HomeMy WebLinkAboutX2018-2077 - Permits�1 City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
E 'h Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
"'�arrntxs Combination Type - CIP
COMB Permit: X2018-2077
IIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIII II
Project No : 1629-2018
Issued Date : 0 7/1 912 01 8
Inspection Area : 7
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. • • s e
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 Holiday§..,
Job Address: 241 NEWPORT CENTER DR NB • m
Description: COMM- MOBILE RACKING FOR BCBG RETAIL STORE • • • • m • • • • o
Legal Desc.: P BK 221 PG 30 PAR 6 ° m
mm s
Owner:
IRVINE CO
Address:
550 NEWPORT CENTER DR
9224256
NEWPORT BEACH, CA 92660
Phone:
661-803-9730
Applicant:
ALFONSO RODRIGUEZ ALCARAZ
Address:
27515 DEEP TREE AV
Bus Lie:
SANTA CLARITA CA 91351
Phone:
661-803-9730
Code Edit:
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 1
No of Units : 0
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation:
Contractor:
ADR CONSTRUCTION INC
Address:
27515 DEEPTREE AVE
9224256
CANYON COUNTRY CA 91351
Phone:
661-803-9730
Con State Lie:
1006994
Lie Expire:
09/30/2019
Bus Lie:
BT30062884
Lie Exp Date:
04/30/2019
2016 Worker's Compensation Insurance
V -B Carrier:
STATE COMP
B Policy No:
9224256
0 Expire:
01/1112019
0
CA Seismic Safety:
Building Setbacks
Rear: I
$0.00
Front: I
$0.00
Left: /
$1.00
Right: /
Building Permit Fee: $187.00
Plan Check Fee: $162.69
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: $392.19
PROCESSED BY:
ZONINGAPPROVAL:
GRADING APPROVAL:
Architect:
$0.00
Planning Department -
$37.50
Address:
$0.00
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Phone:
State Lie:
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Engineer:
BURNAM NICHOLAS STIVER
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Address:
62016 NE QUAIL RUN PLACE
o m m e e•
e o 00
Grading PC Fee:
BEND, OR 97701
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WQ Insp. Fee:
Phone:
State Lic:C-085630
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•
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P/W Plan Check:
o m
mm m
emse
Designer:
San Dist:
$0.00
Mechanical %:
Address:
NMUSD Fee:
$0.00
Plumbing %:
Phone:
Special Conditions:
Excise Tax:
$0.00
Planning Department -
$37.50
Additional Fee :
$0.00
Plan check Fee
Fin; Plan Rev
Grading Bonds Fee:
$0.00
Fair Share
Grading PC Consultant:
$0.00
SJH Trans
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
Refund Deposit
Grading PC Fee:
$0.00
Public Works Department -
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
P/W Plan Check:
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$0.00
Plan Check Fee:
$200.19 Fee Due at Permit Issuance : $192.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY: CM
APPROVAL TO ISSUE:
Fire Department
$37.50
Fire Inspection:
$0.00
$0.00
Fin; Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
$200.19 Fee Due at Permit Issuance : $192.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY: CM
APPROVAL TO ISSUE:
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)
lection 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
1e 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
'rofessions 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
of more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness and PjQfOWgPs 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
nprovements are nol•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
rrprawd for the purpose of sale).
o .
I, as owner. afthe property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
pply town 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).
loam exempt 4rom licensure under the Contractors' State License Law for the following reason:
Iy o,y signature MGM: 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 legalll
ell d'Structure thpt 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
Imfessions Code, ie available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
iigeatare of Propeityi0wner or Authorized Agent Date
mraWSED CONTRACTOR'S DECLARATION
hereby affirm u*pi; p4nalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 0 of Division of the Business and Pro(espions Code, a my license is in full force
rLICLINct. License Class License No Datej �)' l Contractor Signature Vi C<. /..�
VARKERS' r,CUP"SATION DECLARATION v��--
IARNING: 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
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I have 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 Code, for th
6irfprmance 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'
carrier and policy number are:
Policy Number
Date
1e of Agent vnone a
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 subject to th"orkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
Dat"Y: /2
CLARATION REGARD1N%CQNSTRUCTION QENDING AGENCY LLV//��
areby affirm under penalty of perjury -that there i 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 1 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 county ;o enter the above -identified property for inspection purposes. /r;i ( r
nsfnr. of Orn dt Y t, nt.,nor nr Ai fhnrb A�Ai z � —�\ Print Prooertv Owner's or Authorized Aoenfs Name�j(
ACTION DATE BY t \ BATION•OF-GOMP,LAN WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 610E TITLdD"AND AQMD RULE
PERMIT EXPIRED I I I U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITFINAL r. //-701 / U— UASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF PROPOSED DEMOLITION
OCCUPANCYISSI SIGNATURE:
Civil Code).
J
/ C
Date / '