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X2018-3796 - Permits
City of Newport B°eackt°•= Batiolgg-Ddvaeion IIIII IIIIIIIIIIII IIIIIIIII IIIIIIIIIIII COMB Permit: X2018-3796 100 Civic Center Drive, Newpprt B,¢aah, C!r 92661•) o ° ° „ o x 2 9 1 8 3 7 9 6 Project No: 2937-2018 4 Permit Counter Phone (94916'44-3268°Be°° ' Inspection Requests Phone (949)644-3255 Issued Date : 0a/0812019 ?� Combination Type -GIP BLEC MECH PLUM Inspection Area : 7 • • ° • °PP_'F�MITS E IRE`T jfO DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Construction Hours: Monday -Friday 7.'Odfi.bn Otu 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 5180 BIRCH ST NB Description:. COMM - TI "WENDYS" 2634 SF. Legal Desc.: P BK 108 PG 27 PAR 3 - Owner: LEGACY BIRCH LLC Contractor: CLOCKWORK CONSTRUCTION INC Architect: DODSON JOHN S Address: P.O. BOX 52230 Address: PO BOX 39 Address: 1330 OLYMPIC BLVD IRVINE CA 92619 LAKEWOOD CA 90714 SANTA MONICA CA 90404 Phone: Phone: 562-425-1402 Phone: 310-452-5533 x 204 State Lic:CO27716 Applicant: DODSON JOHNCon State Lic: 1042273 Engineer: SEIBEL BENJAMIN JOEL Address: 1330 OLUMPIC BLVD. Lic Expire: 07131/2020 Address: 14288 DANIELSON STREET STE 200 ' SANTA MONICA CA 90405 - Bus Lic: BT30066778 POWAY CA 92064 Phone: 310452-5533 x204 Lic Exp Date: 0413012020 Phone: State Lic:C-069349 Code Edit: 2016 Worker's Compensation Insurance Designer. ' Type of Construction: V-BSPR .Carrier: EXEMPT Address: - Occupancy Group: B. Policy No: NO EMPLOYEES Added /New sq.ft.Bldg: 2634 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: I Special Conditions: WASTE MGMT No of Units : 0 Front: I TO HAUL DEBRIS Bldg Height: 0 - Left: I " a' Bldg Sprinklers: Y Right: I Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone.: N Construction Valuation:. $175,000.00. Building Permit Fee: $1,618.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $1,407.66 Additional Fee: $0.00 J Plan check Fee: $0.00 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $547.00 Investigation Fee: $0.00 Grading PC Consultant $0.00 SJH Trans : $0.00 Demolition Fee. Record Management: $166.00 Grading Permit Fee: $0.00 In -lieu Housing Fee $0.00 Building Dept Adm $24.00 Energy Compliance:. $122.50. Grading PC Fee: $0.00 Public Works Department - General Service $197.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $564.00 Disabled Access: $175.00 PM Plan Check : $123.75 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %:. $423.59 San Dist: $0.00 Building Green Fee : $7.00 Mechanical %: $332.82 NMUSO Fee: $0.00: $0.00 Plumbing %: $272.31 - $0.00 TOTAL FEE `. $5,980.63 Plan Check Fee : $2,737.01 Fee Due of Permit Issua(nyce : $3,243.62 r V_ PROCESSED BY: PUBLIC WORKS APPROVAL: �t, ZONING APPROVAL:'" PLAN CHECK BY; ?'RAIDING APPROVAL: � ko APPROVAL TO ISSUE: -f � rr--- OWNER -BUILDER DECLARATION i " • ' A I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indic&ebbeloi bQ the c%eekrR ark(s1Gfyave 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, demolicl°t, or oepair-any silucture, 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 Wring subjects the applicant to a civil penally 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 I_) portions of the work,',and'th9'sfsuo�ture is ntlllfteljderi 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 eMloyees' or porldnal o#ort, builds orlmproves 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 complelfdn, "e -Owner -Builder will have the burden of proving that 1t 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 Erto 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 legal) 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 theapplicable 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.: 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 �rh` 3Pter 9 (�mmencing with Section 7000) of iv'Sion 3 of the Business and Profession a e, an license is in full force and effect. License Class License No %_ 2 7 Date© g Contractor Signat - 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 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: 13 1 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 IN performance of the work for which this permit is issued. Policy No. 1:11 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' compensatio insurance carrier and policy number are: Carrier Policy Number Expiration Date nNe f Agent Phone # ify that, in the performs ce of t e ork 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 agreshould becom4haledury roars' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. re of Applicant D to RATION REGATRUCTION LENDING AGENCY I hereby affirm under p that 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, 1 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 c x 'a I. I agree to comply with all applicable city and county ordinanc ., an I sate laws relating to building construction. I authorize representatives of this city or cc to enter th o ntified property for inspection purposes. (� r Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name 6 (O LJJEAEODate $ ACTION DATE B ECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY 1 REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1, PERMIT EXPIRED I I I U I SUBMITTED ASBESTOS NOTIFICATION TO YCHIVIII cA uvuc✓ LIAQMD - PERMITFINAL CERTIFICATE OF / I�.� I / l/ ASBESTOS NOTIFICATIOPI TAPPLICABLE TO PROPOSED DEMOLI OCCUPANCYISSUED