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Home My WebLink AboutX2017-1802 - Permits,n City of Newport Beach - Building Division IIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIiIII� COMB Permit: X2017-1802 T 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 7 1 8 0 2 Project No : 0300-2017 Permit Counter Phone (949)644-3288 _ Inspection Requests Phone (949)644-3255 �"&raga'' Combination Type - CIP Issued Date : 06/07/2017 0 Inspection Area : 7 Applicant: HOLLAND ROB PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. 568466 Construction Flours: 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: 401 NEWPORT CENTER DR NB Address: 38 TECHNOLOGY STE 100 Description: PRECISE GRADING FOR ADA IMPROVEMENTS "PHASE 4" Address: Legal Desc.: P BK 221 PG 30 PAR 2 m ° Owner: IRVINE CO Contractor: CUESTA CONSTRUCTION CO Architect: Address: 550 NEWPORT CENTER DR Address: 3195A AIRPORT LOOP DR Address: C C o e e e o 0 NEWPORT BEACH, CA 92660 COSTA MESA CA 92626 ®� Phone: Phone: 714-557-5877 Phone: State Lic: o • o Code Edit: 2016 .eee Applicant: HOLLAND ROB Con State Lic: 568466 Engineer: THIESSEN MITCHELL Address: 38 TECHNOLOGY STE 100 Lic Expire: 05/3112019 Address: 38 TECHNOLOGY omee m ° IRVINE, CA 92618 Bus Lic: BT20012806 IRVINE CA 92618 e o° m e• o e e e o 0 Phone: 949-923-6260 Lic Exp Date: 1213112017 Phone: 949-923-6293 State Lic:C-056967 m o • o Code Edit: 2016 Worker's Compensation Insurance Designer: .... Type of Construction: Carrier: SENTINEL INS Address: Occupancy Group: U Policy No: 72WEQ10610 0 0 ommmo Added /New sq.ft. Bldg: 0 Expire: 12/0112017 Phone: ° ° ° ° m • m ° Added /New sq. ft. Garage: 0 ° ...... No of Stories: 0 Building Setbacks Rear: I Special Conditions: SEE X2017-0429 FOR ADDL No of Units : 0 Front: 1 FEES AND GRADING ° ...... Bldg Height: 0 Left: I Bldg Sprinklers: Right: / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $312.506.00 Building Permit Fee: $2,160.00 Excise Tax: $0.00 Planning Department - FireDepartment Plan Check Fee: $1,879.20 Additional Fee : $0.00 Plan check Fee : $0.00 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Investigation Fee: $0.00 Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 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 : $312.51 PNV Plan Check : $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $13.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $4,364.71 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $4,364.71 PROCESSED BY: 5=7 PUBLIC WORKS APPROVAL: ZONING APPROVAL: Al PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: F 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) action 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, 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, siness 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). I am exempt from licensure under the Contractors' State License Law for the following reason: 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 legally 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 �fessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. nature of Prop2gy�Qwner or Authorized Agent Date TENSED COqIM.CTOR'S DECLARATION reN affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cof and m license is in full force I e%l Lica i )PAs License No Date Contractor Signature /7�N' )RRERS' CbMA9NSATION DECLARATION /-_7 ' rNIKe: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE IT O F.COMPENS` IKEA -b IMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. :1419ffirm under-panalty of perjury one of the following declarations: [.[Nave and will.maintain a certificate of consent to self -insure for workerscompensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for thi r: r:- yafice of the work for which this permit is issued. Policy No. -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 uance carries anrlpoiicy number are: Mier•• Policy Number Expiration Date certify that, in the 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: if I should become subjact toyyeVv rkers' co pen ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions Date latureofApplicant /YG^/te /�/-7// -7 )ECLARATION REGARDING CONSTRUCTION LENDING4 hereby affirm under penalty of perjury that there is a construe ion lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ender's Name Lender's Address iy 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 coup y ordinances and state laws relating to building construction. I authorize representatives of this city or county a er the qbo -identified property for inspection purposes. i linnnhve of Prnnar)v nwner nr AueA fhnri7ADent i.e /fvZit�I� Print Prooertv Owner's or Authorized ADent's Name A o� 14e ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY ° t% REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED LIEPA PERMIT EXTENDED QMD PERMIT FINAL U ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: