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HomeMy WebLinkAboutX2019-2775 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII� II COMB Permit: X2019-2775 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 2 7 7 5 Project No: 1974-2019 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Issued Date :1 210 212 01 9 l * Combination Type - CIP ELEC Inspection Area : 7 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID tNSPECT(ON. Construction Hours: Moth day- riday 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: 450 NEWPORT CENTER DR NB l Description: COMM - CELL SITE W/BATTERIES TO EQU PMENT "AT&T' Legal Desc.: P BK 61 PG 10 PAR 1 Owner: IRVINE COMPANY Contractor: METRO RF SERVICES INC Architect: /� Address: 550 NEWPORT CENTER DR Address: 2320 S ARCHIBALD AVE Address: NEWPORT BEACH CA 92660 ONTARIO CA 91761 Phone: 714-928-1597 Phone: 909.230-4920 Phone: State Lie: Applicant: PACHECO CHRISTINE Con State Lie: 695236 Engineer: MONEY ALAN Address: 3659 GREEN ROAD #214 Lic Expire: 04/30/2021 - Address: 2447 W 12TH ST STE 1 CLEVELAND OH 44122 Bus Lic: BT30061761 TEMPE AZ 85281 Phone: 323-847-6994 Lic Exp Date: 01/31/2020 Phone: State Lic:C-046959 ° om " Code Edit: 2016 Worker's Compensation Insurance Designer: Type of Construction: _ Carrier: OLD REPUBLIC GENERAL INS. Address: ° Occupancy Group: U Policy No: AlCW12301700 VOO. Added /New sq.ft. Bldg: 0 Expire: 0511512020 Phone: Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: / Special Conditions: No of Units : 0 Front: / Bldg Height: 0 Left: I t Bldg Sprinklers: Flood Zone: Right: I= Use Zone: Parking Spaces: 0 Fire Hazard Zone : N ° Construction Valuation: $15.000.00 Building Permit Fee: $312.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $271.44 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: $44.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $56.00 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 : $0.00 PM/ Plan Check : $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $81.68 San Dist: $0.00 "quilding Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 ZY: TOTAL FEE: $806.12 L: Plan Check Fee : $479.44 Fee Due at Permit Issuance : $326.68 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: o ° smmmc° o ° 0 eo �. o " ° m c o° c coot: o° 00°Cl: ooaoo� ° 0 °°o 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 o 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). ❑ 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 legalh 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.Jeginfo.ca.gov/calaw.htmi. 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 Section 7000) of Division 3 of the Business and Profes ns Code and my license is in full force and effect. Lil;ftpJgass C,10 G—! License No 2>CI5?7r. Date�2-2-/g Contractor Signature &Z NORKERS' COMPENSATION DECLARATION NARNINE: FAILURE TO.4URE 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 jOST OF COMPENBARION.DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ITatgty affirm under penalty of perjury one of the following declarations: ZI I have angI Wllf Rlnintain 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, ;fiance ofthework for which this permit is issued. Policy No. Lave and. CH 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 r®ncecaa`rrrii r'ndpolicy number�-� are: /f A .awiec C✓Lr� rGG�i Policy Number CLNX 02 Expiration Date 5�"rs- 7a&0 of Ice 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 to the wor ers' comp sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ate CLARATION REGARDING CONSTRUCTION LENDING AGENCY :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 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 ordinances and state laws relating to building construction. I authorize representatives of this city or countyXente .0ae Jove -identified propel for inspection purposes. 7J ACTION DATE BY -DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED Fun PERMITFINAL 7 Zol-O ASB NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: FOR OFFICE USE ONLY Name Civil Code). C9(r1'as Dat/?;z-,- '