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Home My WebLink AboutE2023-0236 - Permits��gWPORT City of Newport Beach p em Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 C,��ORN�P Inspection Requests Phone: (949) 644-3255 newportbeachca.gov/inspections iiiiiiiiiElectrical Permit : E2023-0236 Plan Check No : PC2023.0644 Work Class : Other Issued Date : 03/23/2023 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 Legal Desc : A TR IRVINE SUB BILK 2 LOT 169 IRVINE SUB LOT 169 BLK 2 POR 0 F LOT Description: COMM CHANGE OUT INTERIOR AND EXTERIOR FIXTURES THROUGHOUT ENTIRE BUILDING Owner: GENCAL NEWPORT LIDO LLC Address : 100 N PACIFIC COAST HWY STE650 EL SEGUNDO, CA 90245 Phone : Applicant: MESA ENERGY SYSTEMS INC Address: 2 CROMWELL IRVINE, CA 92618 Phone : (949) 244-1341 Owner/Builder : Address Phone : Code Edition : Type of Construction Building Setbacks Flood Zone Use Zone : PROCESSED BY SPECIAL CONDITIONS: OM - Office --Medical Contractor : MESA ENERGY SYSTEMS INC Address : 2 CROMWELL IRVINE, CA 92618 Phone : (949) 244-1341 Con State Lie : 611215 Lie Expire : 01/31/2025 Bus Lie: BT98039750 Bus Lie Expire:12131/2023 Workers' Compensation Insurance Carrier: CONTINENTAL INSURANCE Policy No: WC734181601 W. C. Expire : 10/1/2023 Fire Hazard Zone : NO Occupancy Groups : OWNER -BUILDER DECLARATION 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) 1 have placed next to the applicable item(s) (Section 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 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 he or she is exempt from Ilcensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit. subjects the applicant to 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 (_) portionsof 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, builds 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). I, 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 apply to anowner of property who builds or improves thereon, and who contracts for the projects With a licensed Contractor pursuant to the Contractors' State License Law). El I am exempt from licensure under the Contractors' State License Law for [he fallowing reason'. By my signature below I acknowledge that, except for my personal residence In which I must have resided for at feast one year prior to completion of the improvements covered by this permit, I cannot legally soli a structure that I have built as an owner-buildor 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:http:IAw .leginfo.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 (co mencing with Sectio 7 00) f Divt ion 3 of the Business and Pr ssior) n license is in full force and effect. License Class License No /n % �) Dat .9 2. Contractor Signatur 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 (5100,000), M 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: El 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 $action 3700 of the Labor Code, for IN performance of the work for which this permit Is Issued. Policy No.. 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' carrier and policy number are: Policy Number Expiration Date of Agent Phone N _ I certify than in the performance of the work for which this permitis issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree iat, if I should beco a leer t e ers' cpmpensatlpn provisions of Section 3700 of the Labor Code, I shall forthwilh comply with those provisions. IECLARATFON ure of RE t RD S UCTION LENDING AGENCY Dat 3 Z 7 hereby 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�C. d/� enders Name Lender's Address y 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 ordinane s and state laws relating to building construction. I authorize representatives of this city or count �to/� er th a Id ' led property for inspection purposes. q`/j �icnature of PFODerty Owner or Authorized AGent I X Tn C_ Print Prooerty Owner's or Authorized ADent's Name JC 1 A ACTION DATE BY ( 056LARATION OF COMPLIANCE WITH CODE OF FEDERAL { FOR OFFICE USE ONLY ` r I REGULATIONS PART 610E TITLE. 40 AND AQMD RULE s 1408 PERMIT EXTENDED _ LJAQMD _ PERMIT FINAli �7 �/ ASBESTOS NONHCATION 15 NOT APPLICABLE TO CERT1FfCATE OF l� h/ PROPOSED DEMOLITION OCCUPANCY 155VEO I SIGNATURE: 2