HomeMy WebLinkAboutX2019-0067 - Permits'P City of Newport Beach- Building Division *X20190067* COMB Permit: X2019-0067
q ` 100 Civic Center Drive, Newport Beach, CA 92660 Project No : Q_49-20-19-
"4' y Permit Counter Phone (949)644-3288 -
s Inspection Requests Phone (949)644-3255
Combination Type - CIP ELEC MECH PLUM Issued Date: 02/2712019
Inspection Area : 7
- PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. -
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 Sunda y�br�lifiHB
Job Address: 1063 NEWPORT CENTER DR NB "
Description: COMM -TI JAND INC. "1628 SF "
Legal Desc.: t{
Owner: IRVINE COMPANY Contractor: HORIZON RETAIL CONSTRUCTION Architect: TRICARICO NICHOLAS - -
Address: 401 NEWPORT CENTER DR A150 Address: 1500 HORIZON DR Address:500 VALLEY RD
NEWPORT BEACH CA 92660. STURTEVANT, WI 53177 WAYNE NJ 07470
Phone: 949-720-4560 Phone: 252-331-3974 Phone: 9731692-0222 State Lic:C015102
Applicant: DAVES SCOTT Con State Lie: 676686 Engineer.
Address: 140 S LAKE AVE, STE 323: Lie Expire: 0913012019. Address: ....
PASADENA CA 91101 Bus Lie: BT30025756°
Dace
Phone: 626-665-2931 Lie Exp Date: 1013112019 Phone: State Lie: e m e •: e. dm
• . ° e
'Code Edit : 2016
Type of Construction:. III -B -SPR
Occupancy Group: BIM
Added /New sq.ft. Bldg: 1628
Added /New sq. ft. Garage:. 0
No of Stories: 1
No of Units: 0
Bldg Height: 0
Bldg Sprinklers:
Flood Zone:
• e o
Construction Valuation:. $320.000.00
Excise Tax:
Building Permit Fee:. $2,488.00 ,
Additional Fee :
Plan Check Fee: $2,164.66
Grading Bonds Fee:
Overtime Plan Ck: .$0.00
Grading PC Consultant:
Investigation Fee: - $0,00
Grading Permit Fee:
Record Management: $96.00
Grading PC Fee:
Energy Compliance:. $224.00
WQ Insp. Fee:
CA Seismic Safety: $0.00
DisabledAccess: $320.00
.Hazardous Mat $0.00
Building Green Fee.: $13.00
TOTAL FEE $7,712.43
PROCESSED BY: -
ZONING APPROVAL:
GRADING APPROVAL:
Worker's Compensation Insurance
Carrier: ZURICH AMERICAN
Policy No: 5919209
Expire: 03/29/2019
Building Setbacks
Rear: I
$0.00
Front`. I
$0.00
Left:
$0.00
Right: 1.
Use Zone:
Parking Spac
• e o
• e
Excise Tax:
$0.00
Additional Fee :
$0.00
Grading Bonds Fee:
$0.00
Grading PC Consultant:
$0.00
Grading Permit Fee:
$0.00
Grading PC Fee:
$0.00
WQ Insp. Fee:
$0.00
Electrical %:
Mechanical %:
Rlumbing %:
$651.36
$511.78
$418.73
Plan Check Fee
Designer:
Address:
Phone:
Special Conditions:
Planning Department-
Plan check Fee : $40.00
Fair Share: $0.00
SJH Trans : $0.00
In -lieu Housing Fee: $0.00
Public Works Department-
Park Dedication'.
$0.00
PMI Plan Check:
$0.00
San Dist:
$0.00
NMUSDFee:
$0.00
$3,164.51
PUBLIC WORKS
PLAN CHECK BY:
APPROVAL TO ISSUE:
Fire Department
Fire Inspection:
Fire Plan Rev
Demolition Fee
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
. as
° c
e
• O
o• a
• e o
• e
a ce
o c
)GO
O
•l.OD
am
m
ea000
•
mauoo
• ^
Dame
$0.00
$0.00
$24.00
$197.00
$564.00
$0.00
$0.00
$0.00
Issuance: $4,547.92
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
im roved for the purpose of sale).
1, 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 lega11,
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://w .leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm ander penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 00 Division 3 9 the Business and Prof;CC a, a G d _force
and effect. Liconse Class License No Date Contractor Signature .�
WORKERS' COMPENSATION DECLARATION J
WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($1100,0001, IN ADDITION TO
,GES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
ffirm anddr penalty of perjury one of the following declarations
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
ice of thoeWorR for which this permit is issued. Policy No.
...
and '111 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' compensar
carrier and policy number are:
Policy Number
Date
cer{iiy that, intoe 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
d f^should d'gppCV%ubjeo the workers' e nen tion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Q
iature of ApplicantDate w,^c„ ���
=.reby 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)
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 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 ordina s and state laws latin Je�bilding construction.
I authorize representatives of this city or county to enter f remove-ider�yf r6C;6Rss ciion purposes.
of Property Owner or Authorized ADent 1� A / n rop wners. or Authorized Agent's Name
ACTION DATE BY ( DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED I LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITEXTENDED LlI n LIAQMD
PERMITFINAL "� �/ ° 'ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATEOF PROPOSED DEMOLITION
OCCUPANCYISSUED SIGNATURE:
-z"7