The URL can be used to link to this page

Home My WebLink AboutX2022-0726 - Permitso��gwvoRr City of Newport Beach Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 r Inspection Requests Phone: (949) 644-3255 CqC/FOAN�P newportbeachca.gov/inspections Combination Type - ELEC Work Class - Other X 2 0 2 2 0 7 2 6II COMB Permit: X2022-0726 Plan Check No : 0653-2022 Issued Date : 0111912023 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 : 1111 CAMELBACK ST Description : COMM CELL SITE "AT&T" Owner: DSI NEWPORT GROWTH & INCOME FUND Address : 1111 CAMELBACK ST NEWPORT BEACH, CA 92660 Phone: Applicant: BRAD LADUA Address: 3300IRVINE AVE,300 NEWPORT BEACH, CA Phone : (949) 387-1265 Owner/Builder : Address: Phone Legal Desc : Contractor: ERISSON INC DBA E US INC Address: 6300 LEGACY DR PLANO TX 75024, CA Phone : (469) 266-7025 Con State Lic : 698896 Lic Expire: 11/30/2024 Bus Lic : BT30052827 Bus Lic Expire : 10/31/2023 Workers' Compensation Insurance Carrier: ACE AMERICAN Policy No : WLRC50734936 W. C. Expire: 11/1/2023 A`. Architect Address Phone: State Lic Engineer: KITSTEINER ROBERT Address : 1270 RUTLAND RD #4 NEWPORT BEACH, CA 92660 Phone: (951) 833-0027 Designer: Address Phone: Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $15,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 Occupancy Groups : U No of Units : 0 Alteration sq. ft. Bldg : Bldg Height: No of Stories : 0 Added/New sq. ft. Garage: 0 TOTAL sq. ft.: 0 Building Setbacks Flood Zone Use Zone: .. .,° ° , PROCESSED BY: ° SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable liem(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). 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or [_,) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The ContractorsState 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). 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Slate License Law does not ap ty to an owner of property who builds or Improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I 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 most have resided for at least one year prior to completion of the improvements covered by this permit, I. cannot legal) sell a structure that I have built as an ownor-builder if it has not been constructed in its entirely 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/hvww.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 Section O0) of Divi ion 3 of the Business and PrtTOUSAND ode and m Ii ' In full force and effect. License Class License No Date Contractor Signatur WORKERS'COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRDOLLARS ($100,000), n'ION TO THE COST OF COMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1 hereby affirm under penalty of perjury one of the following declarations: El 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 thf performance 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' compensatio surano, carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # DI 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 that, if I should become Obirlrua workers' ensati ' ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant_. CIS �9�2_, DECLARATION F CONSTRUCTI LENDING A EN 1 hereby affirm under en of perjury that there is a constru ding agency for the performance of the work for which this permit is issued (Section 3097, C II Code). Lender's Name Lender's Address By 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 couny ordinances and slate laws relating to building construction. Q I authorize representatives of this clTy or cou ty ha a'o ' ' rty for inspection purposes. Etta[ ( l Z Signature of Pro Sri Owner or Authorzed Anent -` Print Property Owner's or Authorized Agent's Name aLACW_ ACTION DATE BY OECLAFU T -0F COMPLIANICLIOTH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED _ 3CBkIITTEI:AS6FSTOSNOTIFiCATIONTO PERMITCANCELLED �U-r'E—PA PERMIT EXTENDED--_'J�TI InQMO_-__-------� PERMIT FINAL j y3 f I L,-t ASBESTOSNOTIFICATION15NOl'APPLICABLp t0 CERTIFICATE OF J PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: