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Home My WebLink AboutX2019-1791 - Permitsa Cityof Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2019-1791 100 Civic Center Drive, New ort Beach, CA 92660 X 2 0 1 9 1 7 9 1 P Project No :1289-2019 Permit Counter Phane (949)644-3288Inspection Requests Phone (949)644-3255 Combination Type - CIP - Issued Date: 06/2512019 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:2001 WESTCLIFF DR NB Description: COMM TI INSTALL (2) NEW DEMISING WALLS TO CREATE (3) SUITES FOR FUTURE TENANTS (NO EMP) Legal Desc.:c�'3to ,�• . Owner: HANKEV INVESTMENT COMPANY Contractor: CAMINO REAL DEVELOPMENT Architect: 0. •.aoo Address: 4751 WILSHIRE BLVD #110. Address: 1835 NEWPORT BLVD #A109-103 Address: '� °� �� ° �• _ �; � • LOS ANGELES CA 90010 COSTA MESA CA 92627 • . ° Phone: Phone: 949-873-5821 Phone: .State Lie: •� • °,°° m Applicant: SISSION RYAN Con State Lid: 1011084. Engineer; • •• •° °°° Address: 3100 E CEDAR ST #26 Lie Expire: 0212812020 Address: • ° • • ° ° ONTARIO CA 91761 Bus Lic: BT30060577 °•. ° ® ° m ° o ° Phone: 909-930-2444 Lie Exp Date:- 09/30/2019. Phone: State Lie: ° ...... ••...o Code Edit: 2016 Worker's Compensation Insurance Designer: SISSON LLE ANN o...... Type of Construction: V-B-SPR Carrier: STATE COMP INS FUND Address: 3100 E CEDAR ST #26 Occupancy Group: BIM Policy No: 9217157 - ONTARIO CA 91761 • • • ®° P Y P Y • .. ° Added /New sq.ft. Bldg: 0 Expire: 0813012019 Phone: 909.930.2444 .... ° ... ° Added /New sq. ft. Garage: 0 No of Stories: 3. No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Y II. TOTAL FEE: $867.04 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Building Setbacks Construction Valuation: $20 Special Conditions: Building Permit Fee: $392.00 Plan Check Fee: $341.04 Front: Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $6.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Right: Disabled Access: $87.00 .Hazardous Mat $0.00 Use Zone: Building Green Fee : $1.00 II. TOTAL FEE: $867.04 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Building Setbacks Rear: I Special Conditions: Front: Left: Right: Use Zone: Parking Spaces: - 0 Fire Hazard Zone : N Excise Tax: $0.00 Planning Department - Fire Department Additional Fee: $0.00 Plan check Fee : $40.00 Fire Inspection: $0.00 Grading Bonds Fee: $0.00 Fair Share.: $0.00 Fire Plan Rev. $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Grading PC Fee: $0.00 Public Works Department- General Service $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit. $0.00 PAN Plan Check : $0.00 Grading Bond: $0.00 Electrical W $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing%: $0.00- $0.00 Plan Check Fee : $381.04 Fee Due at Permit Issuance : $486.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: 1 APPROVAL TO ISSUE: OWNER -BUILDER 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) fiction 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 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 ifessions 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 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, ;mess 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 tFiz Movements 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 Moved 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 )ly to an oy(rPeAt04 property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 191n exemlAlrom licensure under the Contractors' State License Law for the following reason: - - Zgnatuj0 D61S,y I acknowledge that, except for my personal residence in which 1 must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot Iegalq a s'tructurs,that Fhave 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 �fdSgions Coda, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. mature of Prqperty J)wner or Authorized Agent Date :BNSED OQWTFYpCTOR'S DECLARATION ireby affirm u nder�penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 ) of ivisi 3 of the Business and Profe si Coslg, and my license is in full force I Effect. Liaenae Class License No Date Z ^ Contractor Signature � Hr )BARS' COMPENSATION DECLARATION NW, FAILURE TO SECff11RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINA PENALTIES AND CIVIL FINES UP TO ONE HUND ED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE iT OFCOMPENIIjrjq� 6AN1AGES AS PROVIDED FOR IN SECTION 3105 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Orel affirm under pETnalty of perjury one of the following declarations: JagJe and wJlr 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 th, (ormance of the Ark 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' compensatio ns ance carrier and policy number are: carrier Policy Number Expiration Date Jame of Agent Phone # :1I certify that, in the perfqrma.nce 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 hat, if I should become sje t the rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant Dat )ECLARATION REGA G CONSTRUCTION LENDING AGENCY hereby affirm under p a ty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 ,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 owner's behalf.rn I have read this application and the information I ave provided is correct. -1 '1-tf U i� 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 county o e r ve-identified property for inspection purposes. 3ignature of Property Owner or Authorized Agent - Print Property Owner's or Authorized Agent's Na /, D z ACTION DATE BY CLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMITEXPIRED i i FUJI MITTED PERMIT CANCELLED EpA CERTIFICATE OF ITFINAL\- 03 ® SIGNAT EDO EM�TIF IOA�N IS NOTA_ PPLICABLE TO OCCUPANCYISSUED