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Home My WebLink AboutXC2022-2118 - PermitsCity of ��E`X'PO,gT D e Communit F 100 Civic ( J Permit Coi Inspection �'9<icoa"`P newportbe Combina Work Cla Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XC2O22-2118 Development Department -Building Division X C 2 0 2 2 2 1 1 8 inter Drive, Newport Beach, CA 92660 Plan Check No: PC2022-3191 iter Phone: (949) 644-3288 Issued Date : 0212412023 tequests Phone: (949) 644-3255 Inspection Area : 7 chca.gov/inspections m Type - ELEC MECH PLUM s - Tenant Improvement PERMITS EX 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 BIRC�i ST, 1000 Legal Desc : P BK 181 PG 13 PAR 5 Description : COMM TI- PEC SUITE 8792 SF Owner: JOHN HAN, USA Address : 865 S FIGU LOS ANGEI Phone: Applicant: KELLY LEE Address : 18600 MAC IRVINE, CA Phone: (949)608-3 Owner/Builder : Address : K LIFE INSURANCE COMPANY Contractor: JLC ASSOCIATES INC A 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 Bus Lic: BT30053881 HUR BLVD, 100 Bus Lic Expire : 01/31/2024 12 Workers' Compensation Insurance Carrier: INS CO OF THE WEST Policy No: WVE504521604 W. C, Expire : 1/1/2024 Architect: ALGAZE NELSON Address: 6083 BRISTOL PKWY CULVER CITY, CA 90230 Phone; (213)929-1400 State Lic : CO21090 Engineer Address Phone: Designer Address Phone: Phone: Code Edition : 2C 19 Fire Sprinklers : YES Construction Valuation : $131,880.00 Type of Construction : I- Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 Occupancy Groups : B No of Units : 0 Alteration sq. ft. Bldg : 8,792 Bldg Height : No of Stories : 11 Added/New sq. ft. Garage : 0 TOTAL sq. ft. 0 Building Setbacks Flood Zone : X Use Zone : P - Koll Center PROCESSED BY: SPECIAL CONDITI I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable items) 3eellon 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 to permit to file a signed statement that fie or she is licensed pursuant to the provisions of the ContractorsStale License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 'rofessions 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 ($500). 1 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U p rfloons of the work, and the structure is notintended proffered far 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 nprovements are not intended or offered for sale. ir, 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 I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7D44, 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), 3 1 am exempt from licensure under the Contractors' Stale License Law for the following reason! _ y my signature below I acknowledge that, except for my personal residence In which I must have resided forat 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-buildar if It has not been constructed in its entirety by licori 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''Neb site:http:llwwwaeginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Agent Date ACENSED CONTRACTOR'S DECLARATION hereby affirm under penally of perjury that. I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my)iGeit ts" in full force nd effect. License Class License No Dai Ze /Z'%LZ3_ Contractor Signalug�/ IIORKERS' COMPENSATION DECLARATION +ARNING: 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 (S100,0001, 7N ADDITION TO THE DST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION OTDB OF THE LABOR COPE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: DI 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+ e O rands of the work for which this permit Is issued. Policy No. ve 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' compensatior Isu ance carrier and policy number are: of Agent Policy Number Expiration Date Phone # J certify that, inthe performance of thew k for which th 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 agi hat, if I should become subject to thew rs' co en ion provisions of Section 3 4he-tabor Code, I shall forthwith comply with those provisions. 3gnature of Applicant_ Dated )ECLARATION REGARDING tO T CTI NDISIGAGENCY `�,\j hereby affirm under penalty of perj that t be Is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Ci II Code). _endar's Name Lender's Address 3y 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 1 have provid correct I agree to comply with all applicable city and county ord' s aid state iarwii relating to building construction. /^ I authorize representatives of this city or count t er t abc"B;ideritified property for inspection purposes. ii naiure of Property Owner or Authorized A ent �' Print Property Owner's or Authorized Agent's Name Date ACTION DATE By CLARATION.OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TgLE AO AND AQMD RULE PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL i CERTIFICATE OF OCCUPANCY ISSUED t0