The URL can be used to link to this page

Home My WebLink AboutX2020-0708 - Permitsn City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 ` w Permit Counter Phone (949)644-3288 u Inspection Requests Phone (949)644-3255 Combination Type - CIP ��IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII �� COMB Permit: X2020-0708 x 2 0 2 0 0 7 6 6 Project No : 0528-2020 Issued Date : 03/16/2020 Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY OR PERMIT WILL BE INVALID 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: 22 CORPORATE PLZ NB St: 1 FI: 1 Description: COMM REPLACE WASHER DISINFECTOR, STERILIZER AND SINK "HOAG ORTHOPEDIC INSTITUTE" Legal Desc.: PM 93.45 PAR 19 POR OF PAR Owner: IRVINE CO Contractor: ADVANCED GENERAL CONSTRUCTION Architect: INSPECT®R Address: 550 NEWPORT CENTER DR Address: 6545 HAZELTINE AVE # 212 Address: Disabled Access : $0.00 NEWPORT BEACH, CA 92660 $0.00 VAN NUYS, CA 91401 $1.00 $0.00 Phone: $0.00 Phone: 818.239-6979 Phone: State Lie: Applicant: NOURMOHAMMADI KHOSROW Con State Lie: 951083 Engineer: NOURMOHAMMADI KHOSROW .... Address: 2515 BAMBOO Lie Expire: 08/31/2020 Address: 2515 BAMBOO e e NEWPORT BEACH CA 92660 Bus Lie: BT30071415 emee NEWPORT BEACH CA 92660 Phone: 949-622-8700 Lie Exp Date: 03131/2021 Phone: 949-822-8700 State Lic:C-071141 •e mm Code Edit: 2019 Type of Construction: III -A -SPR Occupancy Group: B Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Y Flood Zone: Construction Valuation: $6.000.00 Building Permit Fee: $168.00 Plan Check Fee: $146.16 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $4.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $359.16 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Worker's Compensation Insurance Carrier: BENCHMARK INSURANCE Policy No: CST5016180 Expire: 05/2412020 Building Setbacks Use Zone: Excise Tax: Additional Fee: Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: / Front: / Left: / Right: / 3arkina Spaces $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee 0 Designer: Address: Phone: Special Conditions: Fire Hazard Zone : N 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 PMI Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 o m mmmmmm m coon o m o 00 0 m 00 0 0 0 0 00 eemo $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $186.16 Fee Due at Permit Issuance : $173.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: o mme000 0 0 ooeoo e ma000 000000 0 0 0 m o omm000 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: o m mmmmmm m coon o m o 00 0 m 00 0 0 0 0 00 eemo $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $186.16 Fee Due at Permit Issuance : $173.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: o mme000 0 0 ooeoo e ma000 000000 0 0 0 m o omm000 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 U 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 improved 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 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 legall) 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.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm urgqej enalty of perj that I am licensed under provisions of Cha ter 9 ( co.�'Imencing with Secti n 7000) of Division 3 of the Business d Profess' Code, arrd my license is in full force and effect. Lioense Mess License No I 0 S .5 ate L�3' ib ;1-�,9-D Contractor-ir ature NOR ..rf-RS' COMPENSATION DECLARATION NARNINQ 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 CAST Of COMPENUTIV DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. :hE11r1q)Paffirm undbr penalty of perjury one of the following declarations: 1 have and wit+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 th %giance of the wort for which this permit is issued. Policy No. •Mavg and will ly rftain 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 aourBRce carrier and policy number are: 998MISR • Policy Number Expiration Date Varve of+Acient • • • _ Phone # eAly that, inttleperformance of the�vyyQQrk 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 1F1 should AP,c g1pPf Dbject to the worl(epa' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. I (.- Igba -6 I hereby affirm under penalty of perjury that there is'a-donstruction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By 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 count ordinanc s and state laws relating to building construction. I authorize representatives of this city or county o nter the a ove-ids tifi property for inspection purposes. �IT�IY,\ CSG-1,ti�Qs[j � k63- f6.,,�D�/ Signature of Property Owner or Auth ed Agent Print Property Owner's or Authorized A e ams ACTION DATE BY 15ECLARATION OF CO PLI NCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 51 TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITEXTENDED LIAQMD.' PERMITFINAL �t� � SBEST99S-NOTIFICATIQN IS NOT APPLICABLE TO CERTIFICATE OF / PROPO Q'DE )MOLITION _ �„�- OCCUPANCYISSUED SIG E: IIoAAA,