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Home My WebLink AboutX2021-1314 - Permits��4,•,,r� City of N Dwport Beach - Building Division "X2021-1314" COMB Permit: X2021-1314 '� Tr 1c0 Civic car ter Drive, Newport Beach, CA 92660 Project No : 1170-2021 w ' Permit Counti ir Phone (949)644-3288 Inspection Re 4uests Phone (949)644-3255 � � w� Issued Date : 02/08/2022 Combination Type - CIP1�1 Inspection Area : 7 N. PROJECrS MUST BE PERMIT WILL B LETED EINVA PERC Construe c ion Hours.SMonday s Friday 7:00 aAmT to6:30 p.m. and AFTER ISUANCE OR LID d Saturday from 8:00 a.m. oP6.00 p.m. No work ono Sundays or Holidays LID Job Address: 4100 CAMPUS DR 413 Description: COMM - REPL (2) STAIRS & RAILINGS - Legal Desc.: N TR 3201 LOT 19 - Owner: IRVINE FOUR LLC Contractor: PARK CONST & MNGMT INC Architect: RIGGS JEFFREY ; Address: 11766 WILSHIRE B VD #820 Address: 1709 EAST 22ND STREET Address: 25 PECOS LOS ANGELES, CA 90058 Phone: Phone: 323-244-1378 RSM CA 92688 LOS ANGELES CA 0025 Phone: 949-233-1553 State Lic:CO21317 -� Con State Lic: 1049602 Engineer: SOMA JR PHILIP GEORGE - Applicant: RIGGS JEFFREY Lic Expire:/04962023 Address: 252 SOUTH BRENTWOOD Address: 25 PECOS ANAHEIM CA 92804 RSM CA 92688 Bus Lic: BT30070270 ,..,, Phone: 949-233-1553 Lic Exp Date: 12/31/2022 Phone: 949-252-7660 State Lic:C-046231 2019 Worker's Compensation Insurance Designer: -• Code Edit : STATE COMP Address: Carrier: Type of Construction: V-B Policy No: STATE - Occupancy Group: B Phone: Added /New sq.ft. Bldg: Expire: 01124/2023 Added /New sq. ft. Garage: Special Conditions: No of Stories: 2 Building Setbacks Rear: / No of Units : 0 Front: / Bldg Height: 0 Left: I Right: / Bldg Sprinklers: Use Zone: Parkin Spaces: 0 Fire Hazard Zone : N Flood Zone: X Construction Valuation: 8 750.00 Building Permit Fee: $558. 0 Excise Tax: $0.00 Planning Department- Fire Department Plan Check Fee: $485.46 Additional Fee : $0.00 Plan check Fee : $0.00 Fire Inspection: $0.00 Overtime Plan Ck: $0. 0 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Investigation Fee: $0. 0 Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Record Management : $0. 0 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Gelne'r�al 3ervticedm $0.00 Energy Compliance: $0. 0 Grading PC Fee: $0.00 Public Works Department - Refund Deposit $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 CA Seismic Safety : $0. 0 PAN Plan Check: $0.00 Grading Bond: $0.00 Disabled Access : $0 00 Hazardous Mat $0 00 Electrical %: $0.00 San Dist : $0.00 $0.00 Building Green Fee : $2 00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0,00 Plumbing %: $0.00 TOTAL FEE: $1,045.46 Plan Check Fee : $475.89 Fee Due at Permit Issuance : $569.57 PUBLIC WORKS APPROVAL: PROCESSED BY: PLAN CHECK BY: ZONING APPROVAL: APPROVAL TO ISSUE: GRADING APPROVAL: 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 improved for the purpose of sale). 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 1, 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 owne, of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I am exempt rrorn licensure under the Contractors' State License Law for the following reason: Dy ,r,y signature uelow . 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 legall', sell a structure th3' 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.htm]. Cignotdre of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I, hercty affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 of D vis'on 3 of the Business and Profe od , an my license is in full force and effsct. Licnnse Clnss License No Date 2- u''7 _L`L Contractor Signature M/CEI;ERS' COMPENSATION DECLARATION 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 .:OMPENSAFION; 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: h.nve and vill 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, )arformance 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' 1Sgpe carrier and policy number are: I r^� I '^ C Policy Number Expiration Date of Agent I 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 agre that, if should becomeect toJpe workers`compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �/ Signature of Applicant_ T�L.c(� 1 Date 1C Z��`6 DECLARATION REGA DING C I r<ui.I wn LtrvulNr AGENCY T� 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, Civil 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 owners 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 count to nt abo -I an led property for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam yr u•, a.�1.� Date ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQM D RULE 1403 PERMIT EXPIRED 1 SUBMITTED ASBESTOS NOTIFICATION TO AQMD PERMITFINAL ! 7) G r� _TO§ NOTIFICATION IS NOTAPPLICABLE TO CERTIFICgTEOF l0 Fr y ( ROPOSEDtC¢ ITIO OCCUPANCYISSUED III II^ Y`� ar-NATI ID \