HomeMy WebLinkAboutX2021-0658 - Permitswi r; City of Newport Beach - Building Division 1111111111111111 HE H 111 COMB Permit: X2021-065
x rfi2� P 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 0598-2021
r~ } s Permit Counter Phone (949)644-3288
.^ Inspection Requests Phone (949)644-3255
Combination Type - CIP MECH ELEC Issued Date : 08/10/2021
CilYiY'�+
Inspection Area : 2
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0811012024 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 orHglidays
Job Address: 200 W PROMONTORY DR NB 4
Description: COMM CHANGE OUT (16) A/C UNITS ON ROOF OF CLUBHOUSE .�
Legal Desc.: PARCEL MAP 49-15 PAR 1 POR OF PAR
Owner: IRVINE COMPANY Contractor: SUBCOOLING HEATING 8 AIR Architect:
Address: 550 NEWPORT CENTER DR Address: 43397 BUSINESS PARK DR, STE D2 Address:
NEWPORT BEACH, CA 92660 TEMECULA CA 92590
Phone: Phone: 951/587-3887 Phone: State Lic:
Applicant:
KEMP KATHY
Address:
3675 RUFFIN RD #320
SAN DIEGO, CA 92123
Phone:
951-587-3887
Code Edit : 2019
Type of Construction:
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units : 0
Bldg Height: 0
Bldg Sprinklers:
$15,000.00
Building Permit Fee: $334.00
Plan Check Fee: $290.58
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management :
$26.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $859.72
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Con State Lic:
1072513
Lic Expire:
01/31/2023
Bus Lic:
BT30069434
Lic Exp Date:
1013112021
Worker's Compensation Insurance
Carrier: COMPWEST INS CO
Policy No: WCV5504431
Expire: 08/31/2021
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing W
Rear: /
Front: /
Left: /
Right: /
Engineer
Address:
Phone: State Lic:
Designer: DAVID EDUARDO A
Address:
Phone:
Special Conditions:
Zone :N
$0.00
Planning Department-
Fire Department
$0.00
Plan check Fee:
$52.00
Fire Inspection:
$0.00
$0.00
Fair Share :
$0.00
Fire Plan Rev
$0.00
$0.00
SJH Trans :
$0.00
Demolition Fee
$0.00
In -lieu Housing Fee :
$0.00
Building Dept Adm
$0.00
$0.00
Public Works Department -
General Service
$0.00
$0.00
Park Dedication : $0.00
Refund Deposit
$0.00
PAN Plan Check: $0.00
Grading Bond:
$0.00
$87.44
San Dist: $0.00
$68.70
NMUSD Fee: $0.00
$0.00
$0.00
$0.00
Plan Check Fee
: $365.90 Fee Due at Permit Issuance :
$493.82
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
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 L) 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 forthe 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://www.leginfo.ca.gov/calaw.htmi.
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 700D) of ivision 3 of the Business and Professions Cod e, and my license is in full force
and effect. License Class License No Date tCr� Contractor Signatl,I$e�_ uL`
WOR?ERS' ;CMP NSATION DECLARATION
WARNING: 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 ($100,000), IN ADDITION TO THE
COnT OF COMPENSA, ION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under oanalty of perjury one of the following declarations:
J' 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 the
p€Pfgrmance of the 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
o° Agent
Date
certify that,'Iri the'p^rformance 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
if I should become subjec p the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Q
O"
of Applicant
Date / kb•? A
CLARATION RE,iAF DING CONSTRUCTION LENDING AGENCY TT
:reby 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
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.
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 to er the aJyove-identified property for inspection purposes.
nature of Prooertv Owner or Authorized AGent Y Print Prooertv Owner's or Authorized Aoent's Name
ACTION DATE Bi° DECLARATION OF CMPLIANCE WITH CDE OF FEDEI REGULATIONS PA T061 OF TITLE 40A DOAQMD RULERAL FOR OFFICE USE ONLY
PERMIT EXPIRED
LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
DEPA
PERMIT EXTENDED
LJAQMD
PERMITFINAL
CERTIFICATE OF
OCCUPANCY ISSUED
D A— .-.
FbA
!)
0 ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
PROPOSED DEMOLITION
SIGNATURE:
Civil Code).
Date