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Home My WebLink AboutXC2023-0303 - Permits,�wPoRT City of Newport Beach Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 >4+ = Permit Counter Phone: (949) 718-1888 a newportbeachca.gov/civic Cq�IFOPN�P Combination Type - ELEC MECH PLUM Work Class - Other COMB Permit : XC2023-0303 X C 2 0 2 3 0 3 0�� II Plan Check No : PC2023-1931 Issued Date : 01/25/2024 •- .�'q •'^' ^ "�_'7 Final Date: Permit Status: Issued 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: 22 CORPORATE PLZ, 200 Legal Desc : P BK 93 PG 45 PAR 19 PM 93-45 PAR 19 POR OF PAR Description: COMM X-RAY MACHINE REPLACEMENT (*FIXTURE AND EQUIPMENT ONLY*) FOR "NEWPORT ORTHOPEDIC INSTITUTE" Owner: IRVINE COMPANY Address : 110 INNOVATION DRIVE IRVINE, CA 92617 Phone: (949)720-2000 Applicant; KIRT HOLMBLAD Address: 4675 MACARTHUR CT, 100 NEWPORT BEACH, CA 92660 Phone : (949) 260-8632 Owner/Builder : Address : Contractor: BASCO Address : 2750 MOORE AVENUE FULLERTON, CA 92833 Phone : (714) 870-0217 x1308 Con State Lic : 125897 Lic Expire : 05/31/2025 Bus Lic: BT30046326 Bus Lic Expire : 02/28/2024 Workers' Compensation Insurance Carrier: TRAVELERS PROPERTY CASUALTY CO OF AMERICA Policy No: UBON1616082225K W. C. Expire: 5/1/2024 Architect : ERIC A JAMES Address : 4675 MACARTHUR CT #350 NEWPORT BEACH, CA 92660 Phone : (949) 863-9434 State Lic Engineer: ESCOBEDOALLEN Address: 700 S FLOWER ST #2100 LOS ANGELES, CA 90017 Phone : (213) 418-0201 Designer Address Phone: Phone: Code Edition : Fire Sprinklers : NO Construction Valuation : $12,000.00 Type of Construction : III-B 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 : 2 Added/New sq. ft. Garage : 0 , TOTAL sq. ft. 0 ... Building Setbacks Flood Zone : X Use Zone : PC - Corporate Plaza PROCESSED BY: SPECIAL CONDITIONS ILDER DECLARATION I hereby aIhrm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the resson(s) indicated below by the checkmark(s) I have placed next to the applicable items) (Saction 7031.5. Business and Professions Code: Any city or county that requires a permit to construct, after, 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 theprovisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions 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 not 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 sate (Section 7044, Business and Professions Code: The Contractors' Stale 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 withinone year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Slate License Law does not ,5t-_t ply to an owner of properly who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I am exempt from licensure under the Contractors' Slate 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 legallt self a structure that I have built as an owner -builder if ithas 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 she:http:(lwww.leglnfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent-- Date _ LICENSED CONTRACTOR'S DECLARATION ,�Ry� �n}/ I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7(j Di ' on of the Business and Prof l \ `C d .and... my license is in full force and effect. License Class License No Date Z 2 Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: FAIW RE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT' AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1f100.0001.IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES. I hereby affirm under penalty of perjury one of the following declarations: 111 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 p ormance of the work for which this permit is issued. Policy Ne. 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' componsatiol insurance carrier and policy number are: Policy Number Date TIe of Agent Phone # cartify'that. in the perfor e e k for which this 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 ages, L if I should becomes pool th wor ors. compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant _ Dale_ L Z CLARATION REGARDING O -U) N LENDING AGENCY areby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil Cod ). )hers Name Lender's Address my signature below, I certify to each of the following: I am the prope'1', o'vner or authorized to act on the property owner's behalf. I have read fills anphcalion and the information 1 have provided is correct. I Pgw,e to oomoly with all applicable city and <Z9ty ce Ina es and state larelating to building construction. I aultmrtze rep,esa, datives of this city or county Ier th,`ryt%G�`bove-identifiws ed property for Inspection purposes. I V natU R of Pmr arty Owner or Authorizad Anent d Print Prooertv Owner's or Authorized Aaent's Name DATE I BY L-6ECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY ( REGULATIONS PART 61 OF TITLE. 40 AND. AQMD RULE FfRl7i�1 EXPIREDU I SUBMITTED ASBESTOS NOTIFICATION TO YERmr) CANCELLED OEPA TER''417 f aTENOfD LJ/1QMD PERMITFINAL ��''''777��'7J CERTIFIC'1TE OF IL 1 G ASBESTOS NOPEkATION 15 NOT APPLICABLE TO PRO 05ED DEMOLIFD OLCuPANCY ISSUED I SIGNATURE: /, !_