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HomeMy WebLinkAboutX2021-1973 - PermitsoRT City of Newport Beach �a�w p d Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 u ` Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 newportbeachca.gov/inspections Combination Type - ELEC MECH PLUM Work Class - Tenant Improvement X 2 0 2 1 1 9 7 3COMB Permit : X2O21-1973 Plan Check No : 1726-2021 Issued Date : 0312112023 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 : 949 W 16TH ST Legal Desc : A TR FIRST ADD TO NEWPORT MESA TR BILK LOT 1013 FIRST ADD. TO NEWPORT MESA TR LOTS 1013 & Description: PUBLIC -USE -NEWPORT BEACH UTILITY YARD OFFICE REMODEL (BLDG 5) 934 SF Owner: CITY OF NEWPORT BEACH Address : 100 CIVIC CENTER DR NEWPORT BEACH, CA 92660 Phone Applicant: CITY OF NEWPORT BEACH Address : 100 CIVIC CENTER DR NEWPORT BEACH, CA 92660 Phone: Owner/Builder : Address: Phone Contractor: J T CONST GROUP INC Address : 1730 EVERGREEN STREET DUARTE, CA 91010 Phone : (626) 500-0404 Con State Lic: 1011456 Lie Expire : 02/29/2024 Bus Lie: BT30081012 Bus Lie Expire : 03/31/2024 Workers' Compensation Insurance Carrier: INS CO OF THE WEST Policy No: WVE505001403 W. C. Expire : 8/8/2023 Architect Address Phone: State Lie Engineer: EDWARD LOK NG Address: 1511 COTA AV LONG BEACH, CA 90813 Phone: (562)912-7900 Designer Address Phone: Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $149,999.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 Occupancy Groups : B No of Units : 0 Alteration sq. ft. Bldg : 934 Bldg Height: No of Stories : 1 Added/New sq. ft. Garage : 0 TOTAL sq. ft. : 0 Building Setbacks Flood Zone : X Use Zone : PF - Public Facilities BY: 111 ' PROCESSED SPECIAL CONDITIONS: "' ' 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 Items) 'action 7031.0, Business and Professions Cade, 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 to permit to file a signed statement that he or she is Teensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and rofesslons Code) or that he or she is exempt from tloensure, 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 ($500j, 11, 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, usiness 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 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 thepurpose of sale). 3 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 ly 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. y my signature below I acknowledge that, except for my personal residence in which I must have melded for at least one year prior to completion of the improvements Covered by this permit, I cannot legally all a structure that I have built as an owner -budder if ithas not been constructed in its entirely, by licensed contractors. I understand that a copy of theapplicable law, Section 7044 of the Business and ^rofessions Code, is available upon request when this application is submitted prat the following Web siteihttp:liWww.leginfo.ca.gov)oalaw.html. 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 Pr fessions Code, and my license is In full force no effect. License Class License No Dole,,/ Z- r / e 3 Contractor Signatu� � VORKERS' COMPENSATION DECLARATION ARNING: 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 L$100,000), iN ADDITION TO THE OST OF COMPENSATION, DAMAG€SAS PROVIDED FOR IN SECTION 3706 OF THE LAaOR CODE, INTEREST, AND AttORNEY'S FEea hereby affirm under penalty of perjury one of the following deelarahons: �f 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 Kormance 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 permit is issued My workers` Carrier and policy number are: Policy Number of Agent Date certify that, in the performance of the work for which this parrnit is issued, I Shall not employ any person IT; any manner so as to become subject to tno workers' Compensation laws of California, and agre t, if I should become subject to wdrk ` Com�en_satton provisions of Saeliart 3700 of the Lobar Code: shalffnrthwith Comply with those provisions. nature of Apptican '`—� D Z fZTi CLARATIGN R8G DING C NSTR CTION LENDING AGENCY areby 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 3097, Civil Code). ider's Name Lenders Address 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 county ordinances and state laws relating to building construction.. I authorize representatives of this city or ewrLtty to enter_We above -identified property for inspection purposes. v ACTION DATE R'r\l' DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS. PART 61 OF TiTLt 40 AND AQMD RULE 1403 P€RM€T EXPIRED LJ i sU6h1I ,TED AEI F.STO.r. NOTI FICAT1M' TC PERMIT CANCELLED EPA PERMiTEXTEND£D _ PERMITFINAL MASBESTOS NOTIFICATION i NOT APPLICAHiE TO CERTIRCATEOF / PROPCISrrb OUTION OCCUPANCYISSUED SI AATtRE Zr