HomeMy WebLinkAboutXC2022-2065 - PermitsCity of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XC2022-2os5
pQ e Community Development Department -Building Division X C 2 0 2 2 2 0 6 5
�+ 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2022-2878
n{ Permit Counter Phone: (949) 718-1888 Issued Date : 10/11/2023
u = newportbeachca.gov/civic Final Date:
cgriFoaH�P Combination Type - ELEC Permit Status: Issued
Work Class - Other 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: 888 SAN CLEMENTE DR, (CS)
Description : COMM CELL SITE "VERIZON"
Owner: IRVINE COMPANY LLC
Address: 111 INNOVATION DR
IRVINE, CA 92617
Phone: (949)720-3100
Applicant : Garrett Holland
Address : 3471 Via Lido, Suite 202 Via Lido
Newport Beach, CA 92663
Phone: (949)633-6576
Owner/Builder :
Address :
Phone :
Code Edition :
Type of Construction
Occupancy Groups: U
Bldg Height :
Building Setbacks
Flood Zone
Use Zone :
PROCESSED BY:
X
PC - North Newport Center
SPECIAL CONDITIONS:
Legal Desc : A TR IRVINE SUB BLK 55 IRVINE SUB., FOR OF BLOCK 55.
Contractor: MOTIVE ENERGY TELECOMM GROUP Architect
INC
Address : 755 TRADEMARK CIRCLE
Address
CORONA, CA 92879
Phone: (909)915-9880
Phone:
Con State Lic : 1021440
State Lic
Lic Expire : 12/31/2024
Bus Lic : BT30073387
Engineer
Bus Lic Expire : 11/30/2023
Address:
Workers' Compensation Insurance Phone
Carrier: ZURICH AMERICAN INSURANCE COMPANY
Policy No: WC348720015 Designer
W. C. Expire: 4/1/2024 Address
Fire Sprinklers :
Fire Hazard Zone
No of Units :
No of Stories
Phone:
FULSANG ARCHITECTURE
3471 VIA LIDO STE 202 NEWPORT
BEACH, CA 92663
(949)838-4139
C030715
POOLE RICHARD
3400 VIA OPORTO #202
NEWPORT BEACH, CA 92663
(949)633-5809
NO Construction Valuation : $27,000.00
NO Added/New/TI sq. ft. Bldg : 0
0 Alteration sq. ft. Bldg :
Added/New sq. ft. Garage : 0
TOTAL sq. ft. : 0
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkrnark(s) I have placed next to the applicable Remits)
(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 Dlvision 3 of the Business and
Professions Code) or that he or she is exempt from licensors 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).
❑ 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 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
apply to an owner of properly who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law),
❑ I am exempt from licensore under the Contractors' Stale License Law for the following reason
By my signature below I acknowledge that, except fort h personal residence in which I must have resided for al least one year prior to completion h the Improvements
i covered by this permit, I cannot legall,
sell e structure o that I have built pan owner -builder twhn if it has not been constructor in its entirety by licensed contractors. I indoca.go 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 silo:httpaiwvlsv.lagirifo.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 Section 7000) of division 3 of the Business and Professio s Code, and y license is in full force
and effect. License Class License No Date _a _Divi2i Contractor Signature ,fie/�.
NORKERS' COMPENSATION DECLARATION (V/t�
NARNING: 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 lEt0QA00j, IN AODRION TO THE
=OST OF COMPENSATION,. DAMAGES AS PROVIDED FOR IN SECTION 390E OF THE LABOR CODE. INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
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 lh,
ler9rmance of the work for which this permit is issued. Policy No. _
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'
ranee carder and policy number are:
r Policy Number
_. Expiration Date
of Agent
certify that, in the performance 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
if I should become sub)ecl to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
L r
of
Date —I.. G> — / (_ ZS
rreby affirm under penalty of perjurYthat there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Nets Name Lenders Address
my signature below, I Certify to each of the followiny:
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 ail applicable city and county ordinances and state lases relating to building construction.
I authorize representatives of this City Dually county to enter the above -Identified property for inspection purposes. %� (�
nature of Property Owner or Authorized Age 3t h Print Property Owner's or Authorized Aoent's Name l `1�G \`Xn {ii-C
ACTION j DATE. BY
PERM,T EXPIRED
PERMIT CANCEtlfD I
PERIViIT FA7ENDED
CERTIFICATE OF
OCCUPANCYISSUED
OF COMPLIANCE WITH CODE OF FEDEI
PART 51 OF TITLE 40 AND AWAD RULE
I SJBMITTED ASBESTOS NOTIFICATION TO
tzrASBESTOS NOT IF ICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION
FOR OFFICE USE ONLY