The URL can be used to link to this page

Home My WebLink AboutXC2023-0350 - Permits4��WPoRr City of Newport Beach D p Community Development Department- Building Division r t"y 100 Civic Center Drive, Newport Beach, CA 92660 Permit Co nter Phone: (949) 718-1888 S newportbeachca.gov/dvic Cy<,FOF<N�P Combination Type - ELEC MECH PLUM Work Class - Tenant Improvement iiipiiiii0 it COMB Permit : XC2023-0350 Plan Check No : PC2023-2170 Issued Date : 11/0712023 Final Date: Permit Status: Issued Inspection Area : 7 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 BIRCH ST, 9TH FLOOR Legal Desc : P BK 181 PG 13 PAR 5 Description: COMM TI TH FLOOR CORRIDOR, LOBBY AND RESTOOMS 1810 SF Owner: JOHN HAN USA Address : 865 S FIGU LOS ANGEI Phone : (949) 757-0 Applicant: JESSICA S Address : 4770 CAMF NEWPORT Phone: (949)851-3 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 Lie : 645576 Lie Expire : 05/31/2024 XER Bus Lie: BT30053881 DR, STE 100 Bus Lie Expire : 01/31/2024 NCH, CA 92660 Workers' Compensation Insurance Carrier: INS CO OF THE WEST Policy No: WVE504521604 W. C. Expire: 1/1/2024 Architect: SUSAN DWYER Address: 4770 CAMPUS DR NEWPORT BEACH, CA 92660 Phone: (949)851-3080 State Lie : C033724 Engineer Address Phone : Designer: Address Phone: Phone: Code Edition : Fire Sprinklers : NO Construction Valuation : $137,500.00 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 : Bldg Height: No of Stories: 10 Added/New sq. ft. Garage: 0 TOTAL sq. ft. 0 Building Setbacks Flood Zone : X Use Zone : P - Kell Center PROCESSED BY: SPECIAL CON 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 item(s) 3ection 7031.5, Susiness and Professions Code. Any city or county that requires a permit to construct. alter, improve, den'Olish, or repair any structure, prior to Its issuance, also requires the applicant for le permit to file a signed statement that Ile 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 'rofessions Code) or that he or she is exempt from licersure 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 L) all of or U portions of the work, and the structure is not intended oroffered 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 nprovements 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). Z 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 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). I I am exernpt from licensure under the Contractors' State License Law for the following reason y my signature below l 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 legally all a structure that I have built as an ownor-builder if it has not been constructed In !is entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business d 'rofessions Code, is available upon request when this application is submitted or at the following IA'eb site:http:liwww.leginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (Commencing with Section 7000 If Di isioa 3 of the Business and Profes i ns a and y is a is IIf e not effect. License Class License. No Date Contractor Signature PORKERS' COMPENSATION DECLARATION ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UN[AWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE RUNDREO THOUSAND DOLLARS ($100,000), IN ADOMON TO THE DST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: 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 crmance 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' comperisa' Trance carrier and policy number are rier Policy Number ne of Agent certify that, in the performance of the work for which t s permit is if I should become subject to he workers' comp anon provisio Ware of Applicant Date ploy any person in any manner so as to become subject to the workers' compensation laws of California, and agre the Labor Code, I shall forthwith comply with those provisions. /%)�j% Date,._.��r'T '� hereby affirm under penalty of perjury that there i`s a construcTion lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil Code). enders Name Lender's Address y my signature below, I eerl.lfy to each of Lie following: I am the properly owner or authorized to act on the property owner's behalf. I have read this application and the Information I have provided is Corr I agree Io comply with all apphCity Ciity and County ordinances anI w tell ng to building construction. I authorize representatives of this city or county n}Rr the abg Identifiy p art inspectlon purposes. aler's or Authorized ADent's Name ACTION DATE BY I DECLARATION grPCEN*CTANCE W17H CODE. OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND A4MD RULE 11403 PERWEXPiRED I SUBMITTED ASBESTOS NOTIFICATION TO _ PERMIT CANCELLED i CPA _ PER,YFIT EXTENDED AQMp PER,YHT FINAL � .z ASBLSTOS NOiIf-ICAIION ISN Al!CAB CERTIFICATE OF � � PROPOSEY)jlllJFO� OCCUPANCY 75SUE0 SIG NATURERE: ��////�/��i 99