HomeMy WebLinkAboutX2021-3031 - Permits1>rs�
City of Newport Beach- Building Division
*X2021-3031*
COMB Permit: X2021-3031
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-328,8
Project NO : 2634-2U21
u m
Inspection Requests Phone (949)644-3255
Combination Type - CIP ELEC MECH PLUM
INSC-
Issued Date : 01/18/2022
1
Inspection Area : 7
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0111812025 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: 610 NEWPORT CENTER DR NB St: 1 FI: ll
Description: COMM TI'CHIPOTLE MEXICAN GRILL' 15282 SF
Legal Desc.: P BK 295 PG 33 PAR 4
Owner: 610 NEWPORT CENTER DR LLC Contractor: RENAULT 8 MORAN CONSTRUC. Architect: BROWN RUSSELL L JR ....
Address: 660 NEWPORT CENTER DR - Address: 19900 MACARTHER BLVD #600 Address: 1160 SANTA FE DR
NEWPORT BEACH, CA 92660 IRVINE CA 92612 DENVER CO 80204
Phone: 0 0 °
Phone: °000„ oO°oO 949-012-6500 Phone: 303-571-4137 State Lic:CO20920 0
Applicant: MONTEJANO NELLIE
Con State Lic: 1036156
Engineer:
o
° °
Address: 2420 RIVER RD STE 230-915
Lic Expire:
04130/2022
Address:
NORCO CA 92860
Bus Lic:
c
BT30065288
o .....
°
Phone: 951-357-6916
Lic Exp Date: 12131/2022
Phone:
State Lic:
0
Code Edit : 2019
Worker's Compensation Insurance
P
Designer.
Type of Construction: I-A-SPR
Carrier:
EVEREST
Address:
.... ,
Occupancy Group: B
Policy No:
7600021597211
Added /News .ft. Bldg:15282
qExpire:
06/12/2022
Phone:
o 00
Added /New sq. ft. Garage: 0
No of Stories: 18
Building Setbacks
Rear: /
Special Conditions:
No of Units : 0
Front: /
Bldg Height: 0
Left: /
Bldg Sprinklers: Y
Right: I
Flood Zone: X
Use Zone:
Parking Spaces:
0
Fire Hazard Zone : N
Construction Valuation: $672,408.00
Building Permit Fee: $4,737.00
Plan Check Fee: $4,121.19
Excise Tax:
Additional Fee :
$0.00
$0.00
Planning Department -
Fire Department
Overtime Plan Ck: $0.00
Grading Bonds Fee:
$0.00
Plan check Fee :
Fair Share :
$52.00
$0.00
Fire Inspection:
$0.00
Investigation Fee: $0.00
Grading PC Consultant :
$0.00
SJH Trans :
$0.00
Fire Plan Rev
Demolition Fee
$773.00
Record Management: $226.00
Energy Compliance: $470.69
Grading Permit Fee:
$0.00
In -lieu Housing Fee :
$0.00
Building Dept Adm
$26.00
CA Seismic Safety: $0.00
Grading PC Fee:
WQ Insp. Fee:
$0.00
$0.00
Public Works Department -
General Service
$219,00
Disabled Access : $672.41
Park Dedication :
$0.00
Refund Deposit
$564.00
Hazardous Mat $0.00
Electrical %: $1,240.15
PAN Plan Check:
San Dist:
$0.00
Grading Bond:
$0.00
Building Green Fee : $27.00
Mechanical %:
$974.40
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$797.24
$0.00
$0.00
TOTAL FEE : $14,900.08
Plan Check Fee:
$6,818.09
Fee Due at Permit Issuance :
$8,081.99
PROCESSED BY:
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
1 `
PLAN CHECK
BY:
GRADING APPROVAL:
APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION
1 hereby affirm under perhalty of perjury that I am exempt4om the Contractors' State License Law for the reason(s) Indicated below by the checkmark(s) I have placed nerd to the applicable items)
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to cons"cL alter, improve, demolish, or repair arty structure, prarto Its issuance, also requires the applicant for
the permit to file a sighed 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 goensure 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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do U ail 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 Ia sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
M roved for the purpose of sale).
LJ 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
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, 1 cannot legally
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 s'de:http:;Avm.legbdo.ca.gmicalaw.htrnl.
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 Secti 0) of Mon 3 of the Business and P ons Cade mt cens is in fug force
and effect. License Class R License No 103 R Isco Da Contractor Signature
jYORKERS' COMPENSATION DECLARATION
RMUGN : FAILURE TO SECURE VVORKERS' COMMMU17ON COwaiAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMNAL PENALTIES Aral CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (610a,000), IN ADDITION TO THE
COSTOFCOMPENSATION, DAMAGES AS PFKMMD FORIR SECTION 3M OF THE LASORCODE, INMEREST, ANDATTORNErS FEES.
hereby affirm under penalty of perjury one of the following deciarations:
❑ 1 have and will maintain a Certificate of consent to selMnsure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the labor Code, for the
)Vbrmance OF the work forwhCh this permit Is Issued. Policy No.
have and will maintain 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' compen
rance carrier and policy number are:
der pv2sf lkr rnieY IhILS1T Qt 1C f a Policy Number 1G OOA 21.-5=I Exp kation Date Cn% L2 22
leorAgent Ka►Atn & McLennan AOt nc-q r LCG Phoned Q- 5 n!1
certify that, in the performance of the work forwhidi this permit is issued, I shall not employ arty person In any manner so as to become subject to the workers' compensation laws of California, and
, if I should b a Jed to the Ions of Section 3700 of the Labor Code I shag forthwith com y with those rovis"ro ns
P P
store ofJWlicant i Date
:LARATION REGA D G CO L ING AGENCY
+coy affirm under penalty of perjury that there is lit construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civil Code).
fer's Name Lender's Address
ny Signature below, I certify to each of the fallowing:
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 cored.
1 agree to Comply with all applicable city and county ordinances and state laws relating to bulkfmg construction.
I authorae nepresenta"115 of this city er courl eats h— aheTe End property for inspection purposes. a j
BY
PART 61 OF TOLE 40AND AQMD RULE
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PERMIIEXPIRED I I %O I SuBMrrMD ASBESTOS NOTIFICATION TO
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