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Home My WebLink AboutX2021-1361 - Permits6wrr}� City of Newport Beach - Building Division *X2021-1361` COMB Permit: X2021-1361 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 1202-2021 Permit Counter Phone(949)644-3288 Mi- Inspection Requests Phone (949)644-3255 Combination Type - BLDG ELEC w g a % Y ®r � 1 Issued Date : 1111612021 Inspection Area 7 : PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1111612024 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: 6208 (CS) W COAST HWY NB Description: COMM CELL SITE "T MOBILE" Legal Desc.: Owner: CHATRISA ENTERPRISES LLC Contractor: PRAMIRA INC Architect: Address: 6208 W COAST HWY Address: 2552 WALNUT AVE STE 200 Address: NEWPORT BEACH CA 92663 TUSTIN, CA 92780 Phone: Phone: 800-678-1169 Phone: Applicant: SAITO BARBARA Con State Lic: 1066171 Engineer: Address: 3300 IRVINE AVE#300 Lic Expire: 0613012022 Address: NEWPORT BEACH CA 92660 Bus Lic: BT30076225 Phone: 909-723-3152 Lic Exp Date: 0813112022 Phone: Code Edit: 2019 Type of Construction: Occupancy Group: U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 0 No of Units: 0 Bldg Height: 0 Bldg Sprinklers: Construction Valuation: Building Permit Fee: $630.00 Plan Check Fee: $548.10 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $44.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $2.00 TOTAL FEE : $1,407.07 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Worker's Compensation Insurance Carrier: INS CO OF THEWEST Policy No: WGA505927800 Expire: 01/23/2022 Building Setbacks Zone: Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee : Electrical %: Mechanical %: Plumbing %: Rear: / Front: / Left: / Right: I narking Spaces $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $82.47 $0.00 $0.00 Plan Check Fee 0 Designer: Address: Phone: State Lic PROCTORJACOB 651 E GALENA PARK BLVD #101 DRAPER UT 84020 801-990-1775 State Lic:C-070567 Special Conditions: LIQUEFACTION & HIGH DENSITY AREA Fire Hazard Zone : N Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PAN Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department $52.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 $48.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $623.73 Fee Due at Permit Issuance: $783.34 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 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 (_) 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-Builderwill 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 bJ;a.v 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 Orofess,ons 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 ) iv io 3 of the Business and Prof#THS e i f II force 3nH etfPct. License Cass License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: FAILUF = TO S-CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREOLLARS ($100,000), IN ADDITION TO THE 0J:.1 L F COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. BErauy affirm under penalty of perjury one of the following declarations: I have and %"i'I meintain 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 oeirormance of the work 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' compensatiol (nsbf.atnce carrier and policy number are: Policy Number me of Agent Date I certify that, in the perfor 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 It, if I should become sub t h w r com en ps/aJttiii nn provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /• Inature of Applicant 1 �l�ivLC�i Date iCLARATION REGA S RUCTION LENDING AGENCY ereby affirm under penalty of jury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, ivil Code). nder's Name Lender's Address 3y 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 h e pr vided is correct. I agree to comply with all applicable city and county ces and state laws relating to building construction. I authorize representatives of this city or count to i t'fied p rty for inspection purposes. Signature of PropertyOwner or Authorized Agent Print Property Owner's or Authorized Ag ACTION DATE BY R TION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMIT EXTENDED AQMD ERML CERTIFICATE OF OCCUPANCYISSUED J L.L � BEST S N TION 15 NOT APPLI PROPOSED SIGNATURE' Name