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Home My WebLink AboutXC2023-0030 - Permits��WPo�T City of Newport Beach C Community Development Department- Building Division y n 100 Civic Center Drive, Newport Beach, CA 92660 T Permit Counter Phone: (949) 644-3288 r+� Inspection Requests Phone: (949) 644-3255 C9(./Fnpi��P newportbeachca.gov/inspections Combination Type - ELEC Work Class - Other 111111111111111lil1111111111111111111111111111111�1111111ilCOMB Permit: XC2023-0030 Plan Check No: PC2023-0267 Issued Date : 0312212023 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: 361 HOSPITAL RD Description : COMM 16 EV CHARGERS Owner: GENCAL NEWPORT LIDO LLC Address : 100 N PACIFIC COAST HWY STE650 EL SEGUNDO, CA 90245 Phone : Applicant: TYLER GALGAS Address : 15500 ERWIN ST 4008 VAN NUYS, CA 91411 Phone : (818) 519-7038 Owner/Builder : Address : Phone: Legal Desc : A TR IRVINE SUB BLK 2 LOT 169 IRVINE SUB LOT 169 BLK 2 POR O F LOT Contractor: GREEN WATER AND POWER Address : 15500 ERWIN ST., 4008 VAN NUYS, CA 91411 Phone : (818) 519-7038 Con State Lic : 927030 Lic Expire : 11130/2024 Bus Lic : BT30081041 Bus Lic Expire : 03/31/2024 Workers' Compensation Insurance Carrier: STATE COMPENSATION INSURANCE FUND Policy No: 9148139 W. C. Expire: 9/9/2023 Code Edition : 2022 Fire Sprinklers : NO Type of Construction : V-B Fire Hazard Zone : NO Occupancy Groups : U No of Units : 0 Bldg Height: No of Stories : Building Setbacks : Flood Zone : X Use Zone : OM - Office --Medical PROCESSED BY: SPECIAL CONDITIONS: Architect Address Phone: State Lic Engineer Address Phone Designer: DANIEL GOLD Address : 15500 ERWIN ST 4008 VAN NUYS, CA 91411 Phone : (818) 519-7038 ' Construction Valuation : $30,000.00 Added/New/TI sq. ft. Bldg : 0 Alteration sq. ft. Bldg : Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 0 NOFECI OR I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) coon 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 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 fessions Code) or that he or she is exempt frem 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 more than five hundred dollars ($500). 1, as owner of the property, or my employees with wages as their sole compensation, will do (_). all of or U portions of the work, andthestructure is notintended or offered for sale (Section 7044, mass 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 rovements are not intended or offered for sale. jr, 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 roved for the purpose of sale). 1, 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 ly 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), J I am exempt from licensure under the Contractors' State 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 oil 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 IT 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:/iWmv.leginfo.ca.gov/calaw.html, ignature of Property Owner or Authorized Agent 10ENSED CONTRACTOR'S DECLARATION ments covered by this permit, I cannot law, Section 7044 of the Business and Date hereby affirm under penalty' of perjury that. I am licensed under provisions of Chapter 9 (commencing with Section 0 O) of Division 3 of the Business and Professions Code and m f.cansa is In full force nd effect. License Class License No L�_�[� f e ann �, �yoC.'i�7 Y/J COMPENSATION DECLARATION NARKING; FAILURE TO SFCURc WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 13100,0001, IN ADDITION TO THE CO-T OF CO`APENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CORE, INTEREST, AND ATTORNEYS FEES. hereby al`irm under nenPity of perjury one of the following declarations:, 1' have and will maintain a certificate of consent to soli -insure for workers' compensation, Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for Ih, elk° iR,a.abe of the work for which this permit is issued. Policy No. and will mointain 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" carrier and policy number are: Policy Number of Agent Date eLdlfy ;hat,in tre performance of the work for which this permit is issued.. I shall notemploy any person in any manner so as to become subject to the workers' compensation laws of Caiffomla, and agra t, if I should becnnle s,,bject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. na4 ra of Appl..ant __. CLARATION KEG,tF:IW NG'CPNSTR CTION LENDING AGENCY Ireby 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 Code). Ider's Name Lenders Address 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 state laws relating to building. construction. I authorize representatives of this city or county to ter �the �aba a- entitled property for inspection purposes. ` — ) �(' \ _ /� I nature of Property Owner or Authorized Agent ,A A(i�%N� Print Property Owner's or Authorized Agent's Name T VJ l 4' CYD G �CVGSA'na&� 31 710' ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQNID RULE 14G3 PERMITEXPIRED i ISUBMITT€D ASBESTOS NOTIFICATION TO PERMITEXTENDED LJAQMD _ PERMIT FINAL 1. / ASBESTOS NOTIFICATION 15 NOTAPPLICABLE TO CERTIFICATE Of �1° C' PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: