HomeMy WebLinkAboutX2019-0341 - Permitsn� City of Newport Beach - Building Division IIIIIIIIIIIIIIIIUIIIIIIIIIIIIIIIII�ll II COMB Permit: X2019-0341
4a. 100 Civic Center Drive, Newport Beach, CA 92660 x 2 0 1 9 0 3 4 1 Project No : 0238-2019
'. Permit Counter Phone (949)644-3288
SAY Inspection Requests Phone (949)644-3255
Combination Type - CIP PLUM Issued Date:
Inspection Arearea :2019
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: 680 NEWPORT CENTER DR NB St: 1 FI: 1
Description: COMM TI 455 SF NIS RESTROOM ACCESSIBILITY UPGRADES
Legal Desc.: P.M. 295-33 PAR 7 AND POR PAR fi a
Owner: IRVINE CO
Address: 550 NEWPORT CENTER DR
NEWPORT BEACH, CA 92660
Phone:
Applicant: YAM MARK
Address: 392 N LEMAY CT
ORANGE CA 92867
Phone: 626-757-2320
Code Edit: 2016
Type of Construction V-BSPR
Occupancy Group: B
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories:. 16
No of Units : 0
Bldg Height: 0
Bldg Sprinklers: Y
Contractor:
PACIFIC TUSK BUILDERS CORP
Address:
1100 QUAIL ST #213
$1,113.00
NEWPORT BEACH CA 92660
Phone:
213-999.5695
Con State Lic:
946358
Lic Expire:
04130/2020
Bus Lic
BT30038640
Lic Exp Date:
0313112020
Worker's Compensation Insurance
Carrier:
INS OF THE WEST
Policy No:
WSD504197100
Expire:
07/01/2019
Building Setbacks
Rear: /
$0.00
Front: /
$0.00
Left: /
Building Green Fee :
Right: /
Construction Valuation:
$100.000.00
Phone:
Building Permit fee:
$1,113.00
Excise Tax:
Plan Check Fee: $968.31 - -
Additional Fee:
Overtime Plan Ck:
$0.00
Grading Bonds Fee:
Investigation Fee:
$0.00
Grading PC Consultant:
Record Management:
$8.00
Grading Permit Fee:
Energy Compliance:
$0.00
Grading PC Fee:
CA Seismic Safety:
$0.00
WQ Insp. Fee:
Disabled Access :
$0.00
$0.00
Hazardous Mat
$0.00
Electrical %:
Building Green Fee :
$4.00
Mechanical %:
Refund Deposit
Plumbing %:
TOTAL FEE: $2,233.48
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Architect: MORFORD PAUL
Address: 4675 MACARTHUR CT#100
Phone:
Special Conditions:
Fire Hazard Zone : N
$0.00
NEWPORT BEACH CA 92660
Phone:
949.863-9434 State Lic:C019058
Engineer:
$0.00
Address:
Phone:
State Lic:
Designer:
Fair Share :
Address:
$0.00
Phone:
Special Conditions:
Fire Hazard Zone : N
$0.00
Planning Department-
Fire Department
$0.00
Plan check Fee:
$40.00
Fire Inspection:
$0.00
Fair Share :
$0.00
Fin: Plan Rev
$0.00
SJH Trans :
$0.00.
Demolition Fee
$0.00
In -lieu Housing Fee:
$0.00
Building Dept Adm
$0.00
Public Works Department -
General Service
$0.00
Park Dedication.:
$0.00
Refund Deposit
PAN Plan Check:
$0.00
Grading Bond:
$0.00
San Dist:
$0.00
$0.00
NMUSD Fee:
$0.00
$100.17
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee : $1,008.31 Fee Due at Permit Issuance : $1,225.17
b OF
-PUWC WORKS APPROVAL:
F 5 b® 44 < f
PLAN CHECK BY:
°0•APPROVAL TO ISSUE:
4 6
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 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
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).
❑ 1 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 legall)
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.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 Chapter 9 (commencing with Section 000) ( ' 'si 3 o he Business and Pr - sions din iceas p�'In full force
and effect. License Class License No Date Contractor Signature /L
NORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDR D THOUSAND DOLLARS ($100,000), IN AUDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
'ormance of the work for which this permit is issued. Policy No.
have andII r�rgintain worka&1compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
Number Expiration Date
ie of Agent lrSCit_. T"y v 1 1124&
certify that, in the performance of the work for which this permit is
if I should become sul$lect to the workers' compensation provisic
of
I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree
action 3700 of the Labor Code, I shall forthwith comply with those provisions.
CLARATION REGARD' G CONSTRUCTION LENDING AGENCY
:reby 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
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.
1 have read this application and the information I have provided is correct.
I agree to comply with all applicable city and cou ty ordinances and state laws relating to building construction.
I authorize representatives of this city or c _ t o anti ove-identif' property for inspection purposes. �/f
nature of Prooertv Owner or Authorized AGent , /% //.1� �rf t%/1 Print Prooertv Owner's or Authorized ADent's Nams 6D
ACTION DATE BY I
RPECLARATION EGULATIONS OF COM0 TILE 40ANDD AQMWITH CODE F FEDERUDERAL FOR OFFICE USE ONLY
PERMITEXP/RED U I SUBMITTED ASBESTOS NOTIFIC/(AON T4
PERMITCANCELLED OEPA • • �•
s—�•• • • s
PERMIT EXTENDED UAQMD
PERMITF/NAL '�,/(p ASBESTOS NOTIFIC6,TION IS NOT APPLICABLE TO
CERTIFICATEOF PR OSEDE E O •i- • • • • •••
OCCUPANCYISSUED SIGNATOR
Civil Code).