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Home My WebLink AboutX2021-1891 - Permits"'I'o4 City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII� COMB Permit: X2021-1891 3 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 1 8 9 1 Project No : 1628-2021 a. Permit Counter Phone (949)644-3288 :;,. �. Inspection Requests Phone (949)644-3255 r trdsu �i' ; Combination Type - CIP ELEC MECH PLUM Issued Date : 03/0812022 Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0310812025 OR PERMIT WILL BE INVALID 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: 1401 AVOCADO AVE NB St: 1 FI: 4 Unit: 403 Description: COMM TI- NON-OSHPD 3 AMBULATORY CARE FACILITY WITH MAX 5 PATIENTS INCAPABLE OF UNASSISTED SELF PRESERVATION Legal Desc.: P BK 193 PG 17 PAR 2 Owner: NCMB NO 2 LLC Contractor: RENAULT & MORAN CONSTRUC. Address: 1401 AVOCADO AVE #901 Address: 19900 MACARTHER BLVD #600 NEWPORT BEACH, CA 92660 IRVINE CA 92612 Phone: 949/706-2229 Phone: 949-412-6500 Applicant: MOAYERI SHARON Con State Lic: 1038156 Address: 1401 AVOCADO AVE, STE 403 Lic Expire: 04/30/2022 NEWPORT BEACH CA 92660 Bus Lic: BT30065288 Phone: 949/706-2229 Lic Exp Date: 1213112022 Code Edit : 2019 Worker's Compensation Insurance Type of Construction: I-A-SPR Carrier: EVEREST Occupancy Group: B Policy No: 7600021597211 Added /New sq.ft. Bldg: 1382 Expire: 0611212022 Added /New sq. ft. Garage:. 0 No of Stories: 8 Building Setbacks Rear: I No of Units : 0 Front: I Bldg Height: 0 Left: I Bldg Sprinklers: Y Right: / Flood Zone: X Use Zone: Parking Spaces: 0 Construction Valuation: $124.500.00 Building Permit Fee: $1,414.00 Plan Check Fee: $1,298.18 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $86.00 Energy Compliance: $87.15 CA Seismic Safety: $0.00 Disabled Access : $124.50 Hazardous Mat $0.00 Building Green Fee : $5.00 TOTAL FEE: $4,794.86 PROCESSED BY: ZONING APPROVAL: Architect: SAUNDERS NIALL F Address: 2700 W COAST HWY #200 NEWPORT BEACH CA 92663 Phone: 949-721-0730 State Lic:CO26955 Engineer: NOUR DR SAUM Address: 3839 BIRCH ST NEWPORT BEACH CA 92660 Phone: 949-852-8700 State Lic:C-015597 Designer: Address: Phone: Special Conditions:' 5 Excise Tax: $0.00 Planning Department - Additional Fee : $357.00 Plan check Fee Grading Bonds Fee: $0.00 Fair Share Grading PC Consultant : $0.00 SJH Trans Grading Permit Fee: $0.00 In -lieu Housing Fee Grading PC Fee: $0.00 Public Works Department - WQ Insp. Fee: $0.00 Park Dedication : $0.00 PAN Plan Check : $0.00 Electrical %: $370.19 San Dist: $0.00 Mechanical %: $290.86 NMUSD Fee: $0.00 Plumbing %: $237.98 plu l Fire Department $52.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev $472.00 $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 Plan Check Fee : $2,741.10 Fee Due at Permit Issuance : $2,053.76 a ` ' AJEEL A WORKS APPROVAL: o a o a o o•� aoo - PLAN CHECK BY: GRADING APPROVAL: • APPROVAL TG v9SUE: 0 0 • e e n4 0 0 o no o • 0 0 0 ee ow o s ao eoo �-e OWNER -BUILDER DECLARATION 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) (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' State 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 violation of Section 7031.5 by any applicant 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 compensation, will do L) all of or (_) portions 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 an owner of property who, through 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 improvement is sold within one year of completion, 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). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By 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 legaill sell 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 copy of the applicable law, Section 7044 of the Business and Professions 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 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with 0 Section 0 o-f Division 3 of the Business and Profgss"i Code, and my license is in full force and effect. License Class License No Date Z Contractor Signature ` WORKERS' COMPENSATION DECLARATION WARNING: 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 ($100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. 11 e'reby affirm under penalty of perjury one of the following declarations: 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, pe rmance 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, 1 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 thCn1lrkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applicant ice• - Da IECLARATION REGARDIN C N TRUCTION LENDING AGENCY 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 to ter the above -identified property for inspection purposes. 9/j,(I,>`Qu�N 3yj ZZ ;ignature of Prooertv Owner or Authorized AgentY k, ��, riot Property Owners or Authorized Agent's Name Date ACTION DATE BY " ) DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED LJ I SUBMITTED ASBESTOS NQTIFIC§TIQN LO.' PERMITCANCELLED LIEPA • • e ; • ' • •• PERMITEXTENDED A.JAQMD • x PERMITFINAL 0,��_70 �� BESTOS NOTIFICATION IS NOTAPPLICABLE TO CERTIFICATE OF / G� PRO OSEDDEMO ION,.. Jq� .•„ OCCUPANCY ISSUED SIGNATU �/. •. • • e ec • e e • e e eee oe oe • � eee c•