HomeMy WebLinkAboutX2019-1704 - PermitsCity of Newport Beach -Building Division *X2019-1704* COMB Permit: X2019-1704
o 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 1220-2019
N Permit CounterPhone(949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - BLDG ELEC Issued Date: 061071201E
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 Sundays gr,�o(Ida s
Job Address: 2507 EASTBLUFF DR NB
Description: COMM -RELOCATE 18' PARKING LOT LIGHT POLE W/ <2' BASE.
Legal Desc.: PM 49-22 PARS 23 & POR PAR 1. a 4�
6
Owner: IRVINE COMPANY Contractor: WEST COAST BACKHOE SERVICES INC Architect:
Address:. 111 INNOVATION Address: 10681 CHESTNUT AVENUE Address: -
IRVINE CA 92612 STANTON CA 90680
Phone:. Phone: 714.840-6246 Phone: State Lic: -
Applicant:, FAPOHUNDA FRANCIS
Address: 2301 DUPONT DR STE 150
IRVINE CA 92612
Phone: 714-424-0001
Code Edit: 2016
Type of Construction:
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units : 0
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation: $2
Building Permit Fee:
$104.00
Plan Check Fee: $90.48
03/31/2021.
Overtime Plan Ck:
$0.00
Investigation Fee:.
$0.00
Record Management:
$6.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
II TOTAL FEE: $255.0
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Con State Lic:
639268
Engineer:
Lic Expire:
03/31/2021.
Address:
Bus Lic
BT30060393
In -lieu Housing Fee
Lic Exp Date:
09/3012019
Phone:
Worker's Compensation Insurance
Designer:
Carrier:
EMPLOYEE SERVICE GROUP
Address:
Policy No:
C66202281
Expire:
1 010112 01 9
Phone:
Building Setbacks
Excise Tax:
Additional Fee:
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Rleffbhw %:
Rear: I
Front: /
Left: /
Right: /
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$13.61
$0.00
$0.00
State Lic
HATCH ROBERT
2301 DUPONT DR #150
IRVINE CA 92612
714-424-0001
Special Conditions:
Planning Department -
.Fire Department
Plan check Fee
Fire Inspection:
Fair Share :
Fire Plan Rev
SJH Trans :
Demolition Fee
In -lieu Housing Fee
Building Dept Adm
Public Works Department -
Park Dedication:
$0.00
P/W Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Plan Check Fee: $136.81 Fee Due
PUBLIC WORKS AI PROVAI
PLAN CHECK BY:
APPROVAL TO ISSUE:
o n
GOY••n
0
•maoa
Cb 00t)
• C
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Issuance: $118.28
.Fire Department
$40.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
Plan Check Fee: $136.81 Fee Due
PUBLIC WORKS AI PROVAI
PLAN CHECK BY:
APPROVAL TO ISSUE:
o n
GOY••n
0
•maoa
Cb 00t)
• C
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Issuance: $118.28
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 (_) all of or L) 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
a 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:
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 legal)
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://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7000 IV'a T 3 of the Business and Prof. est Code, and my license is in full force
and effect. Licensa E1ass License No Date G t Contractor Signalurb:
1JORKF„ RS' COWFEhSATION DECLARATION
4tiIQIILI'RIECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
,.O3T OF COMPENS�pTI N.D MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
hg6ve andy�RlmlairQtain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the
)e r grace of tFe awok for which this permit is issued. Policy No.
and wal rp9iM1Pain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
carriePand policy number are:
Policy Number
Date
I earthtyy that, in the performance oft w rk for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree
�tpi$ 6s'hould becouie* bject to th- wo ers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. s� ,7
mature of Applicant Dat _ P/t"/ IT
CLARATION REGARDI CONST UCTION LENDING AGENCY
sreby affirm under pen ty of perju that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
ider'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 or 7aes and state la
I authorize representatives of this city or count toe - bove-i t
nature of Prooertv Owner or Authorized ADent
ACTION
PERMIT EXPIRED
PERMITCANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCVISSUED
l�
DATE I BY
�76RIding construction.
inspection purposes.
Print Prooertv Owner's or Authorized
OF COMPLIANCE WITH CODE OF FEDERAL
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
I SUBMITTED ASBESTOS NOTIFICATION TO
UASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION
SIGNATURE:
FOR OFFICE USE ONLY
1C