HomeMy WebLinkAboutXC2023-0465 - Permits��WPO,� City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XC2023-0465
C� J' 11,
Community Development Department- Building Division X C 2 0 2 3 e 4 6 5
`�' 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2023-2764
U N'� i Permit Counter Phone: (949) 718-1888 Issued Date : 12/13/2023
newportbeachce.gov/civic Final Date:
'14, cO n"`P Combination Type - ELEC MECH Permit Status: Issued
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 : 620 NEWPORT CENTER DR, 150 Legal Desc :
Description: COMM OFFICE TI GPT "IRVINE COMPANY: CUSTOMER RESOURCE CENTER" 1,460 SF
Owner: IRVINE CO
Address : 111 INNOVATION
IRVINE, CA 92618
Phone : (714) 366-7205
Applicant:
JUDY YAM
Address:
392 N LEMAY CT
ORANGE, CA 92867
Phone:
(626)675-9882
Owner/Builder :
Address :
Contractor: PACIFIC TUSK BUILDERS CORP
Address : 1301 DOVE ST, 130
NEWPORT BEACH, CA 92660
Phone :
(213) 999-5696
Con State Lic
: 946368
Lic Expire :
04/30/2024
Bus Lic:
BT30038640
Bus Lic Expire : 03/31/2024
Workers' Compensation Insurance
Carrier: INS CO OF THE WEST
Policy No : WSD5041971
W. C. Expire: 7/1/2024
Architect :
MORFORD PAUL
Address :
4675 MACARTHUR CT #100 NEWPORT
BEACH, CA 92660
Phone:
(949)863-9434
State Lic
Engineer:
Address
Phone:
Designer:
Address
Phone: Phone
Code Edition :
2022
Fire Sprinklers :
YES
Construction Valuation :
$66,000.00
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 :
1,460
Bldg Height:
No of Stories :
16
Added/New sq. ft. Garage :
0
TOTAL sq. ft.
0
Building Setbacks
Flood Zone :
X
Use Zone :
PC -
North NewportCenter
PROCESSED BY:
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate. License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable items)
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
rc permit to file a signed statement that he of she is licensed pursuant to thin provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Irofessions Code) or that he or she Is exempt from 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
of more than five hundred dollars (S500).
1, as owner 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,
lusiness 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
nprovod for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors iG 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 improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law),
1 1 am exempt from licensure under the Contractors' State License Law for the fallowing 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 Improvements covered bythis permit, I cannot legally
oil a structure that I have built as an owr or -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copyof the applicable law, Section 7044 of the Business and
'rofessfons Code., is available upon request when this application is submitted orat the following Web site http:liwww'.leginto.ca.gov/calavcbtml,
fignature of Property Owner or Authorized Agent ._.__ _Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing With Section 7000) of Divisipp 3-of the Business and Profes 'one Code, and license is In full force
nd effect. License Class License No Date 12-17.'T Contractor Signature
VORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SU84ECT AN EMPLOYER TO CRIMINAL PENALTIES AND GML FINES UP TO ONE HUNDRED THOUSAND DOLLARS 15f00,D00j, IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3TOS OF THE LABOR CODE, 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 of Industrial Relations as provided for by Section 3700 of the Labor Code, for thl
eyforma..nce 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`
rance 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 not employ any person in any manner so as to become subject to the workers' compensation laws of Califorola, and
, if I should become subject to a workers' comps anon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Iature of Applicant ,7 Date_ t 1- 'y L 3
IECLARATION REGARDING CONSTRUCTION LEN IN0 AGENCY
hereby affirm under penalty of perjury that there is a co truction lending agency for the performance ofthe work for whichthispermit is issued (Section 3097, Civil Code).
enders Name Lender's Address
ly 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 andthe information I have provided Is correct.
I agree to comply with all aloc cable city and county ordinances and slate laws relating to building construction.
I authorize representatives of this city or county to enter the abo e-i n?Ifled property for inspection purposes.
:icnature of PrODOrtV Owner or Authorized Adam Print Procenv Owner's or Authorized Aoent's Name
ACTION DATE BY DECLARATION OF CwMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AONIO RULE
1403
PERMIT tXrM'dU _ I SUBMITTED ASBESTOS NOTIFICATION TO
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PERfN17 FIMAL 650E5105 NOTIFICATION 15 O'APPLICABLE TO
CERTIFICATE OF ! PROPOSED DE OLITION
OCCUPANCY ISStJEO �____ _ SIGNATURE: )
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