HomeMy WebLinkAboutX2018-2866 - Permitsw1a$ City of Newport Beach - Building Division
ti 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
�. Inspection Requests Phone (949)644-3255
nx,>y Combination Type - CIP ELEC
COMB Permit: X2018-2866
IIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIII II
Project No: 2297-2018
Issued Date : 01/18/2019
Inspection Area : 6
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: 21181 NEWPORT COAST DR NB,
Description: COMM STOREFRONT HARDSCAPE, ADA INPROVEMENTS AND RAMP RECONSTRUCTION, RELOCATING LIGHTPOLES p'of
Legal Desc.: PM 318-27 PAR 1 POR OF PAR C4
Owner: VONS COMPANIES INC
Address: 1371 OAKLAND BLVD #200
Contractor:
Address:
WEST COAST BACKHOE INC Architect:
10681 CHESTNUT AVENUE Address:.
WALNUT CREEK, CA 94596
STANTON CA 90680
Phone:
Phone:
714-840-6246
Phone: State Lic:
Applicant: HOLLAND ROB
Con State Lic:
639268
Engineer: MCLAUGHLAN KEVAN
Address: 38 TECHNOLOGY
Lic Expire:
03/31/2019
Address: 4727 FIDLER AVE
IRVIEN, CA 92618
Bus Lic:
BT30060393
LONG BEACH CA 90808
Phone: 949-923-6260
Lic Exp Date: 09/3012019
Phone: 949.923.6141 State Lic:C-075657
Code Edit: 2016
Worker's Compensation Insurance
Designer:
.Type of Construction:
Carrier:
EMPLOYEE SERVICE GROUP Address:
Occupancy Group: U
Policy No:
065202281
Added /New sq.ft. Bldg: 0
Expire:
10/01/2019
Phone:
Added /New sq. ft. Garage: 0
_
No of Stories: 0
Building Setbacks
Rear: I
Special Conditions:
No of Units : 0
Front: /
Bldg Height: 0
Left: /
'
Bldg Sprinklers:
Right: /
Flood Zone: X
Use Zone:
Parking Spaces:
0 Fire Hazard Zone : N
-
Construction Valuation: $125,000.00
Building Permit Fee: $1,318.00
Excise Tax:
$0.00
Planning Department - Fire Department
Plan Check Fee: $1,146.66
Additional Fee :
$0.00
Plan check Fee: $80.00 Fire Inspection:
$0.00
Overtime Plan Ck: $0.00
Grading Bonds Fee:
$0.00
Fair Share : $0.00 Fire Plan Rev
$44.75
Investigation Fee: $0.00
Grading PC Consultant :
$0.00
SJH Trans : $0.00 Demolition Fee
Record Management: $30.00
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 : $125.00
PAN Plan Check: $41.25 Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %: .. _.
$345.05
San Dist: $0.00
Building Green Fee : $5.00
Mechanical%:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbirtg %:
$0.00
-
$0.00
TOTAL FEE : $3,135.71
Plan Check Fee:
$1,260.70 Fee Due at Permit Issuance: .
$1,875.01
PROCESSED BY:,PUfYLIC
WORKS APPROVAL:
1
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
" ` o APPRPVAL TO ISSUE:
.E �.
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)
lection 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
is 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
Irofessions 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
of more than five hundred dollars ($500).
7 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,
Iusiness 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
nprovements 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 1t was not built or
n 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
pply 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:
ly 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, 1 cannot legall)
ell 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
'rofessions 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
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 ) of Divi ion 3 of the Business and Pro essions Cod and my license is in full force
nd effect. License Class License No Dat Contractor Signature.
YORKERS' COMPENSATION DECLARATION
IARNING: 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
OST 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:
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 Cade, for th
Vante of the work for which this permit is issued. Policy No.
have ant, ll 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' compensalioi
Isurance c i le nd policy numper are: n
Date
of
certify the , ' the performance 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 agre
L if I should become suu/}ifriect to the wor AGrs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ����� ¢
nature of Applicant) `�� DaCej/////���'' �lr�Ci
CLARATION REG DING CONSTRUCTION LENDING AGENCY
Ireby 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.
I authorize representatives of this city or county to enter thh ove-identified property for inspection purposes. �Q-(
nature of ProDertv Owner or Authorized Aftl �— Print Property Owner's or Authorized Agent's Nam 111^Mw '[' 1 t�1'y D
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED U I SUBMITTED ASBESTOS NO INtA'110A TO i
PERMIT CANCELLED EPA
• •.
PERMIT EXTENDED qMD
PERMITFINAL®�'4"�,�.� ASBESTOS NOTIFICAT N IS NOT APPLICABLE TO
CERTIFICATEOF PROPO EMOLITIO • • • •'•
OCCUPANCYISSUED SIGNAT E: ••. ••• • • • • : • • —