HomeMy WebLinkAboutXC2023-0208 - PermitsCity of Newport Beach
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COMB Permit : XCZOZ3-OZO8
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Community Development Department- Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
Plan Check No : PC2023-1456
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Permit Counter Phone: (949) 718-1888
Issued Date : 08/0112023
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Final Date:
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Combination Type - ELEC MECH PLUM
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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 : 809 NEWPORT CENTER DR
Description: COMM TI "GOOD AMERICA" 3006 SF
Owner: IRVINE CO
Address : 111 INNOVATION
IRVINE, CA 92618
Phone: (714)366-7205
Applicant: KATHLEEN TRIOLO
Address : 17800 MITCHELL NORTH
IRVINE, CA 92614
Phone: (714)366-7205
Owner/Builder
Address :
Legal Desc : P BK 221 PG 30 PAR 6 P.M. 221-30 PAR 6 FOR OF PAR AND FOR PA R 1 OF P.M.
Contractor: STEVEN HIRSCH CONSTRUCTION
Address : 100 CONIFER HILL DRIVE STE 306
DANVERS, MA 01923, CA
Phone:
(978)762-8744
Con State Lie
: B80649
Lie Expire :
07/31/2024
Bus Lie:
BT30082269
Bus Lie Expire : OB/31/2024
Workers' Compensation Insurance
Carrier: TRAVELERS PROPERTY CASUALTY
COMPANY OF AMERICA
Policy No: UBOP858106
W. C. Expire: 9/30/2023
Architect:
AMYBAGLEY
Address :
17800 MITCHELL NORTH IRVINE, CA
92614
Phone:
(714)299-5957
State Lie
Engineer:
Address :
Phone :
Designer:
Address
Phone:
Phone:
Code Edition :
2022
Fire Sprinklers : YES
Construction Valuation :
$174,000.00
Type of Construction :
III-B
Fire Hazard Zone : NO
Added/NewITI sq. ft. Bldg :
0
Occupancy Groups :
M
No of Units : 1
Alteration sq. ft. Bldg :
3,006
Bldg Height :
No of Stories : 1
Added/New sq. ft. Garage:
0
TOTAL sq. ft.
0
Building Setbacks
Flood Zone :
X
Use Zone :
PC - North Newport Center
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PROCESSED BY:
SPECIAL CONDITIONS: HAULER: DIRECT DISPOSAL
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the ContractorsState License Law for the reasons) 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
he 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
7rofessions Code) or that he or she is exempt from Iioensure 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
Tot more than five hundred dollars ($500).
I, 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,
3usness 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
nlprovements 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
mproved 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
s-pfpty 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 1 am exempt from Picensura under the Contractors' Stale License Law for the following reason
3y my signature below I acknowledge that, except for my personal residence In which I must have resided For at toast one year prior to cvmpl¢tion of the improvements covered by this permit, 1 camiel legall�
tell a structure that I have built as an owner -builder if it has not been constructed in its entirely 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:ltwarv.leginfo.ca..govlc law.html..
Signature of Property Owner or Authorized Agent..-__ Date
LICENSED 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 Profeyai�is v a y license is in full force
snd effect. License Class License No Data _'j!--J-_7 "i Contractor Signature /;y
NO RKERS' COMPENSATION DECLARATION v — TLr
VARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAUE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP To ONE HUNORED THOUSAND D0LLARS i$100,0001, IN ADDITION TO 7HE
:o ST OF COMPENSATION, DAMAGES "PROVIDED FOR IN SECTION 3709 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 th
lerformance of the work for which this permit is Issued. Policy No.
-Art have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for whichthis permit Is issued. My workers' compensatiol
�Isurance 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 California, and
if I should becorne subjeW9 the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
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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).
.tinder's NameLender's Address
3V my signature below, I certify to each of the following:
I am the property owner or authorized to eelon the property owner's behalf.
I have read this application andthe information I have provided is correct.
I agree to comply withall applicable city and county o mantes and stale laws relating to building construction.
I authorize 6p.esentatives of this city or county to r tr%.�" a/htee-i ratified property for inspection purposes. // d`aQ/'7GYrV6c�J
signature of Pril,Erty Owner or Authorized Agent ,�/ _ (.,,.-. Pnnt Property Owner's or Authorized Acent's Name Ll.._a% / exF�i✓r}r�eer/ Date
nti iON DATE I BY (.Z DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
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