HomeMy WebLinkAboutXC2022-2107 - Permits�E`x'PORT City of Newport Beach II IIIIIIIIIIIIIIIIIIIIIIII IIIIIIIII IIII IIIIIII II II COMB Permit: XC2022-2107
p� d Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2022-3145
u >•G+ r Permit Counter Phone: (949) 644-3288 Issued Date : 01/04/2023
.s. Inspection Requests Phone: (949) 644-3255
Cq</Fp0.N�P newportbeachca.gov/inspections Inspection Area : 7
Combination Type - ELEC MECH 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, 130 Legal Desc : P BK 120 PG 27 PAR 1
Description: COMM - TI "PACIFIC TUSK BUILDERS' 4,503 SF
Owner: OCEAN WEST, WEST CAPITOL PARTNERS
Address : 2101 ROSECRANS AVE STE3270
EL SEGUNDO, CA 90245
Phone :
(213) 326-4539
Applicant :
Taleen Badawi Metcalf
Address :
4802 Briarhill dr.
Yorba Linda, CA 92886
Phone:
(323)547-5361
Owner/Builder :
Address :
Phone
Contractor: PACIFIC TUSK BUILDERS CORP
Address : 1100 QUAIL ST #213
NEWPORT BEACH, CA 92660
Phone : (213) 999-5696
Con State Lie : 946368
Lie Expire: 04/30/2024
Bus Lie: ST30038640
Bus Lie Expire : 03/31/2023
Workers' Compensation Insurance
Carrier: INSURANCE+COMPANY+OF+THE+WEST
Policy No: WSD5041971
W. C. Expire : 7/1/2023
Code Edition : 2019
Fire Sprinklers :
YES
Type of Construction : I -A
Fire Hazard Zone :
NO
Occupancy Groups : B
No of Units :
0
Bldg Height:
No of Stories :
10
Building Setbacks
Flood Zone : X
Use Zone : PC - Newport Place
PROCESSED BY: �4,
SPECIAL CONDITIONS:
Architect
Address
Phone :
State Lie
Engineer:
Address
Phone
Designer : Taleen Badawi Metcalf
Address : 4802 Briarhill dr.
Yorba Linda, CA 92886
Phone : (323) 547-5361
Construction Valuation :
$100,000.00
Added/New/Ti sq. ft. Bldg:
0
Alteration sq. ft. Bldg :
4,503
Added/New sq. ft. Garage:
0
TOTAL sq. ft. :
0
INSPECTOR
0
OWNER -BUILDER UB(.LAKA l tun
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State. License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable ftem(s)
,Section 7031.5. Business and Professions Coda: 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
ing with
:he permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencpermit
7000) of Division 3 of the Business and
it
professions Code) or that he or she is exempt from Iicensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a prmit subjects the applicant to a civil penalty of
not more than five hundred dollars ($50D).
1, 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 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)..
El 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
Erto 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 am exempt from Iicensure under the Contractors' State License Law for the following reason!
By my signature below I acknowledge that, except for my personal rasidence in which I most have resided for at least one year prior to completion of the improvements covered by this permit, 1 cannot legally
sell a structure that I have built as an own•••ar-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 Coda. Is a, ilabia upon request when this application is submitted or at the fallowing Wab sits:httpa/www.laginfo.ca.gov/calaw.html. pate _
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION
1 iereby affirm uaCEr , �:latly of perju that I am licensed under provisions of Chapter 9 (commencing with Section 700 ) o Division 3 of the Business and Pro esskms 3 dda, and my license is in full force
and effect License Class License No \�ab'tib4: Date 1 Ct '1. Contractor Signature
N'Or2KERS' COMPENSATION ECLARATION
iWAPNINCFAILURE'0 SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100p00), IN ADDITION TO THE
CIST OF C ]MPENSA-, IL N,'JAMAGES AS PROVIDED FOR IN SECTION 370E OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I hereby affirm ur.'-. penalty of perjury one of the following declarations:
G I have and will maintain a, certificate of consent to self -insure for workers' compensalion, 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.
[Khave and will ma'nt, in 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' compensatioi
insurance Carrier and policy number are:
Carrier Policy Number Expiration Date
ae of Agent T
Certify that, In the
. if I should bacon
of
ice 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 workers' compensation laws of California, and agree
to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply With those provisions. P �,
baby affirm under penalty of penury that there Is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
ides s Name Lenders Address —
my signature bale,, I certify to each of the following:
I am the property owner or authortzed 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 orkinances and state laws relating to building construction.
I authorize representatives of this city or county to entel the ab fled property for inspection purposes.
mac Pe of Prnnerty Owner or Authorized Agent\-4— Print Property Owner's or Authorized Agent's Named
ACTION
DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFIC€USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
1403
PERMIT EXPIRED1
SUBMITTED ASBESTOS NOTIFICATION TO
*IDATEBYI
EPA
PER,YRT EXTENDED_M6PCRIvP17
FINAL
-13 SBESTOS NOTIF CATIC>NISNOTAPPLICABLE TO
CEPTIFrCA7E OF
OP05ED EMOLIT N
OCCUPANCY ISSUED
P
Date