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Home My WebLink AboutX2022-0725 - PermitsNe•o City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2022-0725 £ 7. 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 2 0 7 2 5 Project No : 0652-2022 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Issued Date : 05/31/2022 °:,w.T Combination Type - BLDG ELEC Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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: 22183 (CS) NEWPORT COAST DR NB Description: COMM CELL SITE "AT&T" Legal Desc.: Owner: PELICAN CREST 11 COMMUNTYASSN 240 I NP C- I X Address: 300 N FLOWER ST Address: W GROVES Addrless: " SANTA ANA CA 92703 ORANGE CA 92867 . Phone: Phone: 714-938-0297 Phone: State Lie: Applicant: LADUA BRAD Con State Lie: 969729 Engineer: KITSTEINER ROBERT Address: 3300 IRVINE AVE 4300 Lie Expire: 08131/2022 Address: 1270 RUTLAND RD 94 , NEWPORT BEACH CA 92660 Bus Lie: BT30073771 NEWPORT BEACH CA 92660 , Phone: 909-202-3448 Lie Exp Date: 12/31/2022 Phone: State Lic:C-086713 Code Edit: 2019 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: SENTINEL INS Address: - - Occupancy Group: U Policy No: 72WEAQ10518 Added /New sq.ft. Bldg: 0 Expire: 1011212022 Phone: - Added /New sq. ft. Garage: 0 ' • , No of Stories: 0 Building Setbacks Rear: / Special Conditions: LANDSLIDE AREA , , No of Units : 0 Front: / Bldg Height: 0 Left: I Bldg Sprinklers: Right: / Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone': N Construction Valuation: $25,000.00 Building Permit Fee: $504.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $438.48 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 $48.50 Investigation Fee: $0.00 Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Record Management : $24.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee : $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 PM Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $65.97 San Dist : $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $1,133.95 Plan Check Fee : $469.17 Fee Due at Permit Issuance : $664.78 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: 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 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 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 not 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, 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). I am exempt f,6m Iicensure under the Contractors' State License Law for the following reason: By my signatum ba'ow 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 sell a structure .that' 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 Codale available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LiCFNSED CONTRACTOR'S DECLARATION hereby affirm urder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0}of Division 3 of the Business and Prof ss' Coe, aaO.0y license is in full force and eff3ct. License Class License No Dal 3f ^ :ZZ Contractor Signature WORKERS' r;^f1P=NSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUND ED TH USAND DOLLARS ($100,000), IN ADDITION TO THE CJd i OF COMPENSA":ION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. sir reuv affirm u^der 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 thi !�errormnnce of the wura for which this permit is issued. Policy No. I 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' prance carrier and policy number are: Policy Number of Agent Date 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 agre hat, if I should became subje he worke ' ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of Applicant Date % Z )ECLARATION REGAR TRUCTION LENDING AGENCY hereby affirm under p n� y of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil ode). _ender's Name / Lender's Address 3y my 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 correct. I agree to comply with all applicable city and county ordinances and s ate laws relating to building construction. I authorize representatives of this city or coun t the abov entifiefor inspection purposes. 3i nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Da " Z ACTION DATE BY DE ION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 610E TITLE 40 AND AQMD RULE PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMIT EXTENDED AQMD PERMITFINAL CERTIFICATE OF OCCUPANCYISSUED �''� %' SBESTOS NOTIFIC TION IS NOT APPLICABLE TO PROP EDbEp�10 1 INI SIGNATURE.