HomeMy WebLinkAboutXC2022-1971 - Permits4aeWPoRT City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XC2U22-1971
Community Development Department- Building Division X C 2 9 2 2 1 9 7 1
�y 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2022-2409
Permit Counter Phone: (949) 644-3288 Issued Date : 1112912022
Inspection Requests Phone: (949) 644-3255 Inspection Area : 7
Cq</FpµN�P newportbeachca.gov/inspections
Combination Type - ELEC MECH PLUM
Work Class - Tenant Improvement
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: 450 NEWPORT CENTER DR, 650
Legal Desc : P BK 61 PG 10 PAR 1
Description: COMM TI "RAJ CAPITAL" 4960 SF
Owner: IRVINE COMPANY LLC
Contractor: PACIFIC TUSK BUILDERS CORP
Architect : KELLY JAMES
Address : 111 INNOVATION DR
Address : 1100 QUAIL ST #213
Address : 5161 CALIFORNIA
AVE #100 IRVINE, CA
IRVINE, CA 92617
NEWPORT BEACH, CA 92660
92617
Phone: (949)720-3100
Phone: (213)999-5696
Phone: (949)701-4139
Con State Lie : 946368
State Lie
Lie Expire : 04/30/2024
Applicant: ERIN RUNYON
Bus Lie: BT30038640
Engineer
Address : 5301 CALIFORNIA AVE STE 100
Bus Lie Expire : 03/31/2023
Address
IRVINE, CA 92617
Insurance
Phone.
Phone: (949) 720-4136
Workers' Compensation
Carrier: INSURANCE+COMPANY+OF+THE+WEST
Owner/Builder:
Policy No: WSD5041971
Designer'.
Address :
W. C. Expire: 7/1/2023
Address
Phone:
Phone:
Code Edition : 2019
Fire Sprinklers : NO
Construction Valuation :
$450,000.00
Type of Construction : I -A
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 : 6
Added/New sq. ft. Garage:
0
TOTAL sq. ft. :
0
Building Setbacks
Flood Zone : X
Use Zone : PC - North Newport Center
PROCESSED BY:
I � "
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
t 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 Rem(s)
(Section 7031.5, Business and Professions Code: Any city or county that requires a perm It 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 licensors 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 1$500),
71 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,
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 or Improves thereon, 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 must 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 owner -builder if it has not been constructed in its entirety 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:LVm .teginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION 1
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section of Div' ion 3 of the Business and P ss'. odp, 1. my license is In full force
and effect. License Class License No Date Z 2 Contractor Signal
WORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORXERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (SiD0,000), IN ADDITION TO TH
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES -
hereby affirm under penalty of perjury one of the following declarations:
Z1 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, fort!
performance of the work for which this permit is issued. Policy No.
e 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' compensatic
Insurance carrier and policy number are:
Policy Number Expiration Date
of Agent Phone ff,
certify that, in the pore manse of She work for which this �parmit is Issued, shall not employ any person in any manner so as to become subject to the work ' compensation laws of California, and ogre
t, if I should baco s je to the workers' mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of of Applicant _ D e
CLARATION RE ii ROING TRU -I N NF)ING AGENCY
=.reby affirm unde penalty of Palo that v ere is a construction lending agency for the performance of the work for whichthispermit is issued (Section 3 97, Civil Code).
(der s Name Lender's 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 coup ordinances and state laws relating to building. construction.
I authorize representatives of this city or cou ter the ai`�Iove-dent Ted property for inspection purposes. , / / I / / yI
(nature of Property Owner or Authorized AgenI /J S.. �..`/ Print Property Owner's or Authorized Agent's Nam /V� "z 8�f Da �� z/. %1
DECLARAVON OF LOMKIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AONID RULE
1403
SPPMITTED ASBESTOS NOTIFICATION TO
PERNFTTEXTENOED
PERNRTFINAL 'a—&'(3 %— S BEST OTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF PROPOSEO'O ITHDN
OCCUPANCYISSUED /�R���