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Home My WebLink AboutXC2022-2096 - Permits�EWPO//T City of Newport Beach C� 6+ Community Development Department- Building Division X C 2 0 2 2 2 0 9 6 COMB Permit : XC2022-2096 F 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2022-3085 6 >r ? Permit Counter Phone: (949) 644-3288 Issued Date : 03/02/2023 Inspection Requests Phone: (949) 644-3255 Inspection Area : 7 newportbeachca.gov/inspections Combination Type - ELEC MECH 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: 4340 VON KARMAN AVE, 260 Legal Desc : P BK 387 PG 20 PAR 1 UN HOLD PARCEL 1 OF PARCEL MAP 387-20; HOLD PARCEL FOR Description : COMM TI - "PEAK ENTERPRISES LLC" 2045 SF Owner: PEAK ENTERPRISES LLC Contractor: TENANT WORKS INC Architect Address : 40 SALT BUSH Address : 26 MONTGOMERY Address IRVINE, CA 92603 NEWPORT BEACH, CA 92660 Phone : (714) 392-5060 Phone : (949) 706-9038 Phone Con State Lie : 738903 State Lie Lie Expire : 08/31/2023 Applicant: TENANT WORKS INC Bus Lie: BT20011003 Engineer Address : 26 MONTGOMERY Bus Lie Expire : 12/31/2023 Address NEWPORT BEACH, CA 92660 Phone : (949) 706-9038 Workers' Compensation Insurance Phone: Carrier: STATE COMPENSATION INSURANCE FUND Owner/Builder: Policy No: 9227570 Designer Address : W. C. Expire : 3/9/2023 Address Phone: Phone: LO YU-NGOK 10736 JEFFERSON BLVD, 722 CULVER CITY, CA 90230 (320)980-8981 Code Edition : 2019 Fire Sprinklers : YES Construction Valuation : Type of Construction : II -A Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg Occupancy Groups : B No of Units : 0 Alteration sq. ft. Bldg : Bldg Height: No of Stories : 4 Added/New sq. ft. Garage TOTAL sq. ft. Building Setbacks Flood Zone : X Use Zone : PC - Koll Center PROCESSED BY: \4— t $75,000.60 0 2,045 0 0 SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION € 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 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 appiicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (Commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exemptfrom iicensure 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). 13 1, as owner of the properly, or my employees with wages as their sole compensation, will do U all of or L) 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). '❑ 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 property who builds or Improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 11 1 am exempt from Iicensure under the Contractors' Slate License Law for the following reason:_ _ By my signature below € acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally sell a structure that 1 have built as an Gwner-builder it it has not been constructod in its ent rety by licensed contractors. I understand that a copyof 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:/jW ry .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 (Commencing With Section 70 of vim oS the Buslness and Prof oode, an •ense is �ull rce and effect. License Class License. No Date Contractor Signature L WORKERS' CC`ht'.PFNSATION DECLARATION WARNING: FAILURE TO Sq'URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,D00), IN ADDITION TO THE CGST OF rOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3TO6 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I nereoy affirm under penalty of perjury one of the following declarations: 111 llbve 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 Coda, for th porfor.ronce of the work for which this permit is issued. Policy No. have and will mr irtain 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` ran.:e carrier and policy number are: Policy Number ne of Agent — certify that. in 4ha ca.ormance of tha we , if I should berc ale <tibiec'Nolbe worker of Date not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ogre 3700 of the Labor Code, I shall forthwith comply with those provisions - Date hereby affirm under penalty of perjury that there is a construction tending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). endeis Name Lenders 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 ordinances an tate law elatlnp,l to building. construction. I authorize representatives of this city or count en the e.. -' entifieeyt9for inspection purposes. . :�....�n .a f o.n,.om n,. ., 1r a, rtnn��a,i Arm a�,,///fff Print Prooertv Owner's or Authorized Acerne Name yeOi�l i (L�e DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL 1. REGULATIONS PART 51 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED PERMIT CANCELLED 'Z1 CER VICATE OF OCCUPANCYISSUED NOTIFICATION TO NOTIFICATION 15 FOR OFFICE USE ONLY