HomeMy WebLinkAboutX2021-2023 - PermitsCity 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
rs y n* Combination Type - CIP ELEC MECH PLUM GRAD
111111111111111111111111111111111111111111111p11111111COMB Permit: X2021-2023
Project No: 1764-2021
Issued Date : 12123/2021
Inspection Area : 7
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1212312024 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: 11 HOAG DR NB
Description: COMM TI & ADDITION "JAMES IRVINE BUILDING" 6218 SF ADD, 6665 SF TI
Legal Desc.:
Owner:
Address:
Phone:
Applicant:
Address:
Phone:
HOAG MEMORIAL HOSPITAL
Contractor: SLATER BUILDERS INC
Architect: NOUIZILI ILYES M
510 SUPERIOR AV STE 290
Address: 3100 - B PULLMAN STREET
Address: 10 EDELMAN
NEWPORT BEACH CA 92663
COSTA MESA CA 92626
IRVINE CA 92618
949-355-9268
Phone: 714-615-6108
Phone: 949-788-4054 State Lic:C032135
DIONNE CHRISTOPHER
10EDELMAN
IRVINE CA 92603
949-660-9178 X 1157
Code Edit : 2019
T-ype-of-C-o nstru ctio n.---V-B-SPR-
Occupancy Group: A-3/B
Added /New sq.ft. Bldg: 6218
Added /New sq. ft. Garage: 0
No of Stories: 1
No of Units : 0
Bldg Height: 0
Bldg Sprinklers: Y
Flood Zone: X
Con State Lic:
675832
Engineer:
BISHOFF RYAN WILLIAM
Lic Expire:
08131/2023
Address:
3300 IRVINE AVE #245
Bus Lic:
BT30025319
NEWPORT BEACH CA 92660
Lic Exp Date:
02/28/2022
Phone:
949-862-8510 State
Lic:S-006250
Worker's Compensation Insurance
Designer:
Carrier:
C-Y-PRESS-INS-GOMPANY
Address -
Policy No:
SLWC245302
Expire:
0211612022
Phone:
p!
In
Building Setbacks
Rear: 0
Special Conditions:
ROBERT'S WASTE
dr'
Front: 0
TO HAUL DEBRIS
"�> j
Left: 0
Right: 0+
Use Zone: PC38
Parkinq Spaces: 0
Fire Hazard
Zone : N
Construction Valuation:
$1,500,000.00
Building Permit Fee:
$8,671.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $7,543.77
Additional Fee:
$0.00
Plan check Fee : $416.00
Fire Inspection:
$0.00
Overtime Plan Ck:
$0.00
Grading Bonds Fee:
$0.00
Fair Share : $0.00
Fire Plan Rev
$619.00
Investigation Fee:
$0.00
Grading PC Consultant :
$1,790.88
SJH Trans : $0.00
Demolition Fee
Record Management:
$306.00
Grading Permit Fee:
$1,020.00
In -lieu Housing Fee : $0.00
Building Dept Adm
$26.00
Energy Compliance:
$550.00
Grading PC Fee:
$393.12
Public Works Department -
General Service
$219.00
CA Seismic Safety :
$0.00
WQ Insp. Fee:
$152.00
Park Dedication : $0.00
Refund Deposit
$564.00
Disabled Access :
$944.00
PAN Plan Check: $812.00
Grading Bond:
$0.00
Hazardous Mat
$0.00
Electrical %:
$2,270.07
San Dist: $12,983.18
Building Green Fee :
$60.00
Mechanical %:
$1,783.62
NMUSD Fee: $1,865.40
$0.00
Plumbing %:
$1,459.33
$0.00
TOTAL FEE :
$443448.37
Plan Check Fee
: $13,235.65 Fee Due at Permit Issuance :
$31,212.72
PROCESSED BY:
-
-
PUBLIC WORKS APPROVAL:
/�\
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ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
U`f-IX
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
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, as owner of the property, or my employees with wages as their sale compensation, will do (_) all of or U 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
Tiprovements 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
Tiproved 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).
1 am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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 Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I m licensed under provisions t 7, r 9�(c77ncing with Section 7000) of visio 3 of the Business and Pr�f�ssions de, and,�a license is in full force
nd effect. License Class License No (D/ SS Date Cont Signaturd��e/�
VORKERS' COMPENSATION DECL ATION 7 7�1
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS l$100,0001, IN ADDITION TO THE
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 Industrial Relations as provided for by Section 3700 of the Labor Code, for the
Kormance of the work for which this permit is issued. Policy No.
JI Oave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this ermit is issued.
My workers' compen
n rance carrier a polic/a/7 number arre:
b!� G �u �L L �6 1�
3arrier�� r/ Policy Number__ JL `l Expiration Date
Name of Agent Phone #
:1I certify that, in the performance of the ork for which is permit is' Led, I shall not employ any person in any manner so as to become subject to the worke compensatio
laws of California, and
.hat, if I should become subject to the rkers' com anon pro ' ons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
3ignatureof Applicant Dal;_1�1
f71
)ECLARATION REGA G GNONSTRUCTION LENOI AGENCY
hereby affirm under penalty of perjury that there is ay struction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
-ender's Name Lender's Address
3y my signature below, I certify to each of the follo 1ng:
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 Ad state la relating to building construction.
I authorize representatives of this city or county ter th ove-ident "pro for inspection purposes. /
�2,
signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name ,v =
Date/ -�
ACTION
DATE
BY
DE RATION OF COMPLIA E WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 610E ITLE 40 AND AQMD RULE
1403
PERMIT EXPIREDLJ
I SUBMITTED ASS TOS NOTIFICATION TO
-
PERMITC4NCELLED
0EPA
PERMIT EXTENDED
OMD
PERMITFINAL
/
SBESTOS NOTIFICATION 15 NOT APPLICABLE TO
CERTIFICATE OF
-G-L,
PROPOSED DEMOLITION
OCCUPANCY ISSUED
SIGNATURE:
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