HomeMy WebLinkAboutX2022-0780 - Permits��%Po,F City of Newport Beach - Building Division II IIII IIIIIII�I I II III IIII IIIII� II COMB Permit: X2022-078
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 2 0 7 8 0 Project No : 0696-2022
Permit Counter Phone (949)644-3288
.4r. Inspection Requests Phone (949)644-3255
Combination Type - CIP MECH ELEC PLUM Issued Date
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: 4601 JAMBOREE RD INS
Description: COMM CHANGE OUT (E) ROOF
MOUNTED A/C
Legal Desc.: IRVINE SUB LOT 138 ELK 50 POR OF LOT
Owner: COUNTY OF ORANGE
Contractor:
MESA ENERGY SYSTEMS ING Architect:
Address: 2860 GATEWAY OAKS DR#400
Address:
2 CROMWELL
Address:
SACRAMENTO CA 95833
IRVINE CA 92618
Phone:
Phone:
949-460-4601
Phone: State Lic:
Applicant: HICKY SEAN
Con State Lic:
611215
Engineer:
Address: 2 CROMWELL
Lic Expire:
0113112023
Address:
-
IRVINE CA 92618
Bus Lic:
BT98039750
Phone: 949-244-1341
Lic Exp Date:
12/3112022
Phone: State Lic:
Code Edit : 2019
Worker's Compensation Insurance
Designer: VON DISESEL KENNETH
Type of Construction:
Carrier:
AMERICAN CASULATY INS Address: 2 CORNWELL
Occupancy Group: B
Policy No:
WC7015294385
IRVINE CA 92618
Added /New sq.ft. Bldg: 0
Expire:
1010112022
Phone: 714-420-2400
Added /New sq. ft. Garage: 0
No of Stories: 0
Building Setbacks
Rear: /
Special Conditions:
No of Units : 0
Front: /
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: I
Flood Zone: X
Use Zone: Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $9,260.00
Building Permit Fee: $249.00
Excise Tax:
$0.00
Planning Department - Fire Department
Plan Check Fee: $216.63
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: $6.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee : $0.00 Building Dept Adm
$0.00
Energy Compliance: $61.00
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
P/W Plan Check: $0.00 Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical W
$65.19
San Dist: $0.00 _
Building Green Fee : $1.00
Mechanical %:
$51.22
NMUSD Fee: $0.00
$0.00
Plumbing %:
$41.91
$0.00
TOTAL FEE : $743.95
�-
Plan Check Fee :
$311.96 Fee Due at Permit Issuance : $431.99
PROCESSED BY:
-- PJBLIC 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 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).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) 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 legall,
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://w .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 ection.04 of ivis'on 3 of the Business and ions C de,Id my license is in full force
and effect. License Class License No Date 3 74-1 Contractor Signatur
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI L PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 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
perf9(mance of the work for which this permit is issued. Policy No.
and will In workers' co(npel�sation 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 a d p number are: // (�\
Date
of Agent
certify that, in the performance of the worAor 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
if I should become sulIffiect to ttye workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of Applicant
Dde_'�_ __L
IECLARATION REG,�RDING CONSTRUC ION LENDING AGENCY
hereby affirm under Penalty of perjury t there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
ender's Name Lender's Address
y 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.
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 toVnyr the aboX� kntiUed property for inspection purposes. /' O
Owner's or Authorized AD
ACTION DATE BY / DECLARATION I REGULATIONS PARR61OFICPLIA0 TIITLE 40 ANDCE WITH OAQMD RULEDE OF RAL FOR OFFICE USE ONLY
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINALCERTIFICATE
OCCUPANCYISF
OCCUPANCY ISSUED
V
RED ASBESTOS NOTIFICATION TO
NOTIFICATION,JSNOTAPPUCABLE TO
Y1 TT IC
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