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Home My WebLink AboutX2020-0106 - Permits (2)City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIII II 4 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 8 2 1 3 5 N, ?* Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 �'rdJ�,nua Combination Type- CIP ELEC MECH PLUM GRAD PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR L iU INSPL'C11UN. Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Satur `ili' 8:00 a.m. to 6:00 p.m. No COMB Permit: X2018-2135 Project No : 1679-2018 Issued Date : 0211112019 Inspection Area : 7 Job Address: 393 HOSPITAL RD NB Description: COMM -ASSISTED LIVING FACILITYIPRECISE GRADING 765911SSF,�ITRIA EWPORT EAar,�'p\`cab,e % Cg�Un� Legal Desc.: IRVINE SUB LOT 169 BLK 2 POR OF LOT 1 i' Q AOp Owner: ATRIA SENIOR LIVING Contractor: R 9_QLS0lq CONSTRUGTIObC% {Architect: PANCAKE D G Address: 300 E MARKET ST #100 ' m Address: 955 MAIN ST RD FL 11JJ Address: 1 GARTH LOUISVILLE (/'� (/ _ IRVIyT'r32 rY� IRVINE CA 92612 Phone: 714-267 - l Phone: 949-474-2001 t0 �4'eO"Phone: Applicant: SMITH J HU/DOL`P' ° 5 r*' Cod State Lic. 953845 Engineer: YOUNG ROGER P Address: 19000 MA ARTHUR BLVD #500 Lic Expire: 10/31/2020 Address: 18400 VON KARM IRVINE C 2612i�+- Phone: 949-720-38 Bus Lic: Lic Exp Date: BT30009757 0521120 19 IRVINE CA 92612 Phone: 949-252-1022 Code Edit : - 016 Type of Construction: -A- Occupancy Group: .1, A Added /New sq.ft. Bldg: 765 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Y Flood Zone: X Construction Valuation: $10, Building Permit Fee: $22,735.00' Plan Check Fee:$19,836.45 Overtime Plan Ck: $0.00 Investigation Fee: $0,00 Record Management: $748:00 Energy Compliance: $484.00 CA Seismic Safety: $2,984.14 Disabled Access : $830.00 Hazardous Mat $0.00 Building Green Fee : $427.00 PROCESSED BY: ° Worker's Compensation Insurance,%j Designer: Carrier STARR IN$° Address: Policy No: ,- 1000012j;9 � 100 AiiExpire 07/01/2019 : i Building Setbacks Rear: 1 ® Specialslk�-,�l - PA2017-2121 Fr t: / w00" bll ON X2018-21 EttS $16,084.11 nal Fee : 009 Grading io Grading Bonds Fee_$0.0.00 Noke'. 6r d g Permit Fee: Grading PC F W ee : $0.00 ectrical %: $5,952.02 Mechanical %: $4,676.69 Plumbing %: $3,826.30 Sundays o ff;Iy%s ASty Ft BI,-)/D STE 500 t' ,r State Lic27254 i 111SP ' anning Departmen - Fire Department Plan the 50.00 Fire Inspection: $569.00 are - $0.00 Fire Plan Rev $1,028.00 s : $0.00 Demolition Fee In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Public Works Department- General Service $0.00 Park Dedication : $0.00 Refund Deposit $0.00 PAN Plan Check : $1,216.00 Grading Bond: $0.00 San Dist: $51,930.98 NMUSD Fee: $7,540.80 $0.00 $0.00 TOTAL FEE : $142,910.39 r \ Plan Check Fee: $27,562.46 Fee Due at Permit Issuance : $115,347.93 C PUBLIC WORKS APPROVAL: F— I ZONING APPROVAL: \� GRADING APPROVAL: J PLAN CHECK BY: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason (a) 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 L) 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 legalll 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.htmi. 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 Section 700 of vision 3 of the Business and Profes ' s d and am icense is in full force. and effect. License Class License No Dat �� Il� l Contractor Signatu A LJ WORKERS' C(7,VFIENSATION DECLARATION �` M1RNING: FAILURE TU S.GURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS IS100,0001, IN ADDITION TO THE C'JGT CF 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: 711 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 thI rc�-gylrformance of tho work for which this permit is issued. Policy No. L11 ha"e 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' compensatior �Furance carrierand policy number are: Policy Number of Agent Date JI certify that, :r. ;ho 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 iu;, :f I should become subject to the worke ' comp" ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. lignature of App!irant / /�T� Date Z--- J11 1 12 IECLARATION REGA ING CONSTRUCTION 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 ord" antes and state laws relating to building construction. I authorize representatives of this city or county °onto he �e-Id^entifi property for inspection purposes. lionature of Property Owner or Authorized Agerly Print Property Owner's or Authorized Agent's Name LQk�' ACTION DATE I$ DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND ACIMD RULE 1403 PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED (-ly 14IJ I EPA PERMIT EXTENDED 0AQMD PERMIT FINAL OASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFIC4TE OF PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: 1 1 Date l