HomeMy WebLinkAboutF2023-0070 - Permits�EWPoR
City of Newport Beach
Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
C9</FOFN�P
newportbeachca.gov/inspections
Combination Type -
Work Class - Tenant Improvement
COMB Permit : F2023-0070
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Plan Check No : PC2023-0293
Issued Date : 02127/2023
Inspection Area : FIRE
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
Description :
Owner:
Address
Phone
888 SAN CLEMENTE DR, 150 Legal Desc : A TR IRVINE SUB BLK 55 IRVINE SUB., FOR OF BLOCK 55.
COMM FIRE ALARMS 1 DEVICE (XC2023-0035)
IRVINE CO Contractor
111 INNOVATION Address
IRVINE, CA 92618
Phone:
Applicant:
MARK YAM
Address :
392 N LEMAY CT
ORANGE, CA 92867
Phone:
(626)767-2320
Owner/Builder
:
Address :
Phone:
PACIFIC TUSK BUILDERS CORP
1100 QUAIL ST #213
NEWPORT BEACH, CA 92660
(213)999-5696
Con State Lie :
946368
Lie Expire :
04/30/2024
Bus Lie :
BT30038640
Bus Lie Expire :
03/31/2023
Workers' Compensation Insurance
Carrier: INS CO OF THE WEST
Policy No : WSD5041971
W. C. Expire : 7/1/2023
Code Edition : 2022
Fire Sprinklers :
YES
Type of Construction : II-B
Fire Hazard Zone :
NO
Occupancy Groups :
No of Units:
0
Bldg Height :
No of Stories :
4
Building Setbacks :
Flood Zone : X
Use Zone : PC - North Newport Center
PROCESSED BY: --
SPECIAL CONDITIONS:
Architect
Address
Phone:
State Lie
Engineer:
Address
Phone
Designer: BUILDING ELECTRONIC CONTROLS
Address: 2246 LINDSAY WAY
GLENDORA, CA 91740
Phone : (909) 305-1600
Construction Valuation : $2,592.00
Added/Now/Ti sq. ft. Bldg: 0
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage: 0
TOTAL sq. ft. : 0
a
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).
El 1, 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. It, 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 thepurpose 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 fallowing 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 legal
sell a structuro that I have bull) as an owner -builder if it has not been constructed in its entirety by licensed contractors.) 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.html.
Signature of Property Owner or Authorized Agent _ _ Date.
LICENSED CONTRACTOR'S DECLARATION ��//if
I hereby affirm under penalty of peg'ury that I am licensed under provisions of Chapter 9 (commencing with SecGorT\7000) of Division 3 of the Business and P ess' s Co and. m"cense is In full force
and effect. License Class License No D e 7 '2%' L3 Contractor Signatu '[_,,, "
2KERS' COMPENSATION DECLARATION / tf � U
Nat 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 ($100,090)., IN ADDRION TO THE
OF COMPENSATION, 13AMAOFS AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYe 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
ormance 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 permitis issued. My workers'
carrier and policy number are:
Policy Number Expiration Date
of Agent Phone #_
LJI certify that, in the pert rmance of the work for which this permit is issued, shall not. employ any person in any manner so as to become subject to the workers' compensation laws of California, and ogre
that, if I should become s ct to the workers' corn nsalion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applican4 ��^I'�� to �" Z�" - Z-• 3
DECLARATION RE.OAR NG CORSTRUCTION L N l AGENCY
I hereby 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 3 7, Civil Code).
Lender's Name Lenders 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 ally and countyirlirdiranGes and slate laws relating to building construction.
I authorize representatives of this city or county, a ab ve-I entitled property for inspection purposes. II
Si nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam Y� �7 b4 e-,] Oa. 2-T�1
73
ACTION DATE. BY DE RAT€ON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITI.F 40 AND AQMD RULE
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