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Home My WebLink AboutX2021-3025 - Permitsnw City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2021-3025 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 3 0 2 5 Project No: 2631-2021 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - CIP Issued Date : 12/08/2021 Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 12/08/2024 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: 520 NEWPORT CENTER DR NB St: 1 Fl: 6 Unit: 600 Description: COMM TI - 100 SF (INSIDE 5046 SF SUITE)'RD OLSON REAL ESTATE' Legal Desc.: Owner: 520 NEWPORT CENTER DR LLC Contractor: SIMPSON DAVID CONST CO INC Architect: ALGAZE NELSON Address: 520 NEWPORT CENTER DR Address: 17177 GILLETTE AVE #A Address: 6083 BRISTOL PKWY NEWPORT BEACH CA 92660 IRVINE CA 92614 CULVER CITY CA 90230 Phone: Phone: 949-250-1348 Phone: 213-929-1400 State Lic:CO21090 Applicant: GRAVES HOLLY Con State Lic: 381149 Engineer: Address: 18600 MACARTHUR BLVD STE 100 Lic Expire: 03/31/2023 Address: IRVINE CA 92612 Bus Lic: BT00006013 Phone: 949-608-3710 Lic Exp Date: 06130/2022 Phone: State Lic: Code Edit: 2019 Worker's Compensation Insurance Designer: Type of Construction: V-B-SPR Carrier: CYPRESS INSURANCE CO Address: Occupancy Group: B Policy No: DAWCC222034 Added /New sq.ft. Bldg: 0 Expire: 0510112022 Phone: Added /New sq. ft. Garage: 0 No of Stories: 21 Building Setbacks Rear: / Special Conditions: - No of Units : 0 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: Y Right: / Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N t' Construction Valuation: $11,000.00 { , _,--�_•,: Building Permit Fee: $266.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $231.42 Additional Fee : $0.00 Plan check Fee : $52.00 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: $22.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building,Dept Adm $0.00 Energy Compliance: $0.00 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 : $91.00 P/W Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist : $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $663.42 Plan Check Fee: $435.42 Fee Due at Permit Issuance : $228.00 PROCESSED BY: = p p PUBLIC WORKS APPROVAL: ZONING APPROVAL: lt-/ r PLAN CHECK BY: GRADING APPROVAL: o "` °-a-,.-pa o c, APPROVAL TO ISSUE: f Q C Q v0 O4° W 4 (f O pp OCp 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 L) 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 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' Stale 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 ofthe 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 ate LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 I the Business and Professio d 1' nse's' f and effect. License Class License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: 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 I$100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: 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 arid mance of the work for which this permit is issued. Policy No. h ve 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' compensatio s ce carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # I certify that, in the performance a work for ich th rmit 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 that, if I should become subject tot o p sat r isions S coon 3700 of the Labor Code, I shall forthwith comply with those provisions. / w Signature of Applicant Date vim,! DECLARATION REGAR CONSTRUCTION LENDI G AGEN I hereby affirm under pe alty of perjury that there is a construction 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 behalV I have read this application and the information I have o ded is C act. I agree to comply with all applicable city and county o in ces an fate lating to building construction. I authorize representatives of this city or co ty to ant dentifieerty fo ' tion purposes. Signature of Property Owner or Authorized Agent rin Property Owner's or Authorized Agent's Namer')i labigollronDaterzi—el ha ACTION DATE BY C RATION OF CON1 IANCE WI H CODE OF FEDERAL FOR OFFICE USE ONLY IF OF REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 ••• ••• PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO • • i ; : a +• PERMITCANCELLED JEPA • •` ` PERMIT EXTENDED OMD ` PERMITFINAL J4ASBESTOS NOTIFICAT IS NOT PLICABL CERTIFICATEOF PROPOSED DEM LITION ++• . • • �`• :`• OCCUPANCYISSUED SIGNATURE:ya • ° • . + '+ ' ` • • a