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Home My WebLink AboutX2021-1865 - Permitsrr, City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2021-1865 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 1 8 6 5 Project No : 1610-2021 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 7 Issued Date : 09/17/2021 � Combination Type - BLDG ELEC Inspection Area : 2 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0911712024 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: 200 (CS) W PROMONTORY DR NB Description: COMM CELL SITE "AT&T" Legal Desc.: Owner: IRVINE COMPANY Contractor: INSITE TELECOM INC Architect: °0O° • e Address: 550 NEPORT CENTER DR Address: 521 W BRIARDALE AVENUE Address: •••• NEWPORT BEACH CA 92660 ORANGE CA 92865 • • • m °moo °o Phone: Phone: 714-282-0663 Phone: State Lic: o° Applicant: ERICSSON FRANKLIN Con State Lic: 835985 Engineer: ALKLOUB AMER Address: 1387 CALLE AVANZADO Lic Expire: 04/30/2022 Address: 7815 218TH ST SW #113 SAN CLEMENTE CA 92673 Bus Lic: ST30048458 EDMONDS WA 98026 • �g=� • ° ° Phone: 619-632-2569 Lic Exp Date: 09/30/2021 Phone: State Li¢C-090995 ••• p� mmmoo m••m°° Code Edit: 2019 Worker's Compensation Insurance Designer: „`i Type of Construction: Carrier: STATE COMP Address: Occupancy Group: U Policy No: INWC210220 xmm 1m m ° o Added /New sq.ft. Bldg: 0 Expire: 08/0112022 Phone: Added /New sq. ft. Garage: 0 o `° ®•• o No of Stories: 0 Building Setbacks Rear: / Special Conditions: WORKERS COMP ATT TO _° No of Units : 0 Front: / PERMIT Bldg Height: 0 Left: I Bldg Sprinklers: Right: I Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $60,000.00 Building Permit Fee: $906.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $788.22 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 $194.00 Investigation Fee: $0.00 Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $46.00 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 : $0.00 P/W Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $118.60 San Dist : $0.00 Building Green Fee : $3.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing W $0.00 $0.00 TOTAL FEE : $2,107.82 Plan Check Fee: $873.82 Fee Due at Permit Issuance : $1,234.00 PROCESSED BY: PUBLIC WORKS APPROVAL: C DAY - ZONING APPROVAL: u PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: Ix' 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 exemptfcom Iicensure under the Contractors' State License Law for the following reason: By my signature by pylrl 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 V1 4 Zucture 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 rofessions Code, Is available upon request when this application is submitted or at the following Web site:http://www,leginfo.ca.gov/caiaw.html. Sjgnajure of Prob91Owner or Authorized Agent Date �ICF;NSED CORTRACTOR'S DECLARATION I perepy affirm u rggrganalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of ivi on 3 of the Business and ProfeZns Co d my license is in full force end effect. License Crass License No Date Contractor Sig note �A. L, �QWERS' fOJNPPNSATION DECLARATION IF NARNINC: FAILU901"O 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 RJ9 FCF COMPENSAj10N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. flJ MQ affirm upderygnalty of perjury one of the following declarations: :1 1 have and wiN-41ritain 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 FaInce r;ince of We woa;k for which this permit is issued. Policy No. • .•.••• ave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' compensatiol carrier and policy number are: Policy Number of Agent Date 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 became subject to the workers' compensation laws of California, and agre , if I should becomelsubject to the %orkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. of Date/�� 121 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 county to enter the pbove;j6IprJified property for inspection purposes. 7 of Prooertv Owner or Authorized or Authorized Aaent's Name Civil Code). ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OFTITLE 40 AND AQMD RULE ' 1403 _. PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED ASBESTOS NOTIFICATION TO LJ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION