HomeMy WebLinkAboutX2019-1639 - PermitsIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2019-1639
x 2 0 1 9 1 6 3 9 Project No: 1171-2019
Issued Date : 12/12/2019
Inspection Area : 7
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Construction Flours: 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: 660 NEWPORT CENTER DR NB
Description: COMM - INST & INTERCONNECTION OF BATTERY STORAGE SYSTEM ON ROOF � II-�
Legal Desc.: P.M. 295-33 PAR 6 POR OF PAR � � � {;/ p gam(
City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Owner: IRVINE COMPANY
Combination Type - CIP ELEC
IIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2019-1639
x 2 0 1 9 1 6 3 9 Project No: 1171-2019
Issued Date : 12/12/2019
Inspection Area : 7
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Construction Flours: 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: 660 NEWPORT CENTER DR NB
Description: COMM - INST & INTERCONNECTION OF BATTERY STORAGE SYSTEM ON ROOF � II-�
Legal Desc.: P.M. 295-33 PAR 6 POR OF PAR � � � {;/ p gam(
TOTAL FEE: $7,447.93
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan Check Fee : $3,538.96 Fee Due at Permit Issuance : $3,908.97
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
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Owner: IRVINE COMPANY
Contractor:
RUBICON PROFESSIONAL SERVICES
Architect:
sono°e
e
Address: 111 INNOVATION DR
Address:
3370 CHASTAIN
GARDENS DR #220
Address:
0 0 0
IRVINE CA 92617
KENNESAW CA 90144
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Phone:
Phone:
770.485.1013
Phone:
State Lic:
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Applicant: ROESSLEIN JASON
Con State Lic:
986642
Engineer:
GORBIS STANISLAV
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Address: 3500 DEER CREEK RD
Lic Expire:
09/30/2021
Address:
1101 MARINA VILLAGE PKWY
°
PALO ALTO CA 94304
Bus Lic:
BT30069327
ALAMEDA CA 94501
0 0 0
0 0 0
Phone: 815.814.6347
Lic Exp Date:
10/31/2020
Phone:
408-234-3246 State Lic:C-081928
Code Edit : 2016
Worker's Compensation Insurance
Designer:
Type of Construction:
Carrier:
AMERISURE MUTUAL
Address:
Occupancy Group: U
Policy No:
WC210206903
°
Added /New sq.ft. Bldg: 0
Expire:
07/15/2020
Phone:
Added /New sq. H. Garage: 0
No of Stories: 0
Building Setbacks
Rear: /
Special Conditions:
No of Units: 0
Front: /
Bldg Height: 0
Left: /
Bldg Sprinklers:
Right: /
Flood Zone:
Use Zone: Parking Spaces:
0
Fire Hazard Zone: N
Construction Valuation: $455.000.00
Building Permit Fee: $3,296.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $2,930.26
Additional Fee :
$0.00
Plan check Fee :
$40.00
Fire Inspection:
$0.00
Overtime Plan Ck: $0.00
Grading Bonds Fee:
$0.00
Fair Share :
$0.00
Fire Plan Rev
$228.00
Investigation Fee: $0.00
Grading PC Consultant :
$0.00
SJH Trans :
$0.00
Demolition Fee
Record Management : $28.00
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
WO Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
Disabled Access: $0.00
PAN Plan Check:
$41.25
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %:
$863.42
San Dist:
$0.00
Building Green Fee : $19.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE: $7,447.93
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan Check Fee : $3,538.96 Fee Due at Permit Issuance : $3,908.97
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
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OWNER-BUILDER DECLARATION f
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:„)
Section
tem:„)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
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 it was not built or
nproved 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).
7 I am exemptAo m liidensure under the Contractors' State License Law for the following reason:
Iy my signature ATo (.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
�U asjrbcture 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
tofessions Code �-avjlilable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
ignature of Property Owner or Authorized Agent Date
5C ED CONTRACTOR'S DECLARATION
hereby affirm uxihr pidalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 of ivisi n 3 of the Business and P ofess' ns Cpde, and n, y license is in full force
hd Q(fgCt. License CI99s License No Date Contractor Sign ure
dORKERS' CdM9ENSATION DECLARATION
(Iadldfj.TAILURE TUSECLIRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN L PENALTIES AND CIVIL FINES UP TO ONE HUNOREO THOUSAND OOL RS ($1.0D,001IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
MIS;
y ..
Bffirm underPenalty of perjury one of the following declarations:
e ..e e.
�,I,Fyava 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 th
•�r� � tice of Te Tvrl1for which this permit is issued. Policy No.
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' compensatiol
suranze carrier and policy number are:
Policy Number Expiration Date
ie of Agent
❑I certify that, to the peforman a 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' com ens tion laws of California, and agre
that, if I should become subjec o thew rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant Date (ti L� L5
DECLARATION REGARD( G CONSTRUCTION L ING CY
hereby affirm under pena y of perjury that there is constructi lending agency for the performance of the work for which this permit is issued (Section 3097, ivil Code).
Lender's Name Lender's Address
By 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 pr vide d is correct.
I agree to comply with all applicable city and county or nances and state laws relating to building construction.
I authorize representatives of this city or county to a er a above -identified prop for inspection purposes. '
Signature of Property Owner or Authorized Agent 4,1_ Print Property Owner's or Authorized Agent's Name AM i
ACTION I DATE I BY A DECLARATION OFC1DMPUAti Y41TH CODE OF FEDERAL I FOR OFFICE USE ONLY
PERMIT EXPIRED
PERMITCANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY ISSUED
61 OF TITLE(4b AND AQMD RULE
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