HomeMy WebLinkAboutX2021-2110 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2021-2110
` 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 2 1 1 0 Project No: 1829-2021
Permit Counter Phone (949)644-3288
as Inspection Requests Phone (949)644-3255
Issued Date 08/12/2021
Combination Type - CIP ELEC :
zv u
Inspection Area : 7
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0811212024 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: 850 SAN CLEMENTE DR NB
Description: COMM BI-DIRECTIONAL ANTENNA SYSTEM (X2019-2738) "VIVANTE SENIOR LIVING"
Legal Desc.: P BK 81 PG 8 PAR 2
Owner:
ORANGE COUNTY MUSEUM OF
Address:
850 SAN CLEMENTE DR
NEWPORT BEACH, CA
Phone:
9497591122
Applicant:
KIM/WEST COAST FIRE
Address:
22405 LA PALMA AVE
YORBA LINDA CA 92887
Phone:
714-957-5750
Code Edit: 2019
Type of Construction:
22405 LA PALMA AVE
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units: 0
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation: $70
Building Permit Fee:
$986.00
Plan Check Fee: $857.82
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$62.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$3.00
TOTAL FEE: $2,494.950:
PROCESSED BY:
ZONING APPROVAL:
Contractor:
WEST COAST FIRE & INTEGRATION Architect:
Address:
22405 LA PALMA AV
Address:
YORBA LINDA CA 92887
Phone:
714-957-5750
Phone: State Lic:
Con State Lic:
989173
Engineer:
Lic Expire:
12131/2021
Address:
Bus Lic:
BT30050007
Lic Exp Date:
02/28/2022
Phone: State Lic:
Worker's Compensation
Insurance
Designer: AMICAY SAM
Carrier:
TRAVELERS PROPERTY CASUALTY CO Address:
Policy No:
Expire:
Building Setbacks
Use Zone: PC-19
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
UB8R0709542126G
01/1512022
Rear: /
Front: I
Left: /
Right: /
0
YORBA LINDA, CA 92887
Phone: 714-957-5750
Special Conditions:
$0.00
Planning Department-
$0.00
Plan check Fee
$0.00
Fair Share:
$0.00
SJH Trans:
$0.00
In -lieu Housing Fee:
$0.00
Public Works Department -
$0.00
Park Dedication :
$0.00
PAN Plan Check:
$0.00
$258.13
San Dist:
$0.00
$0.00
NMUSD Fee:
$0.00
$0.00
Plan Check Fee
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GRADING APPROVAL:
oe ego e ® o0 00
0
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V
Fire Department
$104.00
$0.00
Fire Inspection:
Fire Plan Rev
Y0%
\
$0.00
$194.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
$1,171.91 Fee Due at Permit Issuance : $1,293.04
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:✓Y
APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION I
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 U portions of thework, 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
'mproved for the purpose of sale). I
❑ 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 Hcensure 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 legal[)
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
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) ofpZ l Contractor Si natDivision 3 of the Business and Pj�ofe�ssions Code, and y license is in full force
and effect. License Class _ License No Dafi3./ SSl ujey dG
I/ORKERS' COMPENSATION DECLARATION v\
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALI
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of
aormance of the work for which this permit is issued. Policy No.
]I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the pe
rance carrier and policy number are:
Policy Number
of Agent
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is issued. My workers'
Date
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
if I should become subje7ct to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
U/)2/y1
;reby affirm under penalty of perjury thatiNere i� 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 I
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 county to enter th? at�.ove-identified property for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Y-I m Nbl,
ACTION
DATE
BY
DECLARATION O C ANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PAR 610F TITLE 40 AND AQMD RULE
1403
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PERMITEXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO
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PERMIT CANCELLED
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PERMIT EXTENDED
QMD
PERMITFINAL
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ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF
PROPOSED DEMOLITION
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OCCUPANCY ISSUED
SIGNATURE:
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