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Home My WebLink AboutX2021-0624 - PermitsCity of Newport Beach - Building Division IIII�IIII�IIIIIIIIIIIIIIIIIIIIIIIIII� II COMB Permit: X2021-0624 ,r 100 Civic Center Drive, Newport Beach, CA 92660 R y X 2 0 2 1 0 6 2 4 Project No : 0572-2021 Permit Counter Phone (949)644-3288 \\\ v @ Inspection Requests Phone (949)644-3255 Combination Type - CIP MECH ELEC PLUM ��Issued Date : 2021 � Inspection Arearea : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0710812024 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 Job Address: 20331 IRVINE AVE NB St: 1 FI: 2 Unit: E7-202 Description: COMM TI'SEAN MOHTASHAMI D.D.S.' DENTAL OFFICE 2,446 SF Legal Desc.: Owner: SALT HOLDINGS II LP Address: 20331 IRVINE AV STE 7 NEWPORT BEACH CA 92660 Phone: Applicant: PECK KEN Address: 743 W TAFT AV ORANGE CA 92865 Phone: 714-637-1600 Code Edit: 2019 Type of Construction: V-B-SPR Occupancy Group: B Added /New sq.ft. Bldg: 2446 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Y Building Permit Fee: $2,314.00 Plan Check Fee: $2,013.18 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $50.00 Energy Compliance: $192.50 CA Seismic Safety: $0.00 Disabled Access: $275.00 Hazardous Mat - $0.00 Building Green Fee : $11.00 TOTAL FEE : $25,035.38 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: GOLDEN STATE CONST. INC Address: 743 W TAFT AVENUE ORANGE CA 92865 Phone: 714-637-1500 Con State Lic: 611046 Lic Expire: 01/31/2023 Bus Lic: BT30074432 Lic Exp Date: 03/3012022 Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9040861 Expire: 01/0112022 Building Setbacks Use Zone: Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical W Plumbing %: Rear: I Front: / Left: I Right: / arking Spa $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $605.81 $475.99 $389.45 Plan Check Fee Architect: OKAMOTO WESLEY Address: 15487 SENECA RD #203 a.E..h VICTORVILLE CA 92392f Phone: 760-241-7858 State Lic:CO21407 Engineer. Address: LU Phone: State Lic: M Designer: Address: U) Phone: Z Special Conditions: NO MEDICAL GAS ON SITE s Planning Department - Plan check Fee : $208.00 Fair Share: $17,691.45 SJH Trans : $0.00 In -lieu Housing Fee : $0.00 Public Works Department - Park Dedication : $0.00 PAN Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee Building Dept Adm $26.00 General Service $219.00 Refund Deposit $564.00 Grading Bond: $0.00 $0.00 $0.00 $3,133.69 Fee Due at Permit Issuance : $21,901.69 PUBLIC WORKS APPROVAL: PLAN CHECK BY: 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 reas on(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 3rofessions 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 iot more than five hundred dollars ($500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do U a!: 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 '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). ❑ I 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 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 7000 of Di Si 3 of the Business and Proles ions d my license is in full force and effect. License Class License No Date 34,.7/ Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: 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 COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under 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 performance of the work for which this permit is issued. Policy No. have and will -maintain workers' compensation insurppce, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' Date ne of Agent - F r111°O M certify that, in the perf rmance 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 if I should become bject to t orkers' ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. % nature of Applicant ae -7 1 CLARATION REG D ONSTRUCTION LENDING AGENCY Teby 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). 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 ordinances and state laws relating to building construction. authorize representatives of this city or couni toe rttiy�J 696�fied property for inspection purposes. of ACTION PERMIT EXPIRED PERMITCANCELLED PERMITEXTENDED ERML CERTIFICATE CERTIFICATEFICATEOF OCCUPANCYISSUED / G Owner's or Authorized AD OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY PART 61 OF TITLE 40 AND AQMD RULE TC IS NOT APPLICABLE TO