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Home My WebLink AboutX2018-3802 - Permits,;x.no4 City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIII II 100 Civic Center Drive, Newport Beach, CA 92660 x 2 0 1 8 3 8 0 2 N w Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - BLDG ELEC COMB Permit: X2018-3802 Project No : 1505-2018 Issued Date : 1211712018 Inspection Area : 7 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. 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: 4340 CAMPUS DR NB Description: COMM INSTALL (18) LIGHT POLES �- Legal Desc.: N TR 3201 LOT 29 Owner. 43204360 LP Contractor: VINCERO CONSTRUCTION CO LLC Architect: Address: 1600 DOVE ST #480 Address: 16 TECHNOLOGY #156 Address: NEWPORT BEACH, CA 92660 IRVINE CA 92 618 Phone: Phone: 949-278-9143 Phone: State Lic: �_"-�^*` <# Applicant: BETTISON WILLIAM Con State Lic: 1046231 Engineer: AOANON VIRGILIO Address: 333 CITY BLVD WEST, STE 1115 Lic Expire: 10/3112020 Address: 3951 MEDFORD ST ORANGE, CA 92868 Bus Lic: BT30065409 LOS ANGELES CA 90063 Phone: 657-2214513 Lic Exp Date: Phone: State Lic:C-036079 �g Code Edit : 2016 Workers Compensation Insurance Designer: Type of Construction: Carrier: NO EMPLOYEES Address: Occupancy Group: Policy No: - ;.- Added /New sq.ft. Bldg: 0 Expire: Phone: - Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: I Special Conditions: No of Units: 0 Front: I Bldg Height: 0 Left: I Bldg Sprinklers: Right: I Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $108.000.00 Building Permit Fee: $1,216.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $0.00 Additional Fee : $0.00 Plan check Fee : $160.00 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: $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety : $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 PAN Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $85.12 San Dist: $0.00 $0.00 Building Green fee : $5.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $1,466.12 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $1,466.12 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: 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 requires the applicant for :he 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 U all of or `) 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 legall) 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 70 01 of ivis' n 3 of the Business and P fes 1 RAC 6,/ y i_ nse—u' I full force and effect. License Class License No Date f2 /7 �iJ Contractor Signal INORKERS' 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 HUNDRE OU5 ND DOLLARS ($100,000), 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: 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 )rmance 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' compensa rance carrier and policy number are: Policy Number of Agent Date certify that, in the performance o 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 1, if I should become subj ct t e ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant CLARATION REGA DIN - STRU ION LENDING AGENCY' Ireby affirm under penal perjury Wat there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ider's Name Lender's Address 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. I agree to comply with all applicable city and county ordi ' ase state laws relating to building construction. I authorize representatives of this city or coun�t�"e r t [ ntified�roperty for inspection purposes. / nature of Prooertv Owner or Authorized Aoent Y Print Property Owner's or Authorized Agent's Name( " " " ' /'� D -/2 77 / ACTION DATE BY t ECLdRATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND ACMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION nO PERMITC4NCELLED UEPA PERMIT EXTENDED OM D PERMITFINAL .rl I 0 ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF / 71 yr �G PROPOSED DEMOLITION OCCUPANCY ISSUED /tom SIGNATURE: