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Home My WebLink AboutX2020-1731 - Permits (2)U4" City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - CIP ELEC PLUM MECH iiiiigi1 II `-I COMB Permit: X2020-1731 Project No : 1375-2020 Issued Date : 1012912020 Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 10131)XWJU 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 nndays or Holidays Job Address: 2751 IN, COAST HWY NB 4��/ y, Description: COMM TI - 2200 SF. RIR WINDOWS, BALCONY GUARDRAIL, INT DEMO, ADD NEW WINDOWS, ADA UPGRADES TO JROOMS (Add E1171 "IQark) Legal Desc.: TR 919 LOT H SELY 100 FT NWLY 250 FT 1� 66�r.�S � � , Owner: 275112801 PCH LL Contractor: PDC INC Architect: LUSHBA LLIAM 5 o�n Address: 1111 BAYSIDE DR STE 120 Address: 1010 S HATHAWAY ST UNIT C Address: 17191 CITR NEWPORT BEACH CA 92625 SANTA ANA, CA 92705 IRVINE, CA 926 � j Phone: 949-945-2645 Phone: (714) 664-0477 Phone: 949-584-2166 J' ? Lic:CO24887 Applicant: LUSHBAUGH WILLIAM Address: 17191 CITRON IRVINE, CA 92612 Phone: 949-584-2166 Code Edit: 2019 Type of Construction: V-B-SPR Occupancy Group: B Added /New sq.ft. Bldg: 2200 Added/New sq. ft. Garage: 0 No of Stories: 2 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Y Construction Building Permit Fee: $1,495.00 Plan Check Fee: $1,300.65 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $28.00 Energy Compliance: $100.10 CA Seismic Safety: $0.00 Disabled Access: $143.00 Hazardous Mat $0.00 Building Green Fee : $6.00 Con State Lic: 988669 Lic Expire: 1113012021 Bus Lic: BT30055261 Lic Exp Date: 05/3112021 Worker's Compensation Insurance Carrier: EVEREST PREMIER INS CO Policy No: 7600020452191 Expire: 0512912021 Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: 0' Front: 0' Left: 0' Right: 0' parking Spar $0.00 $335.00 $0.00 $0.00 $0.00 $0.00 $0.00 $209.30 $164.45 $134.55 11 TOTAL FEE : $3,962.30 Plan Check Fee PROCESSED BY: ZONING APPROVAL: Engineer: NELSON DAVID Address: 43180 BUSINESS PARK DR STE 200 TEMECULA CA 92590 Phone: 961-695-7101 State Lic:C-076318 Designer: Address: Phone: Special Conditions: LIQUEFACTION AREA INSPLC-reN "increased scope 3/4/21` UR fees due U-42.1 - O Z�(o Planning Department - Plan check Fee Fair Share : SJH Trans : In -lieu Housing Fee: Public Works Department - Park Dedication : $0.00 P/W Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department $46.25 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $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 $2,810.76 Fee Due at Permit Issuance : $1,151.54 PUBLIC WORKS APPROVA PLAN CHECK BY: GRADING APPROVAL: 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 L) 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 legalll 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.govlcalaw.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 Section 7Q00)giv' ion 3 of the Business and Pro s tonp. CodeZd mylicense is in full force and effect. License Class License No Da 5 Z Contractor Signat WORKERS' COMPENSATION DECLARATION IT NARNING: 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 ATTORNEY'S FEES. I 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 Industrial Relations as provided for by Section 3700 of the Labor Code, for th p rmance of the work for which this permit is issued. Policy No. ave 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 is Lied. My workers' compensatio insu nc arrier n olicy number a�re:� / �L r mer � SUr"1�t"tom �GT Policy Number �la 66 o—I 7 �� / rExpiron Date Ci Z�Ti❑1 certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any man r s a o becbject to the workers' compensation laws f California, and agre that, if 1 should become subje to the workers' compen tionprovisions of Section 370 bor C shall fort ith o ly w'provisions. Signature of Applicant - V Datey L DECLARATION REGARDING CONSTRUCTION LENDING AGENCY ,/j„ I 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, Civ Code). Lender's Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's half. I have read this application and the information I have pro ed is orrect. I agree to comply with all applicable city and county nces nd state laws relating to building construction. , I authorize representatives of this city or count t n r he o = entified property for inspection purposes. �f1 Signature of Property Owner or Authorized Agent ( Print Property Owner's or Authorized Agent's Nam.,/TA, N uc' " �" Date S P- ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY 1 REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED A - - - PERMITEXTENDED QMD PERMITFINAL Z3 �LZ ASBESTOS NOT TON IS APPLICABLE TO CERTIFICATE OF / PROPOSED DEM LITI N� - OCCUPANCY ISSUED SIGNATURE: