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HomeMy WebLinkAboutX2020-2017 - Permits€ City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 a =F r Permit Counter Phone (949)644-3288 s Inspection Requests Phone (949)644-3255 Combination Type - CIP MECH ELEC PLUM COMB Permit: X2020-2017 lllllll�lllllll�llllllllllll�llllllllnllll Project No : 1640-2020 Issued Date: 12/0312020 Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1210412023 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: 3101 NEWPORT BLVD NB Description: COMM TI "CHIPOTLE" 210 SF Legal Desc.: Owner: LANDING M2 LLC Address: 3121 NEWPORT BLVD NEWPORT BEACH CA 92663 Phone: Applicant: RAY SAVANNA Address: 2029 VIA SOLONA SAN CLEMENTE CA 92673 Phone: 949-412-0595 Code Edit : 2019 Type of Construction: V-BSPR Occupancy Group: B Added /New sq.ft: Bldg: 210 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units : 0 Bldg Height: 26 Bldg Sprinklers: Y Flood Zone: X Building Permit Fee: $1,209.00 Plan Check Fee: $1,051.83 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $66.00 Energy Compliance: $70.00 CA Seismic Safety: $0.00 Disabled Access : $100.00 Hazardous Mat $0.00 Building Green Fee : $4.00 TOTAL FEE: $4,009.01 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: APEX IMAGING SERVICES Address: 720 INDIGO CT POMONA CA CA 91767 Phone: 909-593-9539 Con State Lic: 467624 Lic Expire: 01/3112021 Bus Lic - BT30067659 Lic Exp Date: 06/30/2021 Worker's Compensation Insurance Carrier: ZURICH AMERICAN INS Policy No: WC661379304 Expire: 1010112021 Building Setbacks Use 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 $316.52 $248.69 $203.47 Architect: DUNGAN JOHN Address: 8826 SANTA FE DR #304 OVERLAND PARK KS 66212 Phone: 913-341-2466 State Lic:C032216 Engineer: Address: Phone: State Lic: Designer: Address: Phone: Special Conditions: LIQUEACTION AREA HIGH DENSITY AREA Fire Hazard Zone : N 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: $0.00 Fire Department $277.50 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 $462.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $4,009.01 ?ULSLIC WORKS APPROVAL: PLAN CHECK BY: �APPROVAL TO ISSUE: 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 appII- nt 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). 111, 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, 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 exempt from licensure under the Contractors' State License Law for the following reason: By 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 legal sell 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http:/Aw .leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 77 of Division 3 of the Business and Prof ssi ode, and licen a is in full force and effect. License Class License No Date 2 / 0 Contractor Signatu C WORKERS' COMPENSATION DECLARATION \\ DARNING: 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 IET00,0001, IN ADDN40N 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: 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 rmance of the work for which this permit is issued. Policy No. have -and will maintain workers ranee carrier ant-DolicY number III of Agent ��' certify that, in the performance of the work for , if I should become suJaject to the workers' co, of Applicant' insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' Date 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 i provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ei-d1 i !2/3/20ZZ )reby affirm under penaltyWerjury that there 'ss construction I I�d Ig agency for the performance of the work for which this permit isissued(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 provided is correct. 1 agree to comply with all applicable city and county ordinances and state ws rela ng to building construction. I authorize representatives of this city or county to � above-identifi d prop y for inspection purposes. �'_ r signature of Property Owner or Authorized Agent — roperty Owner's or Authorized Age ACTION DATE BY DE ION OF COMP A CE WITH CO E OF FEDERAL FOR OFFICE USE ONLY REG TIONS PART 610 TLE 40A OMD RULE 1403 PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO ••� •• ••• ••° es• PERMITCANCELLED /�--. - EPA • • • • • ` • • e PERMIT EXTENDED 0461VID ° • • • • ° • ° PERMITFINAL F-g •74,2z, >QApqtTOS NOTIFICATION IS NO PL BLE TO CERTIFICATEOF PROPMEDD ITON OCCUPANCY ISSUED • °•• ATURE: • • • ••. • ° ^ m c oo acJ r.oJ