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HomeMy WebLinkAboutXC2023-0181 - Permits04,�,,, City of Newport Beach I��I�IIII�������I��III�IIII���IIII�Community Development Department- Building Division X C 2 0 2 3 0 1 8 1COMB Permit:XC2U23-U181 100 Civic Center Drive, Newport Beach, CA 92660Plan Check No: PC2023-1280 Permit Counter Phone: (949) 718-1888Issued Date : 08/29/2023 newportbeachca.gov/civicFinal Date: Combination Type - Permit Status: Issued Work. Class - Other Inspection Area 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 : 398 VIA LIDO NORD Legal Desc : Description: COMM -INSTALL (11) PROTECTIVE BOLLARDS Owner: CITY OF NEWPORT BEACH Contractor: CALIBER PAVING COMPANY INC Architect Address : 100 CIVIC CENTER DR Address : 673 E YOUNG Address NEWPORT BEACH, CA 92660 SANTA ANA, CA 92705 Phone : Phone : (714) 556-0484 Phone Con State Lic : 657602 State Lic Lic Expire : 10/31/2024 Applicant : CAMILLE RIZKO Bus Lic: BT30055606 Engineer: Address : 912 E ELMWOOD AVE Bus Lic Expire : 06/30/2024 Address BURBANK, CA 91501 Phone: (818) 288-8847 Workers' Compensation Insurance Phone: Carrier: ZURICH INS. Owner/Builder : Policy No : WC106299304 Designer Address : W. C. Expire : 10/1/2023 Address Phone: Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $27,000.00 Type of Construction : 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: LIQUEFACTION/HIGH-DENSITY ZONE i hereby affirm under penalty of perjury that t am exempt from the Contractors' State License Lew for the reascri indicated below by the checkmark(s) I have placed next to the applicable items) ;Se4don 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 :he permit to file a signed statement that he or she is licensed pursuant to the previsions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and orofessions Code) or that he or she is exempt from ficensure, and the basis for the alleged exemption. Any violation of Section 703L8 by any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). © I, as owne 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 of improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). © I am exempt from Ilcensure under the Contractors' State License Law for the follow➢ng reason _ -- By my signature below I acknowledge that, except for my personal residence in which I must have resided for at lanst one year prior to completion of the Improvements covered by this permit Lcannot legall} soli a structure that I have built as an owner -builder if it has not boon constructed in its Primly by licenser 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:flwww.leglnfo,ca.govlealaw.html. Signature of Property Owner or Authorized Agent ..�._.—.._..—_ _.�.__.-...._ --- Data LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commanokng with Section 7000 ,of Ivfsf n 3 of the Business and Professity �;e ull fpsGe and effect. License Class License No Date] Contractor Signature, WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORE ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS P000;000)., IN AODn10N TO THE COST OF COMPENSATION, DAMAOFS AS PROVIDED FOR IN SECTION 37M OF THE LABOR CODE, INTEREST, AND ATTORNEY'a FEES. II hereby stil. . under penalty of perjury one of the following doclarations: utI e and will mainiatn a certificate of consent to SOILInaure for workers' compensation. issued by the Director of industrial Relations as provided for by Section 3700 of the Labor Code, for th part once of the Work for which this permit is issued. Policy No, _�- i 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' compensatooi insurance carrier and policy member are: (Carrier Policy Number Expiration Date no of Agent certify that, in the performance of the work for which this permit is issued, I Shall . if I should become subtegKo the ws> ¢ipensahen provts96Vof StOlwu_ of any person in any manner so as to become subject to the workers' compensation laws of California, and ogre ab ode, I shall forthwith comply with those provisions. Date— C� IraDy affirm under penalty of perjury that theta i rAna#ruction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Idor's Name Lender's Address my signature bi I Certify to each of the following: I am the property owner oraulhonzed to act on the property owner's behalf. I have read this application and the intomiation I have provided is rest. I agree to comply Win all applicable city and county an t o law i o building. construction. _ I authorize representatives of this oil" �r co irt,' a-' r l.T� -I on purposes. jI1 �.t ...,i . f Ia.....o.i n, ., ,r c Ih vori A, i ProDerty Owner's or Authorized Agent's Name J o CL_ ACTION DATE TRY GS=lA11.TION OF COfNPLI ITN GOOF. OF F£DEItAL FOR OFFICE USE ONLY Ik REGULATIONS PART 61 OF TIRV At)AND AQMD RW PERMii EXPIRED) I s L.-' I SUBMITTED ASBESTOS NOT'IFICA1ION TO PERbll7 FINAL U ASBESTOS NOT IFICATTON 15 NOT APPLICABLt TO CERTIFICATE OF �tgg PROPOSED OEMOLITtON OCCUPANCY ISSUED /n SIGNATURE: Date P,17iq