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Home My WebLink AboutX2021-1313 - Permitsw, cfT City of w 100 Civic Col Permit Inspection Combing :wport Beach -Building Division *X2021-1313` COMB Permit: X2021-1313 er Drive, Newport Beach, CA 92660 Project NO : 1170-2021 r Phone (949)644-3288 luests Phone (949)644-3255 e 1� Issued Date : 0210812022 Type - CIP Via.?. --•` Inspection ection Area : 7 :S 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECPON. PROJECTS MUST BE COMPLETED BY 02/08/2025 OR PERMIT WILL BE INVALID ion 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: 4060 CAMPUS DR B Description: COMM - REPL (2) TAIRS & RAILINGS •' Legal Desc.: N TR 3201 LOT 18 Contractor: PARK CONST & MNGMT INC Architect: RIGGS JEFFREY , "• • , Owner: IRVINE FOUR LLC Address: 1709 EAST 22ND STREET Address: 25 PECOS Address: 11766 WILSHIRE B VD #820 LOS ANGELES, CA 90058 RSM CA 92688 LOS ANGELES CA 0025 323-244-1378 Phone: 949.233-1553 State Lic:CO21317 Phone: Phone: Engineer: SOMA JR PHILIP GEORGE , , Applicant: RIGGS JEFFREY Con State Lic: 1049602 01/31/2023 Address: 252 SOUTH BRENTWOOD �'a ,,,,, Address: 25 PECOS Lic Expire: Bus Lie: BT30070270 ANAHEIM CA 92804 State Lic:C-046231 • • , RSM CA 92688 Lic Exp Date: 12/31/2022 Phone: 949-252-7660 , Phone: 949-233.1553 2019 Worker's Compensation Insurance Designer: Code Edit : V-B Carrier: STATE COMP Address: ° - Type of Construction: Policy No: 9244664 Occupancy Group: B Expire: 01/24/2023 Phone: Added /New sq.ft. Bldg: Added /New sq. ft. Garage: Building Setbacks Rear: I Special Conditions: p No of Stories: 2 Front: / No of Units : 0 Left: / Bldg Height: 0 Right: / Bldg Sprinklers: Use Zone: Parkin Spaces:. 0 Fire Hazard Zone : N Flood Zone: X 8 750.00 Fire Department tion Valuation: Permit Fee: $558. 0 Excise Tax: $0.00 Planning Department Plan Fee : - $52.00 Fire Inspection: $0.00 ck Fee: $485.46 Additional Fee : $0.00 $0.00 check Fair Share : $0.00 Fire Plan Rev$0.00 FCheck Plan Ck: $0. 0 Grading Bonds Fee: $0.00 SJH Trans : $0.00 Demolition Fee tion Fee: $0. 0 Grading PC Consultant : $0.00 In -lieu Housing Fee : $0.00 BuildGeneral ng Depttiedm anagement: $24. 0 Grading Permit Fee: $0.00 Public Works Department - $000 ompliance: $0. 0 Grading PC Fee: $0.00 cation $0.00 Refund Deposit $0.00 mic Safety : $0. 0 WO Insp. Fee: FAN Pladn'Check: $0 00 Grading Bond: $0.00 Disabled Access : $91. $0. 0 0 Electrical %: $0.00 San Dist: $0.00 $0.00 Hazardous Mat $2. 0 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Building Green Fee : Plumbing %: $0.00 Plan Check Fee : $522.14 Fee Due at Permit Issuance : $690.32 TOTAL FEE : $1,212.46 PUBLIC WORKS APPROVAL: PROCESSED BY: PLAN CHECK BY: ZONING APPROVAL: APPROVAL TO ISSUE: GRADING APPROVAL: OWNER -BUILDER 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 U 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 pmperty 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: iiy my signature 'below , 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 thai 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 Pmlesshns 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 herLLy affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 ) of Division 3 of the Business and Profe s n Code a my lic nse is in full force r.rd cff=_ct. Licon�a CUSS License No Date O� 1nContractor Signature �13F.KERS' COMPENSATION DECLARATION �.ARA.A3. FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TH USAND DOLLARS ($100,000), IN ADDITION TO THE OS r OF :OMPENFAnON, ]DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. ,herebv affirm under penalty of perjury one of the following declarations: ::i. ve and Mill I.iai,ltain 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 lerformance of the work for which this permit is issued. Policy No. f 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 me of Agent Date I certify that, in the performance of the 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 d, if I should become�,ecw kers' co pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Inature of Applica Date .tCLARATION RE..00 I ION LENDING AGENCY areby 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 ode). tder'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 county ordinariges and st laws relating to building construction. yj pA �..� I authorize representatives of this city or county t0 ante a ove-i entifie roperty for inspection purposes. � nature of Property Owner or Authorized Agent '�� Print Property Owner's or Authorized AnanPc r. nm= ACTION I DATE PERMIT EXPIRED PERMIT aNCELLED PERMIT EXTENDED PERMITFINAL -I) CERTIFICATE OF OCCUPANCYISSUED DECLARATION OF COMPLIANCE WITH CODE OF FEDEI REGULATIONS PART 61 of TITLE 40 AND AQMD RULE NOTI NOTIFICATION TO TO FOR OFFICE USE ONLY