HomeMy WebLinkAboutX2022-0406 - Permitsyen„� 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 - BLDG ELEC
Job Address
Description:
Legal Desc.:
Owner:
Address:
Phone:
Applicant:
Address:
Phone
JGKALLINS INVESTMENTS
1999 AVENUE OF THE STARS #28750
LOS ANGELES CA 90067
LADUA BRADLEY
3300 IRVINE AVE #300
NEWPORT BEACH CA 92660
909-202-3448
Code Edit :
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 0
No of Units: 0
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation:
II X 2 ii iiiiiiiii 0 i� ii i6911
COMB Permit: X2022-0406
Project No : 0362-2022
Issued Date : 04/20/2022
Inspection Area : 7
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 04/20/2025 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
1107 (CS) JAMBOREE RD NB
COMM CELL SITE "AT&T"
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Contractor:
X3 MANAGEMENT SERVICES INC
Architect:
Address:
2128 AUTO PARK WAY
Address:
ECONDIDO CA 92029
Phone:
760-658-6455
Phone:
State Lic:
Con State Lic:
933263
Engineer:
PROCTOR JACOB
Lic Expire:
06/30/2023
Address:
651 E GALENA PARK BLVD #101
Bus Lic:
BT30078531
DRAPER UT 84020
Lic Exp Date:
04/30/2023
Phone:
801-990-1775 State Lic:C-070567
2019 Worker's Compensation Insurance
Carrier:
BERKSHIRE HATHAWAY
U Policy No:
XTWC200530
0 Expire:
10/01/2022
0
Building Setbacks
Rear: /
Front: /
Left: /
Right: /
Building Permit Fee: $504.00
Plan Check Fee: $438.48
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$24.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $1,002.76
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Designer:
Address:
Phone:
Special Conditions:
Fire Hazard Zone : N
Excise Tax: $0.00 Planning Department - Fire Department
Additional Fee : $0.00 Plan check Fee: $0.00 Fire Inspection: $0.00
Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00
Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee
Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00
Grading PC Fee: $0.00 Public Works Department- General Service $0.00
WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00
P/W Plan Check: $0.00 Grading Bond: $0.00
Electrical %: $35.28 San Dist: $0.00
Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00
Plumbing %: $0.00 $0.00
Plan Check Fee: $438.48 Fee Due at Permit Issuance : $564.28
OUHLIC WORKS APPROVAL:
19 -PLAN CHECK BY:
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 L) 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 Section 0 ) of ivi 'off n 3 of the Business an P 'o Code, a my license is in full force
and effect. License Class License No Date 171!2� Contractor Signal
WORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSA DOLL RS (E100,000), IN ADDITION TO THE
COST 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:
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
:e of the work for which this permit is issued. Policy No.
have and will frr2lhtain workers'
rrier rance caa Doll Y number
ie of Agent
insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
Date
_JI certify that, in the performance of the ork or which this permit isAsued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
hat, if I should become su ' ers' ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. II
signature of Applicant Date
)ECLARATION REGARD NG C UC IN LENDING AGENCY
hereby affirm under pe alty of pe' rythat the 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
3y 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 co a and state laws relating to building construction. p
I authorize representatives of this city or cou to er the -identified property for inspection purposes.
signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name 1A, at
ACTION DATE BY D OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
RCLARATI INS PART 61 OF TITLE 40 AND, RULE
PERMIT EXPIRED
LI I SUBMITTED ASBESTOS NOTIFICATIO.d TJ_
PERMITCANCELLED
DEPA
PERMIT EXTENDED
L1AQMD
PERMITFINAL
CERTIFICATEOF
OCCUPANCYISSUED
6 S `?
`,/•�
ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
PROPOSED DEMOLITION
SIGNATURE: