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Home My WebLink AboutX2020-2145 - Permits�Erof City of Newport Beach - Building Division o¢ -, 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 sr y, Inspection Requests Phone (949)644-3255 Combination Type - CIP ELEC PLUM *X2020-2145* COMB Permit: J:2020-2145 Project No: 1155-20 }0 Issued Date : 0912412020 Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0912512023 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 Hofidays Job Address: 900 NEWPORT CENTER DR NB Description: TI STE 1405 (387 SF) AND PARTIAL CORRIDOR (238 SF) NORTH TOWER (PACIFIC POINTE) "MARRIO17" I � Legal Desc.: P BK 75 PG 33 PAR 1 TQ� Owner: HHR NEWPORT BEACH LLC Contractor: P W I BUILDERS Architect: TYNER RUSSEL EDWARD Address: PO BOX 579 Address: 3903 WEST MARTIN AVE Address: 2630 SEPULVEDA BLVD LOUISVILLE, TN 37777 LAS VEGAS NV 8911E TORRANCE CA 90505 Phone: Phone: 702-942-8400 Phone: 310-326-3050 State Lic:C014979 Applicant: WICKETT BJ Can State Lie: 816987 Engineer: Address: 2630 SEPULVEDA BLVD Lic Expire: 0113112021 Address: TORRANCE CA 90505 Bus Lic: BT30007525 Phone: 310-326-3050 Lic Exp Date: 1213112020 Phone: State Lic: Code Edit : 2019 Workers Compensation Insurance Designer: Type of Construction: I-ASPR Carrier.. TRAVELERS INDEMINTY Address: Occupancy Group: R1 Policy No: UB7K7781821826G Added /New sq.ft. Bldg: 0 Expire: 0710112021 Phone: Added New sq. ft. Garage: 0 - No of Stories: 16 Building Setbacks Rear. I Special Conditions: No of Units, 1 Front: I Bldg Height: 0 Left: I Bldg Sprinklers: Y Right: I Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone: N Construction Valuation: $20,000.00 Building Permit Fee: $416.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $361.92 Additional Fee : $0.00 Plan check Fee : $0.00 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: $16.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.GO Energy Compliance: $61.00 Grading PC Fee: $0.00 Public Works Department- General Service $0.00 CA Seismic Safety: $0.00 WO Insp. Fee: $0.00 Park Dedication: $0.00 Refund Deposit $0.00 Disabled Access : $91.00 P/W Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical W $108.91 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $70.01 $0.00 TOTAL FEE : $1,125.84 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $1,1;,5.84 PROCESSED BY: PUBLIC WORKS APPROVAL: ,t 1/ ZONING APPROVAL: PLAN CHECK BY: 'Kn,Y^, 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 rer uires 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 Divisio 13 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 penally 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 sa'e (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 it at 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 L cerise 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 0i the Business and Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govlmiaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION ,Dte� I hereby affirm under penalty of perjury that I am licensed under provisions of C8j"gf/commencing with Sect! 7000%,of Division 3 of the Busin nd Professions Code, and r i� fafrsans°iwfull force and effect. License Class 6 License No to 9/L4/2020 Contractor nature canner cr°:acidae a... Mv'"^ WORKERS' COMPENSATION DECLARATION o..�..,,.,,..,� NARNING: 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 (6' 00,000). IN ADDITION TO THE COST OF COMPENSAIIUP DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATToRNEY'S FEES I hereby affirm rower penalty of perjury one of the following declarations: Ci I have and wil' maintain a cerfificate 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 thl onnance of the work for which this permit is issued. Policy No. have 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 issued. My workers' compensatior surance c jar an nolicy number are: 'f Ave9ers UB7K7781822026G 7/1/2021 Policy Number of Agedr certify that, in tue 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 agree I, if I should ome subject to the workers' compenPagQF,piQ4irIoQx&.Secfion 3700 of the Labor Code, I shall forthwith comply with those provisions. .E„r,a dm.®o.�.�,°,� 9/24/2020 Tanner Groseclose o 6C,N a d o., naY:re of Ap of te_ r1 ARATI REGARDING CONSTRUCTION LENDING AGENCY :retry affrrm,wlder p=nalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3 7, fvll Code). ide's Name Lenders Address my signature below, 1 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 complywith all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city o+county to enter the abnva i ti - OSEs. / Tanner Groseclose (� ACTnt�ION DATE I y G �Z9 �tI �y 1403 REGULATIONS PAR'r'RATION OF 061 OFTITLE 40 AND AOMD RULEMPLIANCE WITH CODE OF FOR O�F,[CE USE ONLY rPERMITEXPIREO Li I SUBMITTED ASBESTOS NOTIFICATION TO `iti •II{I PERMIT FINAL {ry,_2 �/ J ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF Iql V �( �,/ PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: