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Home My WebLink AboutX2021-0761 - Permits�,tfil City of Newport Beach - Building Division *X20210761 * COMB Permit: X2021-0761 ' �? `-.., 100 Civic Center Drive, Newport Beach, CA 92660 Job Address: Project No: 0697-2021 �: Permit Counter Phone (949)644-3288 COMM - TI 3289 SF "EVEREVE" $250.00 v. $r Inspection Requests Phone (949)644-3255 Building Green Fee : Owner: c r u` , ' Combination Type - CIP ELEC MECH PLUM Address: Issued Date: 05/2512021 „„ Address: 111 3RD AVE S #400 e e • NS P ryTn m Inspection Area : 7 Applicant: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUS C MPLETED BY 0512512024 OR PERMIT WILL BE INVALID 111 3RD AVE S #400 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: 241 NEWPORT CENTER DR NB Code Edit: Description: COMM - TI 3289 SF "EVEREVE" $250.00 Legal Desc.: P BK 221 PG 30 PAR 6 Building Green Fee : Owner: IRVINE CO Contractor: RETAIL CONTRACTING GROUP INC Architect: BLEES PATRICK Address: 110 INNOVATION DR Address: 3880 LAVERNE AVE N STE 215 „„ Address: 111 3RD AVE S #400 e e • IRVINE A 92617 LAKE ELMO, MN 55042 MINNEAPOLIS MN 55401 •� °' e o Phone: Phone: 612-294.6105 Phone: 612-547-1384 State Lic:C31531 m • : ° ® e"' ° o •• o Applicant: PREISLERAMANDA Address: 111 3RD AVE S #400 Record Management : MINNEAPOLIS MN 55401 Phone: 612.547-1384 Code Edit: 2019 Type of Construction: III -B -SPR Occupancy Group: M Added /New sq.ft. Bldg: 3289 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Y Flood Zone: X Construction Valuation: $250 Building Permit Fee: $2,137.00 Plan Check Fee: $1,859.19 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management : $70.00 Energy Compliance: $175.00 CA Seismic Safety: $0.00 Disabled Access : $250.00 Hazardous Mat $0.00 Building Green Fee : $10.00 TOTAL FEE: $6,668.90 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Con State Lic: 1003116 Engineer: , ,' , • ° Lic Expire: 04/20/2023 Address: me , ° • ° Bus Lic: BT30075292 e e • m e Lic Exp Date: 05/3112022 Phone: State Lic: a e . o emm m • e. o Worker's Compensation Insurance Designer: o®om o aomm,o Carrier: EMPLOYERS MUTUAL CASULATY CO Address: e o o me o 000mao Policy No: 5H71349 0o m ° ° • c m r ° Expire: 07/1512021 Phone: m em 0 ° ° ° m • o oo•moo 0 omoo Building Setbacks Rear: / Special Conditions: ° Front: / Left: I Right: I Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Excise Tax: $0.00 Planning Department - Fire Department Additional Fee : $0.00 Plan check Fee: $0.00 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 $26.00 Grading PC Fee: $0.00 Public Works Department - General Service $219.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $564.00 PAN Plan Check : $0.00 Grading Bond: $0.00 Electrical %: $559.47 San Dist: $0.00 Mechanical %: $439.58 NMUSD Fee: $0.00 $0.00 Plumbing %: $359.66 $0.00 Plan Check Fee: $2,916.32 Fee Due at Permit Issuance : $3,752.58 PUBLIC WORKS APPROVAL: PLAN CHECK BY: L �� APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law forthe 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', tate 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 vi\at',,rnf Section 7031.5 by anyapplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensatio will do L) all of or (ns of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to a owner of propertyough employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvementis sold within oncompletion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I am exempt from licensure under the Contractors' State License Law for the following reason: By my signatures CAIEIT j acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall} sell a structure that "Eve built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and �rofasswns Co0a,is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. SignatuFe of PrQpehyJCWner or Authorized Agent Date MEM$ED CONTRACTOR'S DECLARATION Mhemlyy affirm ur der g@eynalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0) of pivision 3 of the Business and Pf Sion ode, ani license is in full force and effect. License.Clo,ss License No Date 5'475— Contractor SignaturV/12 WORKERS' lQ41�11PiNSATION DECLARATION wARNMV: FAILURL TOSECBRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDE THOUSAND DOLLARS ($100,000), IN ADDITION TO THE C,W4)F COMPENSATICIVDAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I.% j>y.affirm undtr penalty of perjury one of the following declarations: T have and will mai•ntain 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 pPf pvQance of AMA for which this permit is issued. Policy No. N"Ve and wlltmaih(ain 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 rance cauAr and policy number are: Policy Number Date me of Agent I1V1O 1 I certify that, in the performance.0 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 It, if I should becomeu -lett t e workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. (nature of Applicant Dat 51257 !CLARATION REGAE(DIRr, 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,i it Code). rider'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. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and cou y ordi nces and state laws relating to building construction. I authorize representatives of this city or count e r the above -identified property for inspection purposes. T� JJ mature of Prooertv Owner or Authorized ADent Print Property Owners or Authorized Agent's Name ,VUG Coo r�en W, Dat S �o73(�TI ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATJ@%SAART 61 OF TITLE 40 AND AOM D RULE PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PER CANCELLED EPA PERMITFINAL $ _11- ZOT 1 ¢�— ASBEST TIFICA)%ON IS NOTAPPLIC�ABLE TO CERTIOCCUPANCYISF P POSED OLITIQiX �(� OCCUFICAT E S5UED SIG A7 ED J�/%/