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Home My WebLink AboutX2021-0741 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - CIP ELEC PLUM PLUM *X2021-0741* a .! COMB Permit: X2021-0741 Project No : 0678-2021 Issued Date: 05/06/2021 Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0510612024 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: 4699 JAMBOREE RD NB Description: COMM TI -INTERIOR DEMO PRIOR TOT] (13,200 SF) Legal Desc.: P BK 142 PG 18 PAR 1 Owner: HOAG MEMORIAL HOSPITAL PRESBYTERIAN Contractor Address: 510 SUPERIOR AVE STE290 Address: NEWPORT BEACH, CA 92663 Phone: Phone: Applicant: KREUTZER MATTHEW Con State Lic: Address: 3600 SPECTRUM CENTER DR #730 Lic Expire: IRVINE CA 92618 Bus Lic: Phone: 9479-727-9000 Lic Exp Date: Code Edit, 2019 Type of Construction: V-BSPR Occupancy Group: B Added /New sq.ft. Bldg: 13200 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Y Flood Zone: X Building Permit Fee: $1,009.00 Plan Check Fee: $877.83 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $0.00 Energy Compliance: $61.00 CA Seismic Safety: $0.00 Disabled Access : $91.00 Hazardous Mat $0.00 Building Green Fee : $3.00 NELSON HCS INC Architect: 1340 REYNOLDS AVE STE 105 Address: IRVINE, CA 92614 949-274.5828 Phone: 1025484 Engineer: 04/3012023 Address: BT30075182 05/30/2022 Phone: Worker's Compensation Insurance Carrier: STARSTONE Policy No: T80210387881 Expire: Building Setbacks Zone: 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: I Right: I larking Spa $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $264.16 $0.00 $169.81 II TOTAL FEE: $2,522.05 Plan Check Fee PROCESSED BY: 15 //�� D" ZONING APPROVAL: 1POA GRADING APPROVAL: Designer: Address: Phone: HERNANDEZ DARCIA KAY 15615 ALTON PKWY #270 .... IRVINE CA 92618 °Op•� 949-727-9000 State Lic:C030188 • ° •• • Special Conditions: Planning Department - Plan check Fee : Fair Share, SJH Trans: In -lieu Housing Fee: Public Works Department - Park Dedication : $0.00 P/W Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 State Lic: Fire Department $46.25 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $1,079.73 Fee Due at Permit Issuance : $1,442.32 PUBLIC WORKS APPROVAL: PLAN CHECK BY: } & kL_ APPROVAL TO ISSUE: i IQ_ • a .eae®• .aoo. • o o • 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 items) 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 re 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 Cade) 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 ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or nproved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I am exempt from licensure under the Contractors' State License Law for the following reason: ly my signature lye1quy I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall) ell a structure that I haae built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and .... 3rofessicns Code, Is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. ji§ITatdr$ of Pr*%4 y byuner or Authorized Agent Date -IPEl`JSED CONTRACTOR'S DECLARATION -lere�by9ffrm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 if Division 3 of the Business and Profgs�idils,Code, and my license is in full force Ind eirect. LicenaeC:ass License No Date Ile 2QA Contractor Signature �—'S� YOR..KERS' COMPENSATION DECLARATION rARNING: FAILURE 105EEURE 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 UST 8FgOMPENEJIT1bW,J AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. TA M7 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 Ioerforma'nce of tlivavorkfor which this permit is issued. Policy No. �e'and wigi-TgigTin 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' Ice carrier and policy number are: Policy Number Date me of Agent 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 agree It, if I should become ,�s/ybjec t he workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Inature of Applicant' )l Datey :CLARATION REGAAAACING C STRUCTION LENDING AGENCY ereby 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). rider'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 enter a above -identified property for inspection purposes. V mature of PrODertv Owner or Authorized Agent � Print Property Owner's or Authorized Agent's Name !� �� 1'4✓ ' I t �IIV Date 5 I (v fGr%� ACTION DATE BY V I DECLARATION OF I REGULATIONS PART 610E TNCE WITITL40 H DE OF FEDERULERAL I FOR OFFICE USE ONLY PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMITEXTENDED - AQMD PERMITFINAL CERTIFICATE OF OCCUPANCY ISSUED yn ? Z Z3 ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO R OSE E ITI N SIGN TU _