construction Valuation: $50,000.00 Building Permit Fee: $810.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $704.70 Additional Fee, $0.00 Plan check Fee : $52.00 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: $32.00 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 : $91.00 PAN Plan Check: $50.75 Grading Bond: $0.00 Hazardous Mat, $0.00 Electrical %: $212.06 San Dist : $0.00 Building Green Fee : $2.00 Mechanical %: $166.62 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $2,121-13�� I Plan Check Fee : $1,074.63 Fee Due at P rmit Issuance : $1,046.50 PROCESSED BY: ... 3 o o ° o PUBLIC WORKS APPROVAL: ZONING APPROVAL: j 4 PLAN CHECK BY: y GRADING APPROVAL: s y_ -E G G4J v � E f/ APPROVAL TO ISSUE: 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 U all of or U 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). ❑ 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). ❑ 1 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 CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio .7090) of Divi3 of the Business and Pro fes i0� Code, d y license is in full force and effect. License Class License No Date sionContractor Signatur 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 THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I hereby affirm under penalty of perjury one of the following declarations: 111 have 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 perfgr mance of the work for which this permit is issued. Policy No. have and wi{main workers' co 22ennsation insurance, as reyuged by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' rance carrier �qd p\licy number ,af€ ( ) , _ J to of Agent certify that, in the performance of the work for yyr'hich , if I should become Su ect to the work r ' c mpem nature of Applicant Date 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 ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. hereby affirm under natty of perjury 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 y 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 a stap laws relating to building construction. I authorize representatives of this city or count oo me the abo ride Ified property for inspection purposes. �� signature of ProDertv Owner or Authorized Agent X 7,nJ1 / Print Property Owner's or Authorized Agent's Narc�� ACTION DATE BY jLECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED UEPA • • • . • • • i PERMIT EXTENDED ! Q e • • c PERMITFINAL %-13bal A-FAf Lei SBESTOS NOTIFICATION IS NOT APPLICABLE Ttl • •• CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: P nGD p? P//__._S /99 Code).