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HomeMy WebLinkAboutX2021-2955 - Permits (2)City 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 MECH PLUM *X2021-2955* 7-D COMB Permit: X2021-2955 Project No : 0451-2020 Issued Date: 10/2912021 Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 10/29/2024 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 Ft: 13 Description: COMM TI - "CHIPOTLE MEXICAN GRILL CORPORATE OFFICE" 13,565 SF *CHANGE OF CONTRACTOR* Legal Desc.: P BK 295 PG 33 PAR 4 Via.°oa Owner: COSTELLO JAMES W Contractor: RENAULT & MORAN CONSTRUC. Architect: BROWN RUSSELL L JR ° Address: 660 NEWPORT CENTER DR Address: 19900 MACARTHER BLVD #600 Address: 1160 SANTA FE DR ° a a NEWPORT BEACH, CA 92660 IRVINE CA 92612 DENVER CO B0204 Phone: Phone: 949-412-6500 Phone: State Lic:CO20920 ° Applicant: MONTEJANO NELLIE Con State Lic: 1038156 Engineer: a °m Address: 4740 GREEN RIVER RD #102 Lic Expire: 04/30/2022 Address: CORONA CA 92617 Bus Lic: BT30065288 Phone: 951-720-2562 Lic Exp Date: 1213112021 Phone: State Lic: °°.ao ° Code Edit : 2019 Type of Construction: 1-A-SPR Occupancy Group: B Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 18 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Y Flood Zone, X 11 Construction Valuation: Building Permit Fee: Plan Check Fee: $0.00 Overtime Plan Ck: Investigation Fee: Record Management: Energy Compliance: CA Seismic Safety: Disabled Access Hazardous Mat Building Green Fee PROCESSED BY: 0 0 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL FEE: $38.00 ZONING APPROVAL: Worker's Compensation Insurance Carrier: LANDMARK AMERICAN Policy No: LHA141338 Expire: 01/18/2022 Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WO Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: / Front: / Left: / Right: / rking Spa $0.00 $38.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 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 Fire Department $0.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: Plan Check Fee : $0.00 Fee Due at Permit Issuance : PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: _. APPROVAL TO ISSUE: 0 00 0 0 0 0 0 00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $38.00 00 0 0 0 a3a 0 aaaoo 0 aomao ooaao° ° o 0 0 0 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 'rofessions 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 U 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). 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 Ipply to an ovVer otproperly who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I am exeVpllrom licensure under the Contractors' State License Law for the following reason: 3y ml signature bejow 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 legalll leTl a,stmcture thy-l'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 Irof.essions Cor%, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html. it@nature of Property Owner or Authorized Agent Date JUNSED PONT&ACTOR'S DECLARATION hereby affirm tlAder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio%70,,o1,Dv,,son, i3 of the Business and Pr ssions Code, and m rlicense is in full force rnd9ffect. LioeeseElass License No Da12Contractor Sig natur ,.G41>la VORKERS' 00WENSATION DECLARATION MRaING: FAILURE t0 SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE MWOf COMPENSA.TIOAI.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. Arab; affirmgLoggr penalty of perjury one of the following declarations: "f flave and wiill�rrIllintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th Igoerrnance oftte work for which this permit is issued. Policy No. and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' carrier and policy number are: Policy Number Expiration Date of Agent I certify that, in the performance of the work forwhich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre It, if I should become subject olth�elworkeers' comp% sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ` Inature of Applicant •�je6&4 �-�-- Dat� L &Cj /'2 / !CLARATION REG DI eNSTRUCTION LENDING AGENCY ereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, II Code). rider's Name Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county Npter the 77above-identified roperty for inspection purposes. mature of Prooertv Owner or Authorized Agent 1 Print Property Owners or Authorized Agent's Name X r,J&$Z)I) I2"C�A)_ Da f - (i i ACTION PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATEOF OCCUPANCY ISSUED DATE BY rDECLARATION OF I REGULATIONS PA PART TIIT E 40 AND AQMD RULECE WITH CODE OF FOR OFFICE USE ONLY 1Z-5-All L I SUBMITTED ASBESTOS NOTIFICATION TO EPA IS NOTAPPLICABLE TO