HomeMy WebLinkAboutXC2022-2113 - PermitsCity of Newport Beach
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Community Development Department- Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone: (949) 644-3288
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Inspection Requests Phone: (949) 644-3255
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newportbeachca.gov/inspections
Combination Type - ELEC MECH PLUM
Work Class - Tenant Improvement
COMB Permit: XC2022-2113
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Plan Check No: PC2022-3181
Issued Date : 02/14/2023
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 : 360 SAN MIGUEL DR, 405 Legal Desc : P BK 193 PG 17 PAR 3
Description: COMM TI -"DR FARSHIDI" DERMATOLOGY OFFICE 1260 SF
Owner: NCMB NO 4 LLC
Address : 1401 AVOCADO AVE STE901
NEWPORT BEACH, CA 92660
Phone : (949) 279-1257
Applicant: ANTHONY HSU
Address : 26961 CAMINO DE ESTRELLA, 200
CAPISTRANO BEACH, CA 92624
Phone: (949) 388-1250
owner/Builder: NCMB NO 4 LLC
Address: 1401 AVOCADO AVE STE901
NEWPORT BEACH, CA 92660
Phone : (949) 279-1257
Contractor
Address :
Phone:
Con State Lie
Lie Expire
Bus Lie:
Bus Lie Expire
Workers' Compensation Insurance
Carrier :
Policy No:
W. C. Expire:
Architect : WIGGLE GARY
Address : 26961 CAMINO DE ESTRELLA #200
CAPISTRANO BEACH, CA 92624
Phone : (949) 388-1250
State Lie
Engineer:
Address :
Phone:
Designer:
Address:
Phone : a— r C
Code Edition :
2019
Fire Sprinklers :
YES
Construction Valuation :
ft', Bldg
$79,400.00
1,260
Type of Construction
: I -A
Fire Hazard Zone :
NO
Added/New/TI sq. :
Occupancy Groups :
B
No of Units:
0
Alteration sq. ft. Bldg,: -
Bldg Height :
No of Stories :
8
Added/New sq. ft. Garage :
0
TOTAL sq. ft. :
1,260
Building Setbacks
Flood Zone :
X
Use Zone :
- Block 400 Newport Center
�PPC
PROCESSED BY:
J1
SPECIAL CONDITIONS:
;
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 checkmark(s) I 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
IS permit to rile a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Low (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
�rofassions 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
of more than five hundred dollars ($500).
1 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
usiness 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
nprovements 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
nproved for the purpose of sale).
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
to 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),
exempt from licansure under the Contractors' State License Law for the following reason: ,_ _
y ignalure below I ecklTowI III that, except for my personal residence in which I must have resided for at least one year pr nr m complahon of the improvements covered 6y this permit, 1 cannot legail�
II a s ucturo that I have built as an owner -builder if Il has not boan constructed in'sts entiroty by liconsad contractors. I understand that a copy of the applicable law, Sedtion 7044 oftho Business and
ro. stuns Code., is can
upon request when this applici sub Itted Drat the following Web sito:hltpalwwM1v.leginfo.ca.govlcalaw.htmL 7 cJ — Z3
signature of Property Owner or Authorized When
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7400) of Division 3 of the Business and Professions Code, antl my license le In full force
nd effect. License Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
'ARNING: 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 (SI00,000), IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
I 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 Section 3700 of the Labor Code, for th
arformance 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 permitis issued. My workers'
ranee carrier and policy number are:
Policy Number
of Agent
Date
e ify 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 taws of California, and agre
t if Vshould become subject to w KITS' pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 7
nature of Applicant —^"— Date If — 2 G Z "-Z
CLARATION REGA. G SVftCTION LENDING AGENCY
!reby 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).
Ides s Name Lender's 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 taws relating to building construction.
I authorize representatives of this city or county toyntpr ths aj mve-idernifled property for Inspection purposes.
ACTION DATE BY ,` D€'CLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
I REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED I t...I I SUBMITTED ASR,:SIJS NO. 1i L:ATIOlk TO
PERMiTEXTENDED
PERMIT FINAL
CERnFICAYE DF
OCCUPANCYISSUED
NOTIFICATION IS NOT APPLICABLE TO
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