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Home My WebLink AboutX2022-0288 - Permitswr„Q City of Newport Beach - Building Division *X2022-0288" COMB Permit: X2022-0288 100 Civic Ce iter Drive, Newport Beach, CA 92660 ° rl Project No : 0260-2022 Permit Courtier Phone (949)644-3288 �,�q r LL Inspection Requests Phone (949)644-3255 Issued Date : 0210912022 Combinatio Type - CIP Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 02/09/2025 OR PERMIT WILL BE INVALID Construc tion 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: 20162BIRCHSTINE3 , Description: COMM RE -STRIP (E) PARKING LOT , Legal Desc.: TR 706 LOT 136 S LY1/2 Owner: CFM HOLDINGS L C Contractor: UNITED PAVING CO Architect: ESA MOHAMMED , Address: 1198 S POINTE PREMIER Address: 1880 NORTH DELILAH STREET Address: 311 HAIGH RD STE 201 , ANAHEIM CA 9280 CORONA, CA 92879 THOUSAND OAKS, CA 91320 Phone: 949-288-1828 Phone: 951-739-9200 Phone: 806-498-7786 State Lic:CO24004 , Applicant: WILEY MARK Con State Lic: 865828 Engineer: _--„ Address: 1880 N PELICANS r Lic Expire: 1013112023 Address: • ' . CORONA CA 92871 Bus Lic BT30015177 , Phone: 714-624-8867 Lic Exp Date: 05/31/2022 Phone: State Lic: , Code Edit: 2019 Worker's Compensation Insurance Designer: .. , Type of Construction: Carrier: EMPLOYEE SERV GROUP Address: Occupancy Group: U Policy No: C6866102A Added /New sq.ft. Bldg: Expire: 06/01/2022 Phone: Added /New sq. ft. Garage: No of Stories: 0 Building Setbacks Rear: / Special Conditions: No of Units : 0 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: Right: / Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: 01000.00 Building Permit Fee: $419. 0 Excise Tax: $0.00 Planning Department - Fire Department $0.00 Plan Check Fee: $364.53 Additional Fee : $0.00 Plan check Fee : $52.00 Fire Inspection: $48.50 Overtime Plan Ck: $0. 0 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev Investigation Fee: $0. 0 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee $0.00 Record Management: $2. 0 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $0. 0 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $0. 0 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0,00 Disabled Access : $0. 0 P/W Plan Check : $50.75 Grading Bond: Hazardous Mat $0. 0 Electrical %: $0.00 San Dist: $0.00 $0.00 Building Green Fee : $1. 0 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 TOTAL FEE : $937.78 Plan Check Fee : $515.78 Fee Due at Permit Issuance : $422.00 PROCESSED BY: PUBLIC WORKS APPROVAL: rtn A� q� kk t(= ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: �a' 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 7031.6, 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 is 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). 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 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 nprovements 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 nproved for the purpose of sale). I, as owner if 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). I an, exempt fro.n I:censure under the Contractors' State License Law for the following reason: 1:, 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 legal[) eh a st, ucture the, 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 Cod,, i., dvailable upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw.htmi. ;igvature of ProFerty Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm Under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 0) Divisi 3 of the Business and Pr f salons d nd lice se is in full force I,d �f;ect. License Class License No Dat Contractor Signatur VORK 3RS' COMPENSATION DECLARATION IARNING: FAILUR[ TO JECNRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (S100,000), IN ADDITION TO THE CST')' :OMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. herby affirm r'nder 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 erformance 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' ^ e carrier and policy number are: Policy Number of Agent Date 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 agree tat, if I should become s ject to the rk ' compe Ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 'signature of Applicant /�Cy,%�/E,/ Cat 1ECLARATION REGA ING-CONSTRUCTION L*NDINiG AGENCY hereby affirm under penalty of perjury that there isla construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil ode). ender's Name Lender's Address Iy my signature below, I certify to each of the following: 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. agree to comply with all applicable city and county ordinances and state laws lating to building construction. authorize representatives of this city or county tcjentl t e bg) C lentifie roperty for inspection purposes. ACTION DATE BY ✓ DEZ'QCICATION OF COWCANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PAR 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMIT EMENDED AQM D PERMITFINAL CERTIFICATE OF I i LL` h ASBESTOS NOTIFICATION 15 NOT LICAB 0 PRO p gEMOLITiO SS OCCUPANCY ISSUED l� ��/ SIGNATu1I�k(_ /�L