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HomeMy WebLinkAboutX2021-2598 - Permitst � oar City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIII�IIII IIIIIIIII IIIII IIIIIN 11 COMB Permit: X2021-2598 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 2 5 9 e Y Project No: 2259-2021 "` i< Permit Counter Phone (949)644-3288 F +5 Inspection Requests Phone (949)644-3255 e"�$rsa c� Combination Type - CIP MECH ELEC PLUM Issued Date: 1210812021 Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1210812024 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: 1087 NEWPORT CENTER DR NB Description:- COMM TI "RAY BANS" 1149 SF Legal Desc.: P BK 221 PG 30 PAR 6 Owner: IRVINE CO Contractor: PRIME CONTRACTING Architect: BLACK MICHAEL R Address: 550 NEWPORT CENTER DR Address: 41715 ENTERPRISE CIR#105 Address: 3100 E RANDOL MILL NEWPORT BEACH, CA 92660 TEMECULA CA 92590 ARLINGTON, TX 76011 Phone: Phone: 951.383-8086 Phone: 817-633-4200 State Lic:CO26839 0 Applicant: RAYMOND ALEX Con State Lic: 1010421 Engineer: BISHOFF RYAN WILLIAM Address: 3001 BISHOP DR #300 Lic Expire: 01/31/2022 Address: 3300 IRVINE AVE #245 SAN RAMON, CA 92617 Bus Lic: BT30077410 NEWPORT BEACH CA 92660 LU Phone: 925-858-1785 Lic Exp Date: 12/31/2022 Phone: 949-862-8510 State Lic:S-006250 Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: II-B-SPR Carrier: STATE COMP. INS Address: Occupancy Group: M/S2 Policy No: 9267887 Added /New sq.ft. Bldg: 0 Expire: 01/1412022 Phone: Added /New sq. ft. Garage: 0 No of Stories: 1 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 Construction Valuation: $192,000.00 Building Permit Fee: $1,816.00 Excise Tax: $0.00 Planning Department- Fire Department Plan Check Fee: $1,579.92 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: $86.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $26.00 Energy Compliance: $134.40 Grading PC Fee: $0.00 Public Works Department - General Service $219.00 CA Seismic Safety: $0.00 WO Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $564.00 Disabled Access : $192.00 PAN Plan Check : $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $475.43 San Dist: $0.00 Building Green Fee: $8.00 Mechanical %: $373.55 NMUSD Fee: $0.00 $0.00 Plumbing %: $305.63 $0.00 TOTAL FEE : $5,831.93 Plan Check Fee : $2,495.49 Fee Due at Permit Issuance : $3,336.44 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: "PUBLI& WOW& APPROVAL• e � PLAN CHECK BY:: 660FROVALv� IS�U+ao E: � c c 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 is 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 Code) or that he or she is exempt from Iicensure 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). 7 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, 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). 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 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). 1 am exempt from Iicensure 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.html. Iignature 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 Section 70 of Division 3 of the Business and Pronsg(j�, d m lien full nd effect. License Class License No Date ,�- 2 Contractor Signatur v1 n VORKERS' COMPENSATION DECLARATION IARNING: 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 ATTORNEY'S 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 th erfognance of the work forwhich this permit is issued. Policy No. have and will mair�fai[I 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' rance carrier and olic number are:----,. Date ie of Agent certify that, in the`bdrformance of a wo or hicl � permdlis issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree t, if I should becomTalty t to th orke co pen/saattl rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �cc nature of Applicant0WV Datk77 �"Q_ '21 CLARATION REGACONSTRUCTION LENDING AGENCY areby affirm under pf perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). 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 prove Is rect. I agree to comply with all applicable city and county din s nd sta laws r ting to building construction. I authorize representatives of this city or county til er ^ �b:ve-i 'fie rty for inspection purposes. 1,.,, _A, Signature of Property Owner or AL ACTION DATE PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMITFINAL (F 9,7 CERTIFICATE OF OCCUPANCY ISSUED - Print Property Owner's or Authorized Ag OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY PART 61 OF TITLE 40 AND AQMD RULE ON IS N 4APPUCA9LE TO • +.• •• o �c ^ D J.