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Home My WebLink AboutX2022-1458 - Permits (3)ty of Beach 0 a�WP��A olmmunnityDev opmmenDepartment-BuildingDivision II II IIIIIIIIIIIIIIIIIIII COMB Permit:XC2022-1938 n100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2022-2257 Permit Counter Phone: (949) 644-3288 Issued Date : 0912812022 c ee\P Inspection Requests Phone: (949) 644-3255 Inspection Area : 7 ,crFoa`' newportbeachca.gov/inspections Combination Type - ELEC PLUM Work Class - Tenant Improvement 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: 1301 DOVE ST, 6TH FL Legal Desc : P BK 120 PG 27 PAR 1 Description : COMM TI - RESTROOM REMODEL. 6TH FL (365 SF) Owner: 1301 DOVE OWNER LLC Address: 2101 ROSECRANS AVE STE3270 EL SEGUNDO, CA 90245 Phone: Applicant: HOLLY GRAVES Address : 6083 BRISTOL PKWY CULVER CITY, CA 90230 Phone: (949)697-9401 Owner/Builder : Address : Phone Contractor: COASTLINE DEVELOPMENT INC Address : 13911 ENTERPRISE DRIVE GARDEN GROVE, CA 92843 Phone: (714)265-0250 Con State Lic: 485187 Lic Expire : 01/31/2024 Bus Lic: BT30075860 Bus Lic Expire : 07/31/2023 Workers' Compensation Insurance Carrier: COMPWEST INSURANCE CO Policy No : WCV550542500 W. C. Expire : 1/1/2023 Architect Address Phone: State Lic Engineer: Address Phone : Designer Address Phone: al ALGAZE NELSON 6083 BRISTOL PARKWAY CULVER CITY, CA 90230 (213) 929-1400 Code Edition : 2019 Fire Sprinklers : YES Construction Valuation : $36,500.00 Type of Construction : I -A Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 365 Occupancy Groups : B No of Units : 0 Alteration sq. ft. Bldg : 365 Bldg Height: No of Stories : 10 Added/New sq. ft. Garage : 0 Building Setbacks Flood Zone : X Use Zone : PC - Newport Place PROCESSED BY SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION t hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Lawlor 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 W construct, alter, improve, demolish, or repair any structure, prior to Its issuance, also requires the applicant for the 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 Professions Code) or that no or she is exempt from lieensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, 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 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, hullds 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). El 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 ,a�L,ply to an owner of property who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 1 am exempt from lieensure 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 -builder if it. has not been 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:hltpJlwww.Gginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent �__,,.______� _�_.__ Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7 Qp) f1?iyjs' n 3 of the Business and Pr So* Ode, and y license is In full force and effect. license Class License No Da a 7% Ld' Contractor Signatur - tr WORKERS' COMPENSATION DECLARATION WARNING: 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 t6100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706. OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES. I hereby affirm under penalty of perjury one of the following declarations: 13 1 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 performance of the work for which this permit is issued. Policy No. hav I e 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' compensatio is rice carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # I Will that, in lha perf mane of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the workeyflde). ensation laws of California. and agre that, if I should barn s Left to workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply With those provisions. Signature of Applicant _ _ _ �_+i�DatZ8 Zvi _ DECLAf2ATYON REGA INSTRUCTION LENDING AGENCY I hereby affirm under p natty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Lender's Name Lenders Address By 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 slate laws relating to building. construction. I authorize representatives of this city or cou ty n r above -Ids tiff property for inspection purposes. Si nature of Property Owner or Authorized A en ti� Print Pro erty Owner's or Authorized Agent's Name b �w_e;011_ Oat 18 ACTION DATE. BY ECLARAT€ON. OF CONIPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE. 40 AND ACM1AD RULE 1403 PERMIT EXPIRED f I suRM117ED ASBESTOS NOTIFICATION TO _._ PEA VIIT CANCELLED LJCF1 FERivfiT EXTENDED 'LIAOMU _ f PERYl17 FINAL ' �l•2� 59610 'IFICATIONI5 NOT APPUCAIi4E TO CERTIFICATE OF v� /jam' PRO OSFD E U ////�JJ OCCUPANCY ISSUED / SIGNATURE-. �' ilr