The URL can be used to link to this page

Home My WebLink Aboutx2021-3249 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 ;.. Permit Counter Phone (949)644-3288 s�.. Inspection Requests Phone (949)644-3255 c ttrern`r Combination Type - CIP MECH ELEC PLUM �X 2 02 1 3 2 4�� 1�� INSPECTORi"dC COMB Permit: X2021-3249 Project No : 2812-2021 Issued Date : 02109/2022 Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0210912025 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: 510 SUPERIOR AVE NB Description: COMM TI REMOVEIREPLACE (E) IMAGING EQUIPMENT/RECEPTION AREA FOR HOAG RADIOLOGY, ADD CHILLER 1,602 SF. Legal Desc.: IRVINE SUB LOT 169 BLK 2 PORS OF LOT Owner: NEWPORT HEALTHCARE CENTER Contractor: GUTHRIE GENERAL OF CA INC Architect: LIEBKE STEVEN Address: 1 HOAG DR Address: 6677 WEST THUNDERBIRD STE C Address: 1340 REYNOLDS AVE #115 NEWPORT BEACH, CA 92663 GLENDALE, AZ 85306 IRVINE CA 92614 + + Phone: Phone: 602-390.2705 Phone: 949-752-5052 State Lic:CO25341 Applicant: LIEBKE STEVEN Con State Lic: 951506 Engineer: LEE DONALD E ++.+ Address: 1340 REYNOLDS AVE #115 Lic Expire: 08131/2022 Address: 21008 SYLVANWOOD AV IRVINE CA 92614 Bus Lic: BT30071412 LAKEWOOD AV 90715 , °+ Phone: 949-752.5052 Lic Exp Date: 03130/2022 Phone: 562-860-7896 State Lic:C-02311 Code Edit : 2019 Type of Construction: I-A-SPR Occupancy Group: B Added /New sq.ft. Bldg: 1602 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Y Flood Zone: X Construction Valuation: $400,000.00 Building Permit Fee: $3,064.00 Plan Check Fee: $2,665.68 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $192.00 Energy Compliance: $280.00 CA Seismic Safety: $0.00 Disabled Access : $400.00 Hazardous Mat $0.00 Building Green Fee : $16.00 TOTAL FEE : $9,898.77 PROCESSED BY: ZONING APPROVAL: Worker's Compensation Insurance Carrier: AMERISURE MUTUAL INS Policy No: WC2103602 Expire: 10101/2022 Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: / Front: / Left: / Right: / $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $802.16 $630.26 $515.67 Designer: Address: Phone: Special Conditions: Planning Department - Plan check Fee: Fair Share SJH Trans In -lieu Housing Fee: Public Works Department - Park Dedication : $0.00 PAN Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Plan Check Fee : $4,724.01 Fire Department $52.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 $472.00 $26.00 $219.00 $564.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $5,174.76 PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: k v 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 he 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 3rofessions 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 lot 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044, 3usiness 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 mprovements 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 mproved 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 Ipply to an owner ofproperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I am exempt (pgrplicensure under the Contractors' State License Law for the following reason: 3y 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 ,S1 Vsjructure Aahl 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 dvailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. ilgnat" of Property Owner or Authorized Agent Date -ICMSED CONTRtNCTOR'S DECLARATION hereby affirm uader-penalty of p dury that I am licensed under provisions gfI he ter 9 (commencing with Section 0 o D' ision 3 of the Business and Pro s Ion Ode, � ny license is in full force Ind tifect. LIC�1eA15�e} �Class -V License No '-451 DCQ Date g`i Z Contractor Signatur IV0Ik%ERS' (QA--ENSATION DECLARATION Pv VAAM: 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 ;QW.DFZOMPENS ATION,gAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ;herebyaffirm eni:tpEnalty of perjury one of the following declarations: :111iAte and wAl 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 I ante of the vrore for which this permit is issued. Policy No. have and will ma' t ip workers' compensation insurance, ps required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatiol nsurance carrier and olicle number ar P ;arrier 1V1 I � lily er Expiration Date Jame of Agent 1. 1 Phone # :11 certify that, in the performance of the work for c 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 hat, if I should become ub ct (, a workers' c p sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions._ Signature of Applicant I ` gate I/zZ )ECLARATION REG D CONSTRUCTIO LENDING AGENCY hereby 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, Civil Code). _ender's Name Lender's Address 3y my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners 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 o ant a a_bo a--' entifie_d property for inspection purposes. �� Signature of Property Owner or Authorized Agent - Print Property Owner's or Authorized Agent's Nam D e ACTION DATE BY kKLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY RE - TONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED ISUBM ED ASBESTOS NOTIFICATION TO PERMITCANCELLED LIEPA PERMIT EXTENDED QM PERMIT FINAL /�/ �: ASBEST S N TIFICATION IS NOTAJLICABUE TO CERTIFICATEOF % PROPOSE OUTIO OCCUPANCY ISSUED SIGNA RE: