HomeMy WebLinkAboutF2023-0083 - PermitsO�aEWPO� F City
mm Of Newportnity Development Department ar- Building Division II IIIII IIIIII II IIIIII IIIIII II III II II IIIII IIII III II COMB Permit : F2O23-0083
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2023-0344
Permit Counter Phone: (949) 718-1888 Issued Date : 05/05/2023
U \r x newportbeachca.gov/civic Inspection Area : FIRE
�gc,coa" Combination Type -
Work Class - Tenant Improvement
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 : 3050 COAST HWY E Legal Desc : N TR 323 BILK P LOT 6 TR 323 LOT 6 BLK P ALL -EX HWY-
Description: COMM - CO2 MONITORING SYSTEM'CHIPOTLE MEXICAN GRILL'
Owner: HUGH CARSON FAMILY LLC
Address: 3050 E COAST HWY
CORONA DEL MAR, CA 92625
Phone
Applicant: REID CLIVE F
Address: 3109 WILLOWBROOK AVE
PALMDALE, CA 93551, CA 93551
Phone: (702) 844-8428
Owner/Builder :
Address :
Phone
Contractor :
REID CLIVE F
Address :
3109 WILLOWBROOK AVE
PALMDALE, CA 93551, CA 93551
Phone :
(702) 844-8428
Con State Lic
: 817727
Lic Expire :
05131/2024
Bus Lic:
BT30068282
Bus Lic Expire : 07/31/2023
Workers' Compensation Insurance
Carrier:
Policy No: EXEMPT
W. C. Expire:
Code Edition :
2022
Fire Sprinklers : YES
Type of Construction :
V-B
Fire Hazard Zone : NO
Occupancy Groups :
No of Units : 0
Bldg Height:
No of Stories: 1
Building Setbacks
Flood Zone :
Use Zone:
X
-Commercial Corridor
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PROCESSED BY: 1-t
SPECIAL CONDITIONS: HIGH-DESNITY ZONE ON THE WeEKeND
Architect
Address:
Phone:
State Lic
Engineer
Address
Phone:
Designer: REID CLIVE F
Address: 3109 WILLOWBROOK AJ--
PALMDALE, CA 93551, CA £3551
Phone: (702)844-8428
Construction Valuation : $1,075.00
Added/New/TI sq. ft. Bldg : 0
Alteration sq. ft. Bldg:
Added/New sq. ft. Garage : 0
TOTAL sq. ft. 0
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 itertn(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
ne 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 '..
at more than five hundred dollars ($500).
3 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
USmess and professions Code: The Contmctorv' 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
nprovements 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
nproved for the purpose of sale).
-1 1, 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
poly 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 I am exempt from licensors under the Contractors' State License Law for the following reason
y 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, 1 cannot legally
all a structure that I have bull( 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
'rofessions Code., is available upon request when this application is submitted or at the following Web site:http://www.leginfo.m.gov/calsw.btmi,
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing With Section 7000) of Division 3 of the Business and Professions Code, andp license is in full force
no effect. License Class License. No Date US/r7 S,/Ro 4.5 Contractor Signature
VORKERS' COMPENSATION DECLARATION
ARNINGI 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 (8100,1MUL IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3T06 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES -
hereby affirm under 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 th<
adormance of the ww� for which this permit is Issued. Policy No.
.1 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' compensatior
i.,urance carrier ann policy number are:
Policy Number
of Agent
Date
31 certl..-y that. in the prfrforn-18no9 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 egret
iat, if I r•hould become joKlect to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
iigrlrAtur� - Date os�0.5/ zo z3
iECLARATION REGARDING CONSTRUCTION LENDING AGENCY
h3:'r; 3"flrm 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, Civil Code)
enders Name Lender's 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 appucation and the Information 1 have provided is correct.
I agree to comply with all applicable City and county ordinances and sta aws relating to building construction.
I authorize representatives of this city or county to enter the above ntified 2ro erty for inspection purposes.
Signature of Property Owner or Authorized Agent dnl Property Owner's or Authorized A ent's Name E&J L9Ua 6R Date 0 0'
ACTION DATE BY DECLARATION Of COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIrCANCELLED
PERM FFrN1 5 LMWBESTOS NOT] FICAI'ION 15 NY APPLICABLE TO
%.fr-r�-- I //✓ A/�f ,(/ PROPOSED DEMOLITION
D I SIGNATURE: .,yam