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Home My WebLink AboutX2018-3421 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2018-3421 >� 4 100 Civic Center Drive, Newport Beach, CA 92660 '^. X 2 0 1 8 3 4 2 1 Project No: 2657-2018 F Permit Counter Phone (949)644-3288 <. z Inspection Requests Phone (949)644-3255 - Issued Date . 02122/2019 Combination Type' CIP ELEC MECH PLUM xhp .Inspection Area : 7 F PERMITS EXPIRE 480 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 Sundays or Holidays ' Job Address: 20051 BIRCH ST NIS Description COMM -TI 3019 SF "SPEC SUITE" ? s r Legal Desc : TR 706 LOT 84 EX SWLY 112 $ EX NWLY 165 F7 ,� 1 ,1 �.* s ; camC7 i , .Owner: SDW REAL ESTATE HOLDING LLC Contractor O'BRIEN CONSTRUCTION Architect: Address: 3197 AIRPORT LOOP DR #B Address: 24350 VIA LENARDO Address: ' COSTA MESA CA 92626 YORBA LINDA, CA 92887 Phone: Phone: 562.305.3500 Phone:. ,.. State Lic:.. Applicant: SATAS JOHN: Con State Lic: 824025 Engineer: NGUYEN LAM Address. 20061 BIRCH ST Lic Expire: 0913012019 Address: 15375 BARRANCA PKWY #H106 NEWPORT BEACH CA 92660 ' Bus Lic BT30066172 IRVINE CA 92618 Phone: -714-605-6312Lic Exp Date:. 0212812020 Phone: 1949-788-0006 State Lic:C-036957 •^� Code Edit 2016 Worker's Compensation Insurance Designer: Type of Construction: V-A Carrier EXEMPT Address: Occupancy Group: IS Policy No: NOEMPLOYEES Added /Vw sq.ft. Bldg:.. ' 0 Expire: Phone:: . Added iWm sq.. ft. Garage: ' 0 ,No of Stores: 3 Building. Setbacks Rear: I Special Conditions: No of Units i 0 Front: 1: Bldg Height: 0 - Left: I 'Bldg Sprinklers: N` Right: / Flood Zone: Use Zone. Parking Spaces: p 0 Fire Hazard Zone : N Construction Valuation. $133.000.00 Building Permit Fee: $1,366.00 Excise Tax. $0.00 - Planning Department - Fire Department Plan Check Fee: $1,188.42 .Additional Fee; $0.00 '' Plan check Fee : $40.00 - 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: $66.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance: $93.10 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 : $133.00 - PAN Plan Check : ,. $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical%: .$357.62 San Dist: $0.00 -Building Green Fee : $6.00 Mechanical %' $280.99 NMUSD Fee: $0.00 $0.00 Plumbing %:>. $229.90 $0.00 i TOTAL FEE : $3,751.03 Plan Check Fee: $1,011.96 Fee Due at Permit Issuance : $2,739.07 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: t (1�-r--�� PLAN CHECK BY: GRADING APPROVAL: 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(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 Ofessions 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 j 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044, isiness 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 provements 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 proved for the purpose of sale). 1 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 ply to an owner Bf ptBperty 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 libensure under the Contractors' State License Law for the following reason: - my a: hAlow'l Acknowledge that, except for my personal residence in which 1 must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal 11 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 3fessions Code, ie available upon request when this application is submitted or at the following Web site:http://www.Jeginfo.ca.gov/calaw.html. gt`6fre of Property Owner or Authorized Agent Date NtED CUM7KACTOR'S DECLARATION ere6 i affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Segri7000) f Division of the Busi Iss and Profess! s Code, and li se is in full force 0 bifdct. License class License No rJDStAe 9. Contra�tgSao nature JRKERS' COMPENSATION DECLARATION RIbR0INGC�AILURE T , SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO CNE HU DR THOUSAND DOLLARS ($700,000(, IN ADDITION TO THE CeST OF POMPENSA Inm,,DaMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I _hereby-Iffirm under penalty of perjury one of the following declarations: 10ebe 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 Coda, for IN performance of the WON for which this permit is issued. Policy No. Y I have 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' comv,ensatio insurance carrier and policy number are: Carrier Policy Number Expiration Date of AgentPhone # i I certify that, in a performance 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 th�i, if I should atone subject to a workers' compen/s[�(Ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. l Signature of pli nt V te_2�22/! DECLAI A EGARDI ONSTRUCTION LENDING AGENCY I hereby affirm under penty f perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 Civil Code). Lender's Name I Lender's Address Byimy signature below, c rtify to each of the following: I am the property o er or authorized to act on the prop y owner's behalf. I have read this application and the information I have ovided is correct. I agree to comply with all applicable city and county dinances and state laws relating to building construction. I authorize representatives of this city or county to ter the above ' Ified property for inspection purposes. xr n Si nature of Property Owner or Author! ant Print Property Owner's or Authorized Agent's Na /�lAr G� �GG✓D e z '� z� ACTION DATE BY TION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED DEPA PERMIT EMENDED QMD PERMIT FINAL oo• % All �," VU:3r. ASBESTOS NO (CATION IS NOT AP ICABLE TO CERTIFICATE OF p E,'fi DE ITION //11, OCCUPANCYISSUED (GNAT RE: yz/ // .vim