HomeMy WebLinkAboutXC2023-0414 - Permits (3)¢��WPoRr City of Newport Beach
�. b Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
H" Z Permit Counter Phone: (949) 718-1888
newportbeachca.gov/civic
cgGeo 0."�P Combination Type -ELEC MECH
Work Class - Other
COMB Permit : XC2023-0414
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Plan Check No: PC2023-2519
Issued Date : 11/16/2023
Final Date:
Permit Status: Issued
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 : 700 NEWPORT CENTER DR
Description: COMM- REPLACE COOLING TOWER
Owner: PACIFIC MUTUAL LIFE INSURANCE CO
Address : 700 NEWPORT CENTER DR #1
NEWPORT BEACH, CA 92660
Phone:
Applicant: MESA ENERGY SYSTEMS INC
Address : 2 CROMWELL
IRVINE, CA 92618
Phone : (949) 244-1341
Owner/Builder :
Address :
Phone
Legal Desc : N TR 361 ELK 55 IRVINE SUB LOT ELK 55 FOR OF ELK
Contractor:
MESA ENERGY SYSTEMS INC
Address :
2 CROMWELL
IRVINE, CA 92618
Phone :
(949) 244-1341
Con State Lic
: 611215
Lic Expire :
01/31/2025
Bus Lic :
BT98039750
Bus Lic Expire : 12/31/2023
Workers' Compensation Insurance
Carrier: CONTINENTAL INSURANCE COMPANY
Policy No: WC739955452
W. C. Expire: 10/1/2024
Code Edition : 2022
Fire Sprinklers :
Type of Construction : III-B
Fire Hazard Zone
Occupancy Groups : M,U
No of Units :
Bldg Height:
No of Stories
Building Setbacks :
Flood Zone : X
Use Zone : OR - Office —Regional
PROCESSED BY: 605
SPECIAL CONDITIONS:
Architect
Address
Phone :
State Lic
Engineer: JOHN SPENCER
Address : 27 MAUCLY, 209
IRVINE, CA 92618
Phone : (949) 450-0431
Designer
Address
Phone:
NO Construction Valuation :
NO Added/New/TI sq. ft. Bldg
0 Alteration sq. ft. Bldg :
Added/New sq. ft. Garage
TOTAL sq. ft. :
$40,000.00
0
0
0
OWNER -BUILDER DECLARATION
1 hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the c ieckmark(s) I have placed next to the applicable ltem(s)
iection 7031,5, Business and Professions Code: Any city or county tha€ requires a permit to construct, alter, improve, demolish, or repair any structure, prior to Its issuance, also requires the applicant for
ID 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 Suction 7000) of Division 3 of the Business and
'rofessions Code) or that he or she is exempt from ilcensure 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 ($500)..
3 I, as owner of the property, or my employees with wages as their sole compensation, will do {_) all of or U 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
aprovements 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
nproved for the purpose of sale).
1 1, as owner of the property. am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale 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)..
3 1 am exempt from licensee under the Contractors' Male License Law for [tie following reason
:y my signature below I acknowledge that, except for my personal residence in which I must have resided (oral 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 if it has not been constructod in its entiraty, by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
srofessions Code, is evallable upon request when this application is submitted or at the following Web site:htfp:lMA�nv.leginfo.ca.gov/calaw.html.
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 Divjsion 3 of the Business and Professions ode, and mnn dense is In full force
nd effect. License Class License No Date ie 1 23 Contractor Signature
PORKERS' COMPENSATION DECLARATION
'ARMING: 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 (St D0.000), IN AODrfION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
I 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 thf
erformance 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`
ranee carrier and policy number era: / �yv�p �t
ter Lon tfn do `♦-GtkmV1 .i,AyG`� F°o V` Number � �i ����rJ Sy rJ Z.. Expiration Date
of Agent
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 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.
Ialure ofApplican4 _-,?,�,-„� �� _ Date
Y A0ATV1A1 OV ±AOnlAl h_ r`YIUCTIYI IFYIItAI 1 AIiYI\IO hr]CEI/^V'
hereby affirm under penaltyof 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 Lenders 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 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 raHlaaeatalives of this city or county to on above-idenjlfied property for inspection purposes.
FICTION ! DATE by DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERM1 EXPIRED
LJ I SURMITTED ASBESTOS NOTIFICATION TO
EAM CANCELLED
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SIGNATURE: 451s '�