HomeMy WebLinkAboutX2018-3162 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - CIP
tbl�@ Permit: X2018-3162
X 2 9 1 8 3 1 6 2 °° °
�roject•No
Issued Date: 1011812018
° Ir•:91ecNow Area : 7
Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00
Job Address: 2800 PACIFIC VIEW DR NB
Description: MFR-T/O COMP SHINGLES, INSTALL COMP SHINGLES 96 SQ (ASSISTED LIVING FACILITY)
Legal Desc.: P BK 149 PG 25 PAR 1
Owner:
SEAVIEW LUTHERAN PLAZA
Address:
2800 PACIFIC VIEW DR
CORONA DEL MAR, CA 92625
Phone:
Applicant:
TECTA AMERICA SO CAL INC
Address:
1217 E WAKEHAM AVENUE
SANTA ANA CA 92705
Phone:
714-973-6233
Code Edit: 2016
Type of Construction:
Occupancy Group: R2
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stones' 0
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Building Permit Fee: $548.00
Plan Check Fee: $0.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$0.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$2.00
TOTAL FEE: $550.00
PROCESSED BY:
ZONING APPROVAL:
Contractor:
TECTA AMERICA SO CAL INC
Address:
- 1217 E WAKEHAM AVENUE
SANTA ANA CA 92705
Phone:
714-973-6233
Con State Lie:
811111
Lie Expire:
0813112020
Bus Lie:
BT30045213
Lie Exp Date:
1013112019
Worker's Compensation Insurance
Carrier: STARR INDEMNITY
Policy No: 1000001352
Expire: 0313112019
Building Setbacks
Use Zone:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical W
Plumbing %:
Rear: /
Front: /
Left: /
Right: I
3arkino Spaces
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee:
2Tlgmi -•- ea° -
p.m. No work on Sundays or Holidays
Architect:
Address:
Phone: State Lie
Engineer:
Address:
Phone: State Lie
Designer:
Address:
Phone:
Special Conditions: If,
=� 11" 2
,0
Planning Department -
Plan check Fee
Fair Share
SJH Trans
In -lieu Housing Fee:
Public Works Department -
Park Dedication :
$0.00
P/W Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Fire Department
$0.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $550.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATI
S)PC
•
ekem ;from Ehe.Cor;ractors' State License Law for the reasons indicated below b the checkmark s I have laced next to the applicable item s I hereby affirm under penalty of perjurq jlpt j gljl p • () y. () p pp ( )
Section 7031.5, Business and Professions Code: Any city or county thalWquires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
ie 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
'rofessions Code) or that he or she is exempt ¢om licerysure end 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 ($500j, • • • • • . . . ..
7 1, as owner of the property, or my eOip:)yeds with slales A their ;oleo compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
�usiness and Professions Code: The CoPitradtors' State•Licensa Law togs pc: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).
7 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 1 am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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,
ell a structure that 1 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000j p Division 3 of the Business and Profession , and my license is in full force
nd effect. License Class License No Date (" Contractor Signatur Z Z /i
VORKERS' COMPENSATION DECLARATION V
DARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
J 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 th
eLformance 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, for the performance of the work for which this permit is issued. My workers'
carrier and policy number are:
Policy Number
of Agent
Date
]I certify that, in the performance 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
Iat, if I should become subject to the work 5rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
'signature of Applicant Y ::4 D-)/ i -/ I
IECLARATION REGAFZbftG CONSTRUCTION MNDING AGENCY ux
hereby 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, Civil Code).
ender's Name Lender's Address
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.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of this city or county fro enter t ove-identified property for inspection purposes. \(y
lionature of Propertv Owner or Authorized Agent �—. Print Property Owner's or Authorized Agent's Narr)@ Date"
ACTION
DATE
By.
CLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
EGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED
UEPA
PERMITEXTENDED
QMD
PERMITFINAL
p
ASBESTOS NOTIFICATION 15 NOTAPPLICABLE TO
CERTIFICATE OF
r2'f�
)w
PROPOSED DEMOLI /
OCCUPANCY ISSUED
9
SIGNATURFa ��J