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Home My WebLink AboutXC2022-1927 - PermitsaEWPORT City oi Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XC2O22-1927 0� @ Communit Development Department - Building Division X C 2 0 2 2 1 9 2 7 Py 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2022-2174 Permit Coi inter Phone: (949) 644-3288 Issued Date : 11/08/2022 u fir'. Inspection Requests Phone: (949) 644-3255 Inspection Area : 7 °4c�Foa"�P newportbeachca.gov/inspections Combine ion Type - ELEC MECH PLUM Work Class - Tenant Improvement PERMITS E IRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUC ION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 5000 BIRCH ST, 1100 Legal Desc : P BK 181 PG 13 PAR 5 Description : COMM TI EMBARK" 6743 SF Owner: JOHN HANC USA Address : 865 S FIGUE LOS ANGEL Phone : Applicant : NANCY HUE Address : 1301 W 2ND LOS ANGEL Phone: (818)485-77 Owner/Builder: Address : K LIFE INSURANCE COMPANY Contractor: JLC ASSOCIATES INC IA ST STE3320 Address : 3198 A AIRPORT LOOP DR CA 90017 COSTA MESA, CA 92626 Phone: (949)241-4430 Con State Lic: 645576 Lic Expire : 05/31/2024 A Bus Lic: BT30053881 #207 Bus Lic Expire : 01/31/2023 CA 90026 Workers' Compensation Insurance Carrier: I N SU RAN C E+COMPANY+O F+THE+W EST Policy No: WVE504521603 W. C. Expire: 1/1/2023 Architect: WILDER ARTHUR J Address : 3859 CARDIFF AVE CULVER CITY, CA 90232 Phone : (310) 204-2290 State Lic Engineer: Address Phone: Designer: Address : Phone: Phone: Code Edition : 2 19 Fire Sprinklers : NO Construction Valuation Type of Construction : II B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg Occupancy Groups : B No of Units : 0 Alteration sq. ft. Bldg : Bldg Height : No of Stories : 10 Added/New sq. ft. Garage TOTAL sq. ft. Building Setbacks Flood Zone : X Use Zone : P - Koll Center PROCESSED BY: SPECIAL CONDITIO $43B,295.U0 0 0 0 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State 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: Arty 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 orofessions 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 subjacts the applicant to a Civil penalty of Tot more than five hundred dollars ($500). 1 I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business 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 improvements 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 improved for the purpose of sale). 0 1, 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 apply to an owner of property who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' Slate License Law). 0 I am exempt from licensure under the Contractors' State License Law for the following reason By 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 legal sell a structure that I have built as an owner-buildor if It. has not bean constructed in its entirety 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:liwww.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent _ _ Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0 ) G q'vi. "0 3 of the Business and Prof si ns Code, an y If i oil force and effect. License Class License No Date Contractor Signature COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERSCOMPENSATION COVERAGE IS UNLAWFUL, AN SHALL SUBJECT AN EMPLOYER TO CFUMHAI PENALTIES AND CIVIL FINES UP TO ONE HUNDREb THOUSAND DOLLARS ($100;00061N AODn ION TO COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTDRNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: J I Have and Wh, a cent I care 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 la`irmanue of the work for which this permit is issued. Policy No. I 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' compeosatior oance carrier and policy number are: artier _ _ Policy Number Expiration Date ems of Agent _ _, _ _ Phone # 31 certify that, in tl:e rfor ance of the work for who this par t' Iss I shall not employ any person in any manner so as to become subject to the workers' o nation laws of California. and agree cal, if I should become u jact 4o the workers' co nsation O s Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ij,!rl,re of Applrcan t_ _ Data 1iCrAR.+TIQN RCGA.,t i C N TRUCT N LENDI AGE hereby affirm unda- pe arty of perjury that th re is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097, II C de), cinder's game _ Lender's Address y my signature below, I' certify to each of ilia following: I am the property owner or authorized to act on the II owner's behalf. I have read this application and the information I he provided is correct. ` ] I agree to comply with all applicable City and co liy idinances and state laws relating to building construction. I authorize representatives of this City or county, to ter the above-identifled property for inspection purposes. ACTION EXPIRED P€Rfv1iT EXTENDED PEPoWF FlAlA! CER FiTtCATE OF OCCUPANCY ISSUED or Authorized Agent IN Print Property Owner's or Authorized Ac DATE I BY DECOMATION OF CONIPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY I r REGULATIONS PART 61. OF TITLE 40 AND AQMD RULE SUBMITTED ASBESTOS NOTIFICATION TO NOT1FICAVION 15