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Home My WebLink AboutXC2024-0067 - Permits�PORr City of Newport Beach IIIIII�IIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XC2O24-0067 Community Development Department- Building Division X C 2 0 2 4 0 0 6 7 d t 1�mn (I 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2024-0328 Permit Counter Phone: (949) 718-1888 Issued Date: 07/22/2024 newportbeachca.gov/civic Final Date: Combination Type - ELEC MECH PLUM Permit Status: Issued Work Class - Tenant Improvement Inspection Area : 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 : 200 MAIN ST, B Legal Desc : Description: COMM TI FOR "BALBOA CANDY INC' 1360 SF Owner: JSL BALBOA LLC Address : 269 S. BEVERLY DR#366 BEVERLY HILLS, CA 90212 Phone: (310)801-9581 Applicant: ALEXANDRA NAVAS Address: 177 RIVERSIDE AVE, A NEWPORT BEACH, CA 92662 Phone: (949) 395-8755 Owner/Builder : Address : Contractor: PACIFIC WEST CONCRETE INC Address : 3672 PROVINCETOWN AVE IRVINE, CA 92606 Phone: (714)396-0088 Con State Lic: 639232 Lic Expire: 05131/2025 Bus Lic: BT30071085 Bus Lic Expire : 12131/2024 Workers' Compensation Insurance Carrier: STATE FUND Policy No: 9329420 W. C. Expire: 12114/2024 Architect: ROBERT LOUIS LAWRENCE Address : 760 W 16TH ST #M COSTA MESA, CA 92627 Phone: (194) 963-3956 x0 State Lic : CO21447 Engineer: Address: Phone: Designer: Address : Phone: Phone: Code Edition : 2022 Fire Sprinklers : YES Construction Valuation : $60,000.00 Type of Construction : I-B' Fire Hazard Zone : NO Added/Newts sq. ft. Bldg : 0 Occupancy Groups: M,U No of Units : 0 Alteration sq. ft. Bldg : 1,360 Bldg Height: No of Stories : 2 Add/New sq. ft. Garage: 0 TOTAL sq. ft.: 0 Building Setbacks Flood Zone: Use Zone: PROCESSED BY: SPECIAL CONDITIONS: �•� ••• ••• OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractors' State 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 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 (commencing with Section 7000) of Division 3 of the Business and Drofessions 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 fora permit subjects the applicant to a civil penalty of iot more than five hundred dollars ($500). 1, as ownerof the property, or my employees with wages as their sole compensatlon, will do U all of or U portions of the work, and the structure is not Intended or offered for sale (Section 7044, 3usiness 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 mprovements 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 mproved 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 Ipply 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). 1 am exempt from licensure under the Contractors' Stale License Law for the following reason: 3y my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements cowered by this permit, 1 cannot legaill :ell a structure that I have built as an owner -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 erofessions Code. Is available upon request when this application Is submitted or at the following Web site:http:Rvnvw.leginfo.ca.govlcalaw.html. signature of Property Owner or Authorized Agent Date -ICENSED CONTRACTOR'S DECLARATION hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Col and my license is In full force Ind effect. License Class License No Date 7—Z2.--I f4 Contractor Signature VORKERS' COMPENSATION DECLARATION 1ARNING: 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 (i100.000i, IN ADDITION TO THE :DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 7 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, erformance 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' rance carter and policy number are: ier 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 subject to the workers compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply With those provisions. of Dater ZZ.--Z 14 hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work forwhich this permit is issued (Section 3097, Civil Cade). 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 ordinances and state laws relating to building construction. I authorize representatives of this city or county to enter the above -Identified property for inspection purposes. �,,�' ianature of Prooertv Owner or Authorized ADent '� �� Print Property Owner' oP Aut ?ded Agents game ACTION GATE I BY (DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED �LI I `UBMITTED A5BE5TOS NOTIFICATION I U PERMIT CANCELLED _ _ _ _ _ EPA PERMIT EXTENDED TIAOMD PERMIT FINAL /- / SBESTOS NOTIFICATION 15 NOT APPUCABLE TO CERTIFICATEOF r/ PROPOSED DEMOLITION, OCCUPANCYISSUED (_� SIGNATURE: Date %—L.Z- ZA