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Home My WebLink AboutX2022-0096 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 cz Inspection Requests Phone (949)644-3255 Combination Type - CIP PLUM COMB Permit: X2022-0096 iiiiiiiiiigll Project No : 0113-2022 Issued Date : 02/28/2022 Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 02/28/2025 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: 2121 E COAST HWY NB St: 1 FI: 2 Unit: 230 Description: COMM Tl "DR JACQUELINE YOUNESI DENTAL OFFICE" 1820 SF Legal Desc.: P BK 152 PG 28 PAR 2 Owner: COAST BUSINESS CENTER LTD Contractor: BRYCE SANTANIELLO Architect: FORTUNES JAMES Address: 1105 QUAIL ST Address: 3419 VIA LIDO UNIT 115 Address: 2240 SARAH COURT NEWPORT BEACH, CA 92660 NEWPORT BEACH CA 92663 SIGNAL HILL, CA 90755 Phone: Phone: 714-600-3719 Phone: State Lic:C016792 Applicant: GRAHAM MICHELE Con State Lic: 1070607 Engineer: Address: 2961 W MACARTHUR BLVD STE 120 Lic Expire: 11130/2022 Address: SANATA ANA, CA 92704 Bus Lic: NEW LICENSE Phone: 714-556.2656 Lic Exp Date: 02/2812023 Phone: State Lic: Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: II-BSPR Carrier: EXEMPT Address: Occupancy Group: B Policy No: NO EMPLOYEES Added /New sq.ft. Bldg: 0 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: / Special Conditions: - No of Units : 0 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: Y Flood Zone: X Right: / Use Zone: Parking Spaces: 0 Fire Hazard Zone : 9 - R'� q"^ -t- N S, Construction Valuation: $50 000.00 Building Permit Fee: $810.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $704.70 Additional Fee : $0.00 Plan check Fee : $52.00 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.061, Fire Plan Rev $0.00 Investigation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $32.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $61.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $91.00 P/W Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $2.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $136.32 $0.00 II TOTAL FEE : $1,889.02 Plan Check Fee PROCESSED BY: ZONING APPROVAL: _ GRADING APPROVAL: $820.12 Fee Due at Permit Issuance : $1,068.90 PUBLIC, 3,NOR5S°APPR(3&lJt*a . .� a PLAN CHECK BY: J ° V °" V 01 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) 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 the applicant for 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 fessions 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 more than five hundred dollars ($500). I J I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portion: usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throe nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of c nproved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7i pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contn I am exempt from licensure under the Contractors' State License Law for the following reason: y my signature below I acknowledge that, except for my personal residence in which I must have resided for at least r ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. Tofessions Code, is available upon request when this application is submitted or at the following Web site:http:/lwww.l ;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 with Sectio 70( nd effect. License Class License No D tie COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 7 I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Dire erformance of the work for which this permit is issued. Policy No. ]I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for Isurance carrier and policy number are: rner Policy Number ear of Agent in the performance of the work for whit hjsr permit is issued, I shall not employ any person in any become subject to the workers' com nszit �,n provv of Section 3700 of the Labor Code, I shall of Applicant Ireby affirm under pefi3lfjf�f rjtit latfhere is a construction lending agency for the performance of the work for Ider's Name Lenders Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners 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 to laws relating to building construction. I authorize representatives of this city or county to enter t ov dentified prr� y for inspection purposes. of Prooertv Owner or At the work, and the structure is not intended or offered for sale (Section 7044, employees' or personal effort, builds or improves the property, provided that the pletion, the Owner -Builder will have the burden of proving that it was not built or Business and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). year prior to completion of the improvements covered Dy Iris permit, I cannot nderstand that a copy of the applicable law, Section 7044 of the Business and Date Y3 of the Business and Profess iyu de, a d m ice Is in full force Contractor Signature CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE of Industrial Relations as provided for by Section 3700 of the Labor Code, for performance of the work for which this permit is issued. My workers' Date so as to become subject to the workers' compensation laws of California, and agre, h comply with those provisions. Dated 2L h this permit is issued (Section 3097, Qvi Authorized Aaent's Name ACTION DATE BY IRATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY CATIONS PART 61 OF TITLE 40 AND AQMD RULE "03 .•, •.• PERMIT EXPIRED : I SU11MITT5D ASBEST05 NOTIFICATION TO PERMITCANCELLED EPA PERMIT EXTENDED QMD PERMIT FINAL ASBESTOS NOTIFIC O OT AP ABLE TO CERTIFICATE OF Z • 4ROPOSEDDEM I OCCUPANCYISSUED SIGNATURE: •� ° co o 000 00 c uwEonl2.{{0