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HomeMy WebLinkAboutX2015-1805 - PermitsCity of Wewpdrt Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2015-1805 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 5 1 8 0 5 Project No : 1346-2015 s� Permit Counter Phone (949)644-3288 rq Inspection Requests Phone (949)644-3255 Combination Type - CIP ELEC MECH PLUM Issued Date : 2015 Inspection Arearea : 7 Job Address: 1600 W BALBOA BLVD NB Description: COMM TI "LIGHTHOUSE CAFE" 2,707 SF Legal Desc.: Owner: CITY OF NEWPORT BEACH Address: 100 CIVIC CENTER DR NEWPORT BEACH CA 92660 Phone Applicant: WEYHRICH MIKE Address: 1120 BRISTOL ST #120 COSTA MESA CA 92626 Phone: 714.850-7575 Code Edit : 2013 Type of Construction: III -B -SPR Occupancy Group: A2 Added /New sq.ft. Bldg: 2707 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Y PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Contractor: BERGMAN KPRS LLC Architect: Address: 2850 SATURN ST Address: BREA CA 92821 Construction Valuation: $150.000.00 Phone: 714-672.0800 Phone: Con State Lic: 982577 Engineer: Lic Expire: 04/30/2017 Address: Bus Lic: BT30046611 Lic Exp Date: 03/31/2016 Phone: Worker's Compensation Insurance Designer: Carrier: OLD REPUBLIC Address: Policy No: AICW06341401 Fire Department Expire: 10/01/2015 Phone: Building Setbacks Rear: / Front: / Left: I Right: / 1VSP[C4Wi_' FINKEL RICHARD 1120 BRISTOL ST #120 COSTA MESA CA 92626 x 714.850-7575 State Lic:C019014 Special Conditions: State Lic: 0000 0 000000 r.c o Flood Zone: 0.2 Use Zone: Parking Spaces: 0 Fire Hazard Lone : N Construction Valuation: $150.000.00 W ° ° o 00 Building Permit Fee: $1,361.00 Excise Tax: $0.00 Planning Department- Fire Department Plan Check.Fee: $979.92 Additional Fee : $0.00 Plan check Fee : $96.00 Fire Inspection: $0.00° Overtime Plan Ck: $0.00 Fair Share : $0.00 Fire Plan Rev $675.00 • • ° ° ° Investigation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee o ° Record Management: $78.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm 40000, $0,.00• Energy Compliance: $90.00 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 Disabled Access: $150.00 PNV Plan Check: $151.00 Hazardous Mat $0.00 Electrical%: $327.73 San Dist: $0.00 Building Green Fee : $6.00 Mechanical %: $280.91 NMUSD Fee: $0.00 $0.00' ° Plumbing %: $234.09 $0.00 TOTAL FEE : $4,429.65 Plan Check Fee : $2,097.69 Fee Due at Permit Issuance : $2,331.96 PROCESSED BY: L41n / PUBLIC WORKS APPROVAL: Lyle, ZONING APPROVAL: l// V PLAN CHECK BY: GRADING APPROVAL: _ APPROVAL TO ISSUE: l 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 applicab a iterrlk 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 appliE,., 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, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, iiness 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 rovements 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 roved 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 ly 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). U I 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 tl 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 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 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 Division 3 of the Business and effect. License Class License No /Contractor S WORKERS' COMPENSATION DECLARATION vents covered Dy mis permit, I cannot law, Section 7044 of the Business and is in full force 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 D;700 A S 100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: 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 of the Labor Code, for th r ance of the work for which this permit is issued. Policy No. ave and will,rpyintain 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' compensatiol an ce carribg aqd policy number are: C2F@: ._ Policy Number Expiration Date Wamg of Agente.: _ • Phone # hdertify that, iO the pea7b n e of th ork for which this permit is issued, I shall not employ any person in any manner so as to become subject to the wor rs' co p sation laws of California, and agre, hat,.if I shouldbecogle the kers' mpen ti n pr ns o ion 3700 of the Labor Code, I shall forthwith comply with those provisions. Sig'rfature ofd! � Ii caRt to ( • e 15peo ATl7 $EGARD G ONS UCTI(TN LEN AGENCY "Epreby affirm Qndw penalty of perjury that there is a con Lotion lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). V L®rider's Name- Lender's Address • y ly signature bellow, I certify to each of the following/ e e, • • e ,Jam the proepgdy owner or authorized to act on thcidoperty owner's behalf. 1 have and tlys application and the information I have pr vided correct. I agree,to4grPly with all applicable city and county or ance and state I s relating to building construction. - I authorize representatives of t is ity or county to r h ve-iy�Otif' perty for' spedion purposes. Signature of Property Owner or A rized Agent C// Print Property Owner's or Authorized Agent's Ai"TKNl DA 7F AV DECLARATfONOFCOMPLLANCEW/THCODEOF FUR UFFI f/St. Uwy FEDERAL REGULATIONS PART 6f OF THLE40ANO AOMD RULE 7401 PFAWf T FXPIRF0 SIIIILNTTFD ASFYSTO.4; W) Rri('ATk7N TO.- © EPA AMD PCiR&PTCAPICCLLM PERAMT EXTENDED ee ASEE57DS '. G4 IS NOT APPLICAF:LETO POS D fQAt / PEWIT FINAL // / LERTrFrCATFCF '6 ! OCCUPANCYMSUEO 5lL:NAI