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Home My WebLink AboutF2020-0152 - Permits�4 Y.tN't�pP�, 00 Civic center Newport p Beach ch, A19226 Building Division Illl��u��d��lllll h ,, �,. Permit Counter Phone (94g)ggq_3288 Job Address: 20331 IRVINE AVE NB Inspector Area: FIRE Owner: Address: Phone: THE JETTY NEWPORT BEACH LLC 3501 JAMBOREE RD #4200 NEWPORT BEACH CA 92660 949-219-2329 Applicant: Address: HODGE CHRIS 6527 SPRINGS RD Phone: LAKE ISABELLA CA 93240 661-331-4935 Code Edit: 2016 FEES Type of Construction: VB Occupancy Group: B Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: .L No of Units: Jp 0 Flood Zone: X Bldg Sprinklers: /Y 14 Construction Valuation Building PC Fee: Building Overtime PC Fee: Building Extention Fee: Building Investigation Fee Fire Plan Check Fee: Fire Permit Fee: Building Permit Fee : FIRE Permit: F2020-0152 Project No : 1421-2019 Inspection Requests Phone (949)644-3255 Description: COMM TI MEDICAL GAS "ANTON AESTHETICS" (X2019-1955) Legal Description: Contractor: RX PIPING 5� L U N t (D Address: 12314 SHELDON STREET Architect: SUN VALLEY CA Address: Phone: FEES Con State Lic: 841435 Lic Expire: 06/30/2020 Bus Lic: BT30076193 Lic Exp Date: 05/31/2021 Worker's Compensation Insurance Carrier: WESCO INS CO Policy No: WWC3452716 Expire: 02102/2021 Issued Date: 05/18/2020 Setback- Front: Rear: Left: Right: $32,000.00 FEES $0.00 $0.00 Fire Residential Alarm PC Fee: $0.00 Planning Counter Review: $0.00 Planning Zoning PC Fee $228.00 $209.00 Public Works PC Fee: $0.00 Public Works Traffic Plan Check Fee; Phone: Engineer: Address: Phone: Designer: Address: Phone: Special Conditions: �M�; a, State Lic: ISL UMLr e-1 State Lic: HASSIN TARIQ 270 ELDERBERRY ST LA VERNE CA 91750 909-969-4747 (Qw-3�1-`N3�S SP�Z sU1 INSPECTOR $0.00 Records Management: $0.00 $6.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL FEE : $443.00 Plan Check Fee: $228.00 Fee Due at Permit Issuance $215.00 PROCESSED BY: ZONINGAPPROVAL: OTHER DEPARTMENT: FIRE APPROVAL: o < v ° e. ® PLAN CHECKED BY:: APPROVAL TO ISSUE: PERIj�l7,;EX.. . 11,8oCygY5;1FTEf; ISSUANCE OR LAST VALID INSPECTION (s) for aced next to fNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the rate License indicated Law (Chapter,orI 9 (comment ng with )slow by the checkmark(s) lSect Sehave ction 0) of Divisilon 3 of the lBusi Business and Y applicant for a permit subjects the applicant to a civil penalty of .ction 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 e applicant permit to file a signed statement. that he or she is licensed pursuant to the provisions of the Contractors' Stction Ifessions Code) or that he or she s exempt from licensure and the basis for the alleged exemption. Any violationportions of the work, and the 1.5 by any is not intended or offered for sale (Section7044, the more than five hundred dollars ($500). all of or U P or I, as owner of the property, or my employees with wages as their sole compensation, will do (_) siness 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 propertoving y provided ld provements are not intended or offered for sale. If, however, the building or improvement is Bothe ithin one year o'ect (SecHonf7044PIBus Business Owner-Builder d Professions will The Contractors' State License Law doen of P it was not not not proved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct project ply 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 aw). PY Of the applicable law, Section 7044 of the Business and I am exempt from licensure under the ontractors' State License Law for the following reason: I my signature below I acknowledge that, except for my personal residence in which I must have resided for at least ohe year prior to completion of the improvements covered by this permit, I cannot lega application is submitted or at the following Web site:http:ilwww.leginfo.ca.govlcalaw.html. Date ;II 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 co rofessions Code, is available upon request when this app and m license is in full force ignature of Property Owner or Authorized Agent ICENSED CONTRACTOR'S DECLARATION / hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing Date with Section 3000) Ooff/D7 DI Contractor Signatn 3 of the ss and Pro Bio ode, Y nd effect. License No `eZ IVVV� THE icense Class VORKERS' COMPENSATION DECLARATION ENSATION rARNINGCOMPEN5ATOlON CDAMAOES AS PROVIDED FOR IN SECTION 37 IS UNLAWFUL AND CODE, LL SUBJECT T, AND ATTORNEY'S TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ON NDR TH U AND DOLLARS (E700,00a), IN ADDITION TO th : FAILURE URE WORKERS'COMP LAB� THE :OST OF �....eh„affirm under penalty of perjury one of the following declarations: 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, ce of the work for which this permit is issued. Policy No. and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, carrier and policy number are: N mber for the performance of the work for which this permit is issued. My workers' F,miration Date Policy u -- — ....f compensation laws of California, and ame of Agent erh this provisions of Section 3700 m the Labor Code, I shall forthwith comply with thD� rovis' ]I certify that, in the performance oy rqe work hich this permit is issued, I shall not employ any person in any mann at, if I should bin �KFome subject tot e� orkeP ignature of App//////��iECLARATION N CONSTRU ION ENDING AGENCY Lender's Address hereby affirm under penalty of perjury t at th r€is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil code). .ender's Name ly 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 laws relating to building construction. 9 I agree to comply with all applicable city and county ordinanc nd print Property Owner's or Authorized Agent's Name 1 authorize representatives of this city or county to enter the 4 v entified property for inspection purposes. OR C Signature of Propert Owner or Authorized Agent DECLARAnONOFCIOANCEWliHCODEOF ACTION DATE $ FEDERAL REGUI•TIONS PARF.54 OF•ilTLE4f}AND < AOMD RULE 14Q3. • • • • • • • i ED ❑ �ueE� c;D As�srtOS rrsnFj PERMIT EXPIRegnflN jo.... PERA41TCANCELLED ❑ AQMD PERMITEXTENDED ❑ ASBESTOS NOITRCA77ON IS NOT APPLICABLE .O PROPOSEDDEMOL;T4QN.�•, •', PERMIT RNAL CERi1FICATEOF SIGNATURE: •�+ •�• •�• •.• OCCUPANCY755UED