HomeMy WebLinkAboutXC2023-0029 - Permits�rEWPORT City of Newport Beach
D p� Community Development Department- Building Division
F k n 100 Civic Center Drive, Newport Beach, CA 9266D
Permit Counter Phone: (949) 644-3288
u S Inspection Requests Phone: (949) 644-3255
cq4 coPN`P. newportbeachca.gov/inspections
Combination Type - ELEC
Work Class - Other
COMB Permit: XC2023-0029
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Plan Check No: PC2023-0265
Issued Date : 03/0212023
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 : 1101 NEWPORT CENTER DR Legal Desc : P BK 221 PG 30 PAR 7
Description: COMM MOVE (E) ENTRY MARKER SIGN 104 FT
Owner: IRVINE CO
Address : 111 INNOVATION
IRVINE, CA 92618
Phone : (949) 720-3100
Applicant: JAMES BRECK
Address: 3187 AIRWAY AVE., C
COSTA MESA, CA 92626
Phone: (949)368-3003
Owner/Builder :
Address :
Phone
Contractor:
DMK CONSTRUCTION
Address :
5665 TRAILSIDE DR,
YORBA LINDA, CA 92887
Phone:
(714)981-4646
Con State Lie
: 1033812
Lie Expire :
12/31/2023
Bus Lie:
BT30080746
Bus Lie Expire : 02/29/2024
Workers' Compensation Insurance
Carrier: STATE FARM FIRE AND CASUALTY
Policy No: 9253792
W. C. Expire : 5/10/2023
Code Edition : 2022
Fire Sprinklers :
Type of Construction :
Fire Hazard Zone
Occupancy Groups : U
No of Units :
Bldg Height:
No of Stories
Building Setbacks
Flood Zone : X
Use Zone: PC - North Newport Center
PROCESSED BY:
SPECIAL CONDITIONS:
Architect:
Address
Phone :
State Lie
Engineer:
Address
Phone:
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. :
$15,000,.9a. 1
0
0
0
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
ie 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 Susincss and
Irofessions Code) or that he or she is exempt from ficensure 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).
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,
IUsiness 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 properly, provided that the
nprovements are not intended or offered for sale. If, however, file 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).
3 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),
1 am exempt from licensure under the Contractors' State License Law for the following reason: _
ly my signature below f acknowledge that, except for my personal residence in which I must have resided for at (east one year prior to completion of the improvements covered by this permit, I cannot iegall
oil a structure that I have built as an owner-bulldar 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:l/www.leginfo.ca.govlcalaw.btmi.
fignature of Property Owner or Authorized Agent _ Date _
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under previsions of Chapter 9 (commencing with Section (00) of iv' ion 3 of the Business and Profe�5Ions Code, and my license rs In full force
nd effect. License Class License No Date Contractor Signature L, $ 2 • t a 2 ri
VORKERS' COMPENSATION DECLARATION
rARNING; FAILURE Tn, 9.7CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 13100,0001, IN ADDITION TO THE
DST OF COMPEF'SATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I I ha+e and wilt mamtaln a certificate of consent to sell -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
ofiHmance of the work for which this permit Is issued. Policy No.
and wit! m3±-Main workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permitis issued. My workers'
carrier and Policy number are:
Policy Number
of Agent
Date
J1 Certify that, in tf,e 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
gal, L 1 should be-cmc Jubject to the worke,"ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
Date 3• 2_Za f2
arehy affirm ur.dar Ncnalty of perjury that the m/s a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Idler'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 county ordinances and state laws relating to building construction.
I authorize representatives of this city or count enter, 'a above-identifiee/d property for inspection purposes. >/j�-
natura of Pronerty Owner or Authorzed Anent n G _ �a.lftii Print Prnnerty Ownar'c or Aidhnh7Rd Anent's NArn._L Q 2�
ACTION DATE BY DECLARVION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY l
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED CPA
PERMIT FINALI — jG10OT APPLICABLE
CERTIFICATE OSECDMOLIT
DCUPANCYISSUEA SlNA
FV,4 N Cis; # t