HomeMy WebLinkAboutX2021-2088 - PermitsCity of Newport Beach - Building Division "X2021-2088" COMB Permit: X2021-2088
{ sE Y 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 1807-2021
I `f Permit Counter Phone (949)644-3288
Q S Inspection Requests Phone (949)644-3255 6ss t(^+ ^
°,�,yy,,.> Combination Type - CIP ELEC 1 6 t j. ° l �--'` Issued Date : 12/22/2021
Inspection Area : 7
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 12/22/2024 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
Jab Address: 2503 (CS) EASTBLUFF DR NB
Description: COMM -CELL SITE "T-MOBILE"
Legal Desc.:
Owner:
IRVINE COMPANY
Contractor:
WSD CONSTRUCTION
Address:
550 NEWPORT CENTER DR
Address:
9245 SKY PARK COURT #105
NEWPORT BEACH CA 92660
SAN DIEGO, CA 92123
Phone:
9491645-9790
Phone:
619-954-7850
Applicant:
BARBOUR DONALD
Con State Lic:
1022415
Address:
24310 MOULTON PKWY STE 0#1009
Lic Expire:
01/3112023
LAGUNA HILLS CA 92637
Bus Lic:
BT30077545
Phone:
9491336-1550
Lic Exp Date:
12/31/2022
Code Edit : 2019
Type of Construction:
Occupancy Group: U
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 0
No of Units: 0
Bldg Height: 0
Bldg Sprinklers:
Architect:
Address:
Phone:
State Lic:
Engineer:
PINA PAUL COHN
Address:
4430 E MIRALOMA AVE, STE D '
ANAHEIM CA 92807 -
Phone:
562/652-5330 State Lic:C-043035 �-
Worker's Compensation Insurance Designer:
Carrier: UNITED WISCONSIN INSURANCE CO Address:
Policy No: WC50600269020SZ
0 Expire: 0110112022 Phone:
0
Building Setbacks Rear: / Special Conditions:
Front: /
Left: /
Right: /
Use Zone: Parkinc Soaces: 0 Fire Hazard Zone : N
Construction Valuation:
$30,000.00
Building Permit Fee:
$570.00
Excise Tax:
$0.00
Planning Department -
Plan Check Fee: $495.90
Additional Fee :
$0.00
Plan check Fee
Overtime Plan Ck:
$0.00
Grading Bonds Fee:
$0.00
Fair Share:
Investigation Fee:
$0.00
Grading PC Consultant :
$0.00
SJH Trans :
Record Management:
$20.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee
Energy Compliance:
$0.00
Grading PC Fee:
$0.00
Public Works Department -
CA Seismic Safety :
$0.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Disabled Access :
$0.00
PAN Plan Check :
$0.00
Hazardous Mat
$0.00
Electrical %:
$149.23
San Dist:
$0.00
Building Green Fee :
$2.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$0.00
TOTAL FEE: $1,285.63
PROCESSED BY:
ZONING APPROVAL:
Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
Plan Check Fee : $613.83 Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
$0.00
$48.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$671.80
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 Iicensure 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
im roved 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).
❑ I am exempt from Iicensure 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,Zhat ; ;lave 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.htmi.
3;goaW.e of Prnperty Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty ofperjury that 1 am Lensed under provisions of Chapter 9 (commencing with Section 7000) of Ivisio 3_of the Business and Profs o o and my license is in full force
and effect. License Class -e rf.� n' License No Date Contractor Signature
WCRK2RS' CC,NIPENSATION DECLARATION
WARNING: FAILURE'.0 sE.:JRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES AND CIVIL FINES UP TO ONE HUNDRED T OUSA OCEANS ($100,000), IN ADDITION TO THE
11C3r Jr COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNETS FEES.
I hj.eoy affirm under penalty of perjury one of the following declarations:
J ! have and wal TIJ.chin 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 thi
)e ante of tn^ -Nor? for which this permit is issued. Policy No.
I 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
insurance carrier and pc;icy number are:
Carrier /' Policy Number Expiration Date
Name of Agent F _ lC Phone #
N
I certify that, in the performancAthe ork for which this permit is issued, shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agrep
that, if I should become subjeens' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. t�
Signature of Applicant Date _
DECLARATION REGARD CO CTION LENDING AGENCY
I hereby affirm under penal of a at 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:
1 am the property owner or authorized to act on the property owner' behalf.
I have read this application and the information I have provided is rrect.
I agree to comply with all applicable city and county ordi a state laws relating to building construction.
I authorize representatives of this city or county to en he abo -identified property for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized A ame qk(DZ 2' Z
ACTION DATE BY DE LARA OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REG IONS PART fit OF TITLE 40 AND ACMD RULE
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
NOTIFICATION TO
PERMIT FINAL BEIT0Z-IK'�IC� SGNATURE:S� LI�'1FICRTr6 S OT APPLICABLE TO
CERTIFICATE OF
OCCUPANCY ISSUED