HomeMy WebLinkAboutXC2023-0476 - PermitsaewPoRT City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIII II COMB Permit : XC2023-0476
o� ,< 9 Community Development Department -Building Division X C 2 0 2 3 0 4 7 6
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-2854
Permit Counter Phone: (949) 718-1888 Issued Date : 0212012024
newportbeachca.gov/civic Final Date: 04/24/2024
C4(�FO0.N`P Combination Type - ELEC MECH PLUM Permit Status: Final
Work Class - Tenant Improvement 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: 3536 COAST HWY E Legal Desc : N TR 323 BILK U LOT 4 TR 323 LOT 4 BLK U ALL -EX HW
Description: COMM TI FOR "ROSE BAKERY CAFE" 950 SF
Owner; JOHN BRADLEY PENCE
Address : 3416 VIA LIDO, G
NEWPORT BEACH, CA 92663
Phone: (949)673-6333
Applicant: JUSTIN D WESTGAARD
Address: 31368 VIA COLINAS, #105
WESTLAKE VILLAGE, CA 91362
Phone
Owner/Builder :
Address :
Contractor: MONTESANTOS BUILDERS INC
Address : 220 NEWPORT CENTER DR, 322
NEWPORT BEACH, CA 92660
Phone:
(949)239-2022
Con State Lic
: 1077463
Lic Expire :
06/30/2025
Bus Lic :
BT30076141
Bus Lic Expire : 08131/2024
Workers' Compensation Insurance
Carrier: EXEMPT- NO EMPLOYEES
Policy No: EXEMPT
W. C. Expire:
Architect ; ANDREW ERNST ALTHAUS
Address : 31368 VIA COLINAS, 105 WESTLAKE
VILLAGE, CA 91362
Phone: (805) 369-1750
State Lic
Engineer
Address
Phone:
Designer:
Address
Phone:
Phone:
Code Edition :
2022
Fire Sprinklers :
NO
Construction Valuation :
$75,000.00
Type of Construction :
V-B
Fire Hazard Zone :
NO
Added/New/Ti sq. ft. Bldg :
0
Occupancy Groups :
H-1,B,U
No of Units :
0
Alteration sq. ft. Bldg :
950
Bldg Height:
No of Stories :
1
Add/New sq. ft. Garage:
0
TOTAL sq. ft.
0
Building Setbacks
Flood Zone :
X
Use Zone:
CC - Commercial Corridor
PROCESSED BY
SPECIAL CONDITIONS:
DUPLICATE
TION
I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable items)
3eclion 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
re 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 700() of Division 3 of the Business and
Tofessions Code) or that he or she is exemptfrom 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 l
of more than five hundred dollars ($500). '...
7 1, as owner of the property, or my employees with wages as their sole compensation, will do L) 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-Builderwill have the burden of proving that it was not built or
noroved for the purpose of sale).
1 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
poly 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).
J 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 resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally
ell a structure that I have built as an owner -builder it it has not been constructed In Its entirety by licensed contractors. I understand that copy of the applicable law, Section 7044 of the Business and
'rofessions Code, Is available upon request when this application is submitted or at the following Web site:hltp:l/www.leginfo.ca.govlcalaw.htmi. '..
'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 Professions Code, and my license is in full force
nd effect. License Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
DARNING: 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 16400,0001, IN AUDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR COOe, INTEREST, AND ATTORNEY" S FEES.
hereby affirm under penalty of perjury one of the following declarations:
1 have and will maintain a certificate of consent to self -insure for workers' compensation,. issued by the Director or 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.
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' compensa
Nance carrier and policy number are:
Policy Number
of Agent
Date
Certify that, in the performance of the work for which this permit is issued, I shall notemploy any person in any manner so as to become subject to the workers' compensation laws of Cal fom a, 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.
Ignalure of Applicant __„_,_ Date_
rECLARATION REGARDING CONSTRUCTION LENDING AGENCY
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 3097, Civil Code).
ender's Name Lender's Address.
y nay signature below, I certify to each of the following:
I am the property owner or authorized to act on the properly 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 county to enter the above -identified property for inspection purposes.
ionature of ProDertv Owner or Authorized Agent Print Prooertv Owner's or Authorized Anent's Name
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
lilili REGULATIONS PART 61 OF TITLE 40 AND ADMO RULE
1403
PERMIT EXPIRED I U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT AODED ., .1 S ION
NRE IN0TI OLI IN l5 NOT APPCABLE T
CER O
ffCATE
OCCUPANCY ISSUED
Date