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Home My WebLink Aboutx2019-3789 - PermitsYr,# City of Newport Beach - Building Division IIIIUIIIIIIII�Illlllll�llllllll�lllullllllll� II COMB Permit: X2019-3789 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 3 7 8 9 Project No : 2602-2019 ,:. Permit Counter Phone (949)644-3288 c) - Inspection Requests Phone (949)644-3255 Ea ,a,ac+�� Combination Type - MFP MECH ELEC PLUM Issued Date : 07/08/2020 0 Inspection Area: 8 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 07/09/2023 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: 1561 MESA DR NB Description: MFR BLDG R20 (UNITS 121-124) REMODEL 3,250 SF -. Legal Desc.: Owner: PALM MESA LTD Contractor: REFINO INC Architect: WINTERS PATRICK � Address: 12121 WILSHIRE BLVD #700 Address: 9706 4TH AVE N E i7401 Address: 1990 S BUNDY'#400' LOS ANGLES CA 90025 SEATTLE, WA 98115 LOS ANGELES CA 90667 Phone: Phone: 206-260-1509 Phone: 310-626-2100 State LicCO22ff Applicant: PADDOCK STEVE Con State Lie: 787509 Engineer: VARELA BEN Address: 1990 S BUNDY #400 Lie Expire: 0613012021 Address: 6007 WASHINGTON BLVD . LOS ANGELES CA 90067 Bus Lie: BT30072366 CULVER CITY CA 90232 - Phone: 310-626-2100 Lie Exp Date: 0713112021 Phone: 424-208-4764 State Lic:S-005714 Code Edit: 2016 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: STATE FUND Address: Occupancy Group: R21U Policy No: 9161474 Added /New sq.ft. Bldg: 0 Expire: 06125/2021 Phone: Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: / Special Conditions: No of Units : 4 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: N Right: / Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $68,000.00 Building Permit Fee: $933.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $811.71 Additional Fee, $0.00 Plan check Fee: $0.00 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: $0.00 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 WO Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 PIW Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $65.31 San Dist: $0.00. Building Green Fee : $3.00 Mechanical %: $37.32 NMUSD Fee: $0.00 $0.00 Plumbing %: $83.97 - - $0.00 TOTAL FEE : $1,934.31 Plan Check Fee: $773.43 Fee Due at Permit Issuance : $1,160.88 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: S GRADING APPROVAL: -- � APPROVAL TO ISSUE: L L&wo 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 Cade: 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 Irofessions 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 penah of of more than five hundred dollars ($500). 7 I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 nprovements 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 nproved for the purpose of sale). 11, 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 pply 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). 7 I am exempt from licensure under the Contractors' State License Law for the following reason: ly 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 legally ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. lignature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Se ion 7000) of Division 3 of the Busi s and Professions Code n e is in full force and effect. License Class License No �_67.—�. _ Contracto ignature VORKERS' COMPENSATION DECLARATION rARNING: 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 DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS 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 the erformagAe of the work for which this permit is issued. Policy No. kifaWe'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' policy number are: Policy Number Expiratic of Agent Phone # Date I 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, iat, if I should become subject to the wor. Is' pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. lignature of�`P�_( licant v 4�s o" Zo IECLARAl10N RE RDING ONSTR CTION LENDING AGENCY hereby affirm under penalty of perjury t at there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ender's Name Lender's Address ly 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 I agree to comply with all applicable city and county ordi and state laws relating to building c truction. I authorize representatives of this cij�oyeounty to the above- HHt ypperty for inspection pur ses. lignature of Prooertv Owner or Authorize Den �,/ ) Print Prooertv ner s or Authorized ADe Name ACTION DATE 7 REGULATIONS PART OFTIIT E 40 AND AQMD RULECE WITH CODE OF RAL I �OR OFFICE USE ONLY PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EIEPA PERMIT EXTENDED UAQMD PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED ��0'� BESTOS NOTIFICATION IS NOT APPLICAE ROPOS EMjU{TIOt/ RED /�'