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Home My WebLink AboutXC2023-0001 - Permitsa�waoRT City of Newport Beach II IIIII I IIII IIII III III IIIIIIIIIIIIIII II D� Community Development Department- Building Division X C 2 0 2 3 0 0 0 1 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 c T Inspection Requests Phone: (949) 644-3255 1�/cOPN� newportbeachca.gov/inspections Combination Type - Work Class - Tenant Improvement COMB Permit : XC2023-0001 Plan Check No : 0188-2022 Issued Date : 0110612023 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: 2801 W COAST HWY Legal Desc : N TR 919 BLK LOT H TR 919 LOT H SELY 118.10 FT NWLY 150 FT Description: COMM TI 360 SF NEW WINDOW SYSTEM - REV2023-0030 Owner: 2751 & 2801 PCH LLC Contractor : Architect : BRANDON DEADMAN Address : PO BOX 476 Address : Address : 18004 SKY PARK CIRCLE, 200 IRVINE, CA JACKSON, WY 83001 92614 Phone: (714)403-9016 Phone: Phone: (949)757-3240 Con State Lic : State Lic: C-37432 Lic Expire : ""-' Applicant: 2751 & 2801 PCH LLC Bus Lic: Engineer : NELSON DAVID Address : PO BOX 4976 Bus Lic Expire : Address : 43180 BUSINESS PARK DR STE 200 ' JACKSON, WY 83001 TEMECULA, CA 92590 Phone : (714) 403-9016 Workers' Compensation Insurance Phone : (951) 695-7101 Carrier : Owner/Builder : 2751 & 2801 PCH LLC Policy No: Designer: Address : PO BOX 4976 W. C. Expire: Address JACKSON, WY 83001 ' Phone: (714)403-9016 Phone: Code Edition : 2019 Fire Sprinklers : YES Construction Valuation 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 : Bldg Height : No of Stories : 3 Added/New sq. ft. Garage : 0 TOTAL sq. ft. 0 Building Setbacks Flood Zone : AE, 8 FT; X; X Use Zone : MU-W1 - Mixed -Use Water PROCESSED BY: �� SPECIAL CONDITIONS: �.iy! OWNER -BUILDER DECLARATION I hereby affirm under penaltyof perjury that! am exempt from the Contractors' State License Law for the reasons) 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 To permit to file a signed statement that lie 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 Tofessions Code) or that he or she is exempt from licensure and the basis for the alleged exemp€ion. 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 ($500), 3 I, 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 -guilder will have the burden of proving that it was not built or nproved for the purpose of sale). 13 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 Doty 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), am exempt from licensure under the Contractors' State License Law for the following reason: ly 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 lerprovements Covered by this permit, I cannot legally all a structure that I have built as an owner -builder if it has not peon constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and rofessmns Code., Is available upon request when this appli submitted or at the following Web site:http:ll.leginfo.�.gov/calaw.htmt. ignature of Property Owner or Authorized Agent _ I Date_ ACENSED 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, and my license is In full force nd effect. License Class License No Date Contractor Signature VORKERS' COPIDzNSATION DECLARATION IARNINC: FAILURE TO SEN I+RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNOREO THOUSAND DOLLARS ISt00A00L IN ADDITION TO THE C 3T OF CC MPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3TOS OF THE LABOR CODE. INTEREST, AND AT I ORNEY'S FEES. h Treby affirm under T?7-i ty of perjury one of in 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 forn,ance of the work for which this permit is issued. Policy No. I hive and will rn,irfem 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' compensa urance carrier and policy number are: Policy Number of Agent Date mortify that, in C.e pLr.orrranee 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 if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ret,r•i of Appt:art T„ _ Date^____ CLARATION KLG. kDING CONSTRUCTION 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). idei 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 applicablecity and county ordinances and ate laws relating to building construction. I authorize representatives of this city or county to enter the. bov -1 tilled property for inspection purposes. ACTION I DATE BY DECLARATICN-OPffM'fPLIANCE W17H CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 51 OF TITLE 40 AND AQMD RULE 1403 PERMiT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITF1NAL LU ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTiFiCA]TE OF PROPOSED DEMOLITLISN OCCUPANCY i55UED i��Z� SIGNATURE: _�aT\