HomeMy WebLinkAboutXC2023-0009 - Permits��WPOQT
City of Newport Beach
Q @
Community Development Department- Building Division
�j
100 Civic Center Drive, Newport Beach, CA 92660
u
T
Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
cgUvOM1N�P
newportbeachca.gov/inspections
Combination Type -
Work Class - Tenant Improvement
������������ II COMB Pel-mit : XC2023-0009
Plan Check No : jL,%.Svtq
Issued Date: 01/18/2023
Inspection Area : 7
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address: 121 MC FADDEN PL Legal Desc : A TR NEWPORT BEACH CITY BLK 21 LOT 15 NEWPORT BEACH CITY BLK 21 LOT 15 AND BLK 21
LOT
Description: COMM OCCUPANCY LOAD INCREASE (CUP2019-013), FIRE SPRINKLERS, UNDERGROUND FIRE LINE & FIRE ALARM
Owner: NEWPORT TACO LLC
Contractor :
Architect : HILL JOHN STEVEN
Address : 3334 E COAST HWY, 418
Address :
Address : 3195-B AIRPORT LOOP DR COSTA MESA,
CORONA DEL MAR, CA 92625
,, . CA 92626
Phone: (949)813-5683
Phone:
Con State Lic :
Phone: (714)825-8888
State Lic
Lic Expire :
, ,,
Applicant: NEWPORT TACO LLC
Bus Lic:
Engineer: °„Z,
Address : 3334 E COAST HWY, 418
Bus Lic Expire :
Address
CORONA DEL MAR, CA 92625
Phone : (949) 813-5683
Workers' Compensation Insurance
Phone
Carrier :
Owner/Builder : NEWPORT TACO LLC
Policy No:
Designer
Address : 3334 E COAST HWY, 418
W. C. Expire:
Address
CORONA DEL MAR, CA 92625
Phone: (949)813-5683
Phone:
Code Edition : 2016
Fire Sprinklers :
YES
Construction Valuation: $5,500.00
Type of Construction : V-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg : 0
Occupancy Groups : A-2
No of Units :
0
Alteration sq. ft. Bldg :
Bldg Height :
No of Stories :
2
Added/New sq. ft. Garage: 0
TOTAL sq. ft.: 0
Building Setbacks:
Flood Zone : X
Use Zone : MU-W2 - Mixed -Use Water
PROCESSED BY: AI / I
Tvf"k �Wte �tr Q�TT
SPECIAL CONDITIONS:
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 fteri
Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolishr or repair any structure, prior to its issuance, also requires the applicant for
io 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 lieensure 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
of more than five hundred dollars (S500),
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employeesor personal effort, builds or improves the property, provided that the
nprovements are not intended or offered for sale. If, hnwever, 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
nproved 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
'an owner of propertywhobuildsorImproexemptfromIic0 SureundertheContragnalure below I cknowledge that,excepoil" un' that I have built as an Owner-buildor if it has not been constmctod in its entirety by lieonsed contractors. I unders4nnd that a copy of tho applicable law, Section 7044 of Iho Businoss and
'rofessions Code, is available upon request who
ht appllc 'b -s submit)¢d or at t following Web site:httpalwww.leginfo.ca.gov/calaw:html. l
ignature of Prpperty Owner or Authorized Agent
10ENSED CONTRACTOR'S DECLARATI
hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9- (commencing with Section 7000) of Division 3of the Business and Professions Code, and my license is in full force
nd effect. License Class License No Date Contractor Signature
COMPENSATION DECLARATION
rARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CINL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (S100,000), IN ADDITION TO THE
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 5706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
I 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 Or(
erformanpe of the work for which 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'
rance carrier and policy number are:
Policy Number
Agent
Date
ZR car)fy that, in the performance of the work for which this permit is Issued, I shell not employ any person in any manner so as to become subject to the workers' Compensation laws of California, and agree
to , if I •hould become subject�Ibeoke�rs* of Section 3700 of the Labor Code I shall forthwith comply with those provisions. Ilgna re hI.fiRATION REGAR9iI�0
hereby affirm under penalty - perjury that them is a construction landing agency for the perfiormence of the work for which this permit Is issued (Section 3097. Ivil Code).
Pndor s Name Lenders Address
ly 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. Y • t at ?'CU 4 O
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 erfief jibe above -identified property for irspectior purpoTes.
Date
ACTION DATE RY 1 ATION OF COMPLIANCE 1NITH CODE OF FEDERAL FOR OFFICE USE ONLY
OL VTIONS PART 61 OF TITLE 40 AND AQMD RULE
1403 PERMIT EXPIRED — i I SUBMITTED ASBESTOS NOTIFICATION TO
PFRN11TEXTENDED
I L_LAQMD
P[RMITANAL
tJ ASRE51US NOTIFICATION IS NO] APPUCA13U TO
CERTIFICATE OF
PROP05ED DEMOLITION -
OCCUPANCYISSUEO
SIGNATURE::