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Home My WebLink AboutX2019-0772 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2019-0772 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 0 0 7 7 2 Project No: 0516-2019 Permit Counter Phone (949)644-3288 s Inspection Requests Phone (949)644-3255 rr �Y x n Combination Type - CIP ELEC MECH PLUM Issued Date : 09117/2019 Inspection Area : 7 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: 400 NEWPORT CENTER DR NB St: 4 FI: 401 Description: COMM TI -'HMG ALLERGY CLINIC' 2724 SF Legal Desc.: P BK 193 PG 17 PAR 1 Owner: NCMB NO 1 LLC Address: 1401 AVOCADO AVE #901 NEWPORT BEACH, CA 92660 Phone: Applicant: GALPIN KATE Address: 300 SPECTRUM CTR DR STE 730 $0.00 IRVINE CA 92618 Phone: 949-727-9000 Code Edit : 2016 Type of Construction: Vx94WR Occupancy Group: B Added /New sq.ft. Bldg: 2724 Added /New sq. ft. Garage: 0 No of Stories: 7 No of Units : 0 Bldg Height: 0 Bldg Sprinklers:. Building Permit Fee: $2,368.00 Plan Check Fee: $2,121.16 Overtime Plan Ck $0.00 Investigation Fee: $0.00 Record Management: $76.00 Energy Compliance: $210.00 CA Seismic Safety: $0.00 Disabled Access: $300.00 Hazardous Mat $0.00 Building Green Fee : $12.00 PROCESSED BY: Contractor: THORPE CONSTRUCTION INC Address: 4563 EISENHOWER CIR 7600013614 ANAHEIM CA 92807 Phone: 714-777-3811 Con State Lic: 568357 Lic Expire: 05/31/2021 Bus Lic: BT30068935 Lic Exp Date: 09/30/2020. y00 Worker's Compensation Insurance ,q TTA Carrier: EVEREST NATIONAL INS Policy No: 7600013614 Expire: 08/06/2020 Building Setbacks Rear: / $0.00 Front: I Left: / $0.00 Right: TOTAL FEE: $7,969.73 ZONING APPROVAL: GRADING APPROVAL: Architect: HERNANDEZ DARCIA KAY Address: 15615 ALTON PKWY #270 IRVINE CA 92618 Phone: 949-727.9000 State Lic:C030188 Engineer: Address: Phone: Designer: Address: Phone: e m emomom c State Lic: m m o m m m INSPCUT- o o me 0 Special Conditions: FRANCHISED HAULER: ROBERTS WASTE Excise Tax: $0.00 Planning Department - $40.00 Additional Fee: $324.00 Plan check Fee Fire Plan Rev Grading Bonds Fee: $0.00 Fair Share Grading PC Consultant : $0.00 SJH Trans Grading Permit Fee: $0.00 In -lieu Housing Fee: Refund Deposit Grading PC Fee: $0.00 Public Works Department - WQ Insp. Fee: $0.00 Park Dedication : $0.00 PAN Plan Check: $0.00 Electrical %: $619.94 San Dist: $0.00 Mechanical %: $487.10 -NMUSD Fee: $0.00 Plumbing %: $398.53 Plan Check Fee : $3,124.61 Fee Due at Permit Issuance : $4,845.12 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE:` e e oeemoe o m 00000 0 0000e 000000 C ° o 0 000000 c c coon Fire Department $40.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev $228.00 $0.00 Demolition Fee $0.00 Building Dept Adm $24.00 General Service $197.00 Refund Deposit $564.00 Grading Bond: $0.00 $0.00 $0.00 Plan Check Fee : $3,124.61 Fee Due at Permit Issuance : $4,845.12 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE:` e e oeemoe o m 00000 0 0000e 000000 C ° o 0 000000 c c coon OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) 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 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 licensure under the Contractors' State License Law for the following reason: By my signature 64188 1 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 tMaP Phave 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 P"doions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm]. Signature of Ifropartybwner or Authorized Agent to L}CtilISED CONTRACTOR'S DECLARATION I hereby affirm pnderpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) ivi 'on of the Business and Profess! s d an €Is in full f ce 2pci2(ject. Lic"se Class License No Date Contractor Signature INORKERS;COMP•ENSATION DECLARATION NA11IZI$IG: FAILItTO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINA ENALTIES AND CIVIL FINES UP TO ONE HUNDR THOUSAND DOLLARS ($100,000), IN ADDITION TO THE DOBPOF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ilonaby affirm uAder penally of perjury one of the following declarations: a, J I Aave arid'NNI•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 the "f4RTlance of the fork for which this permit is issued. Policy No. Aave and Wj1Crp9intain 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 nsu nce carrier and policy number are: carrier Policy Number Expiration Date \lame of Agent/� Phone # :11 certify that, in the pert fmanc a yyork for whic . hi rmit is issue Shall not employ any person in any manner so as to become subject to the workers' c mpensation laws of California, and agree .hat, if I should become s bject w ('kers' c sat! prof Secb n 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant Date Q� DECLARATION REG// DI ONS RUCTION D G AGENCY hereby affirm underpenal 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). _ender'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 o is behalf. I have read this application and the information I haVnt .. s correct. I agree to comply with all applicable city and countyR a and at s Slat! construction. I authorize representatives of this city or county to o (fled r any f ' ape on purposes. Signature of PropertyOwner or Authorized Agent rent Property Owner's or Authorized Agent's Name Date ACTION DATE BY / DEyLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY ,REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED I I / I U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITFINAL /J�p /C/LJ ASBESTOOT I TI NIS ADPL A L`E TO CERMITFINAL PROPOSED'M 10 OCCUPANCY ISSUED GNATURE � z ®`