HomeMy WebLinkAboutXC2023-0361 - Permits�EWPORr City of Newport Beach III�I�III�III�II�IIIII �IIIIIIIIIIIIIII� II
C� @ Community Development Department- Building Division x c 2 0 z 3 e 3 s 1
F 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 718-1888
�. newportbeachca.gov/civic
C4�fFpRN`P Combination Type -
Work Class - Tenant Improvement
COMB Permit : XCs(123-G361
Plan Check No : PC2023-2226 ;
Issued Date : 01103/2024
Final Date:
Permit Status: Issued
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: 415 NEWPORT CENTER DR Legal Desc : P BK 221 PG 30 PAR 2 PM 221-30 PAR 2 (LLA 09-01504
Description: COMM TI TO ADD SELF-SERVICE'AMAZON' RETURN KIOSK AT (E) "WHOLE FOODS MARKET" 20 SF
Owner: IRVINE COMPANY LLC
Address : 111 INNOVATION DR
IRVINE, CA 92617
Phone: (949)720-3100
Applicant:
STEVE APPEL
Address:
29833 SANTA MARGARITA PKWY, 300
RANCHO SANTA MARGARITA, CA 92688
Phone:
(949)209-5165
Owner/Builder
:
Address :
Phone:
Contractor: CM CORP FACILITIES SERVICE
Address : 27075 COBAT ROAD, SUITE 114
LAGUNA HILL, CA 92653
Phone :
(949) 305-8888
Con State Lie
: 951578
Lie Expire :
10/31/2024
Bus Lie:
BT30083283
Bus Lie Expire : 01/31/2025
Workers' Compensation Insurance
Carrier: INSURANCE COMPANY OF THE WEST
Policy No : WSD506441701
W. C. Expire: 3/10/2024
Code Edition : 2022
Fire Sprinklers :
YES
Type of Construction : II-B
Fire Hazard Zone :
NO
Occupancy Groups : M
No of Units :
0
Bldg Height:
No of Stories :
1
Building Setbacks :
Flood Zone : X
Use Zone : PC - North Newport Center
PROCESSED BY: V-
Architect :
BLUME CRAIG S
Address :
20381 LAKE FOREST DR STE B16 LAKE
FOREST, CA 92630
Phone:
(949)830-9942
State Lie
Engineer
Address
Phone:
Designer:
Address
Phone:
Construction Valuation :
$1,000.00
Added/New/TI sq. ft. Bldg:
0
Alteration sq. ft. Bldg :
20
Added/New sq. ft. Garage :
0
TOTAL sq. ft. :
0
SPECIAL CONDITIONS: ir„ R
OWNER ELIILDEB: DECLARATION.
I hereby effi,m ulcer 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 items)
(Secllon 70:1.r, Businefs Pnd Prnfesslpns (ode: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, poor to its Issuance, also requires the applicant for
the permit to file a signed statement that hL ar she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7e0() of Division 3 of the Business and
Professions Code) or that he or she is exempt from lieeesure 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).
71 I, as o'wnur cf the property, nr my emp!mrees with wages as their sale compensation, will do L) all of or U portions of the work, and the structure is not Intended or offered for sale (Section 7044,
Business .rd Proressions Code T,e Cant, gctr,m 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
iriprovemants are riot intendad it cfrored `Dr srle, II, however, the building or improvement is sold within one year of completion, the Owner-Buifder 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 property who builds or improvesthereon, and Who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
0 1 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 residence in which I must have resided for at least one year prior to completion of the improvements Covered by this permit, I cannot legal],
sell a structure that I have built as an owner-buildor 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 Code, is available upon request when this application is submitted orat the following Web siteihttp:tAvww.leginto.ca.govlcalaw.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 previsions of Chapter 9 (commencing with Section 7000 of Divisons i n 3 of the Business and Profe iCorjg nof my Ucensej�fult force
and effect. License Class License No Date ? Contractor Signature��fi
(WORKERS' COMPENSATION DECLARATION
(WARNING: FAILURE TO SECURE WORMERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (S700,000), IN ADDITION TO THE
''.COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 1706 OF THE LABOR CODE. INTEREST, AND ATTORNEYS FEES.
II hereby affirm under penalty of perjury one of the following declarations:
�0 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, forth
liperformance of the work for which this permit is issued. Policy No.
PI 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' eompensatioi
Insurance carrier and policy number are:
Policy Number
of Agent
Date
certify that, inthe performance of the work for which this permit I$ issued, I shell not employ any person in any manner so as to become subjectto the workers' compensation laws of califomia, and
, if I should become sggject in the yv_orkers' compensaticn provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions,
of
Date 44L; Imo`
Ireby affirm under penalty of perjury that there is a construction ler tld ng agency for the performance of the work for which this permit is issued (Section 3097
Ider'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 laws relating to building. construction.
I authorize representatives of this city or county enter the ve-identified operty for inspection purposes.
nature of Property Owner or Authonzed Anent / � I Prim Prooertv Owner's or Authorized ACent's Name
ACTION
PERMIT EXPIRED
PERMIT fAA'CELlED
PERMIT EXTENDED
PERMITFINAL
EERTiFicATE OF
OCCUPANCY fS5UE0
DATE BY Ll [[ DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
i REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
'Z rd
SUBMITTED ASBESTOS
I5NO1'APPLICABL.E 10
Civil Code).