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x2ol9-01110
N00 Newporirenler ID( -
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www,newportbeachca gov 1 (949) 644-3200
NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of
the property improvements specified at 'ice ca sty+ De ate `t
We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to
make you aware of your responsibilities and possible risk you may incur by having this permit issued in
your name as the Owner -Builder.
We will not issue a building permit until you have read, initialed your understanding of each
provision, signed, and returned this form to us at our official address indicated. An agent of the
owner cannot execute this notice unless you, the property owner, obtain the prior approval of the
permitting authority.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information
s4ra1. i understand a frequent practice of unlicensed persons is to have the property owner obtain an
"Owner -Builder" building permit that erroneously implies that the property owner is providing his or her
own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious
financial risk for any injuries sustained by an unlicensed person and his or her employees while working
on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully
acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers
on my property.
4w�^2. 1 understand building permits are not required to be signed by property owners unless they are
responsible for the construction and are not hiring a licensed Contractor to assume this responsibility.
ig�3. I understand as an "Owner -Builder" I am the responsible party of record on the permit.
understand that I may protect myself from potential financial risk by hiring a licensed Contractor and
having the permit filed in his or her name instead of my own.
. I understand Contractors are required by law to be licensed and bonded in California and to list
their license numbers on permits and contracts.
. I understand if I employ or otherwise engage any persons, other than California licensed
Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor
and materials. I may be considered an "employer" under state and federal law.
5rsr-6. I understand if I am considered an "employer' under state and federal law, I must register with the
state and federal government, withhold payroll taxes, provide workers' compensation disability insurance,
and contribute to unemployment compensation for each "employee." I also understand my failure to abide
by these laws may subject me to serious financial risk.
211_.w7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds
single-family residential structures cannot legally build them with the intent to offer them for sale, unless
all work is performed by licensed subcontractors and the number of structures does not exceed four
within any calendar year, or all of the work is performed under contract with a licensed general building
Contractor.
e"_& I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be
held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any
latent construction defects in the workmanship or materials.
ror slowner_builder_venfdoc 08/12/16 1 oft
-aP4- 9. 1 understand I may obtain more information regarding my obligations as an "employer' from the
Internal Revenue Service, the United States Small Business Administration, the California Department of
Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the
California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.csib.ca.gov for
more information about licensed contractors.
S"-10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and
understand that I am the party legally and financially responsible for proposed construction activity at the
following address: 40Cs r1 u cehMA.. av , rw rw wtW_J VMur ISEA0 4 c_.e. 4y7-l06[_�
S#4.11. I agree that, as the party legally and financially responsible for this proposed construction
activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as
employers.
4%v 12. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to
any of the information I have provided on this form.
Licensed contractors are regulated by laws designed to protect the public. If you contract with someone
who does not have a license, the Contractors' State License Board may be unable to assist you with any
financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed
Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor
or employee of that individual or firm is injured while working on your property, you may be held liable for
damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible
for verifying whether or not those Contractors are properly licensed and the status of their workers'
compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property
owner and returned to the City of Newport Beach, Building Division, for issuing the permit.
Note: A copy of the property owner's driver's license or form notarization is required to be
presented when the permit is issued to verify the property owner's signature.
Print name of property owner: N cn w.to . i I tYr
Property Owner's Signature: nh Z, JA& --_Date: $lI13k 19
Note: The following Authorization Form is required to be completed by the property owner only
when designating an agent of the property owner to apply for a construction permit for the
Owner -Builder.
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal
responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file
the documents necessary to obtain an Owner -Builder Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address: 4Co MWCO-T' CA5N L%%_ DIL• SU11t 406 KA0,.vil'O"r FFV%:::4 C.d '17-66 C)
Name of Authorized Agent: PAW-- tin • SES Tel No LAW6 4'St> AS 2, t
Address of Authorized Agent: t'-to%-36NOc4tvo k`rG CXL-LTZ 'to' &Aeu.Pcan-t- 1010k4s4 a4L qt bt.p
I declare under penalty of perjury that I am the property owner for the address listed above and I
personally filled out the above information and certify its accuracy. Note: A copy of the owner's driver's
license, form notarization, or other veYrfic / n acceptable to the agency is required to be presented when
the permit is issued to verify the propert ner's signature. ^ A r
Note: A copy of the owner's driver's license or form notarization is required to be presented when the
permit is issued to verify the property owner's signature.
formftN"er_buildcr vcrifdoc 08/12/16 2 of2
Act. The Manger shall have all authority, rights, and powers, conferred by the Act and those
necessan, or appropriate to carry out the purposes of this Company as set forth in Section 2 hereof,
and all such authority, rights and powers shall be exercised by or under the discretion of the
Manager..
6. Allocation of Profits and Losses; Tax Matters. For so long as, and during
such time as the Company shall have only one member, the following shall apply for Federal income
tax purposes and relevant state income tax purposes, but only for such purposes: (i) in accordance
with Section 301.7701-3(a) of the Income Tax Regulations, the Company shall be disregarded as an
entity separate from such member; (ii) all items of income, gain, loss, deduction and credit of the
Company shall be treated as recognized directly by such member; and (iii) the assets and liabilities of
the Company shall be treated as the assets and liabilities of such member. For so long as, and during
such time as the Company shall have more than one member, the profits and losses of the Company
shall be allocated between or among the members in proportion to their relative membership
interests. This characterization, solely for tax purposes, does not create or imply a general
partnership between the members for state law or any other purpose. Instead, the members
acknowledge the status of the Company as a limited liability company formed under the Act.
7. Distributions. Distributions shall be made to the Member at the times and in
the aggregate amounts determined by the Manager.
8. No Admission of Additional Members. It is the intent of the Member that
the Company be, and shall remain, a single member lnnited liability company, and no additional
members may be admitted to the Company. Notwithstanding the foregoing, if, by operation of law
the Member distributes its assets, including its membership interest in the Company, to the partners
of Member, then, the Company shall automatically become a multi -member limited liability
company. In such event, the Manager shall take all necessary action pursuant to the Act to properly
identify the multi -member status of the Company.
9. Limitation on Company Assets. The Company shall not acquire or own any
material asset other than (i) that certain real property located at 400 Newport Center Drive, Newport
Beach, California ("Property"), and (ii) such incidental personal property as may be necessary for the
operation of the Property.
10. Liabilitv of Any Member or Manager. No member or the Manager shall have
any liability for the obligations or liabilities of the Company except to the extent provided in the Act.
11. Amendment. This Agreement may be amended from time to time with the
written consent of a "majority in interest of the members" as such term is defined the Act.
12. Governing Law. This Agreement shall be governed by, and construed under,
the laws of the State of California; all rights and remedies being governed by said laws.
13. Governing Act. To the extent that the articles of organization and this
Agreement do not otherwise provide, the Act shall govern all matters by and among the members,
any managers, including the Manager, and the Company.
IN WITNESS WHEREOF, the undersigned, intending to be legally bound hereby, has duly
executed this Limited Liability Company Agreement effective as of the date set forth below.
Dated: March 1, 2007 SOLE MEMBER:
NEWPORT CENTER MEDICAL
BUILDINGS, a California limited partnership
JamJane CT. Rhodes, Co -Trustee of the Frank and
Ie Rhodes Family Trust dated July 14, 1998, as
amended, Ge alp
��r��-�
Eugene S. Rhodes, Co -Trustee of the Frank and
Jane Rhodes Family Trust dated July 14, 1998, as
I MN
�,Ldyd E. (right III, Co -Tr sfee of the Frank and
Jane Rh es Family Trust ted July 14, 1998, as
a ded, General er
Eugene S. Rhodes, Co -Trustee of the Frank A.
Rhode , Jx. Separate Property Trust dated July
14,122- as amended, General Partner
usan E. Rhodes Madjasevic, Co-TAJstee of the
Frank A. Rhodes, Jr. Separate Property Trust
dated July 14, 1998, as amended, General Partner
Signature Page: LLC Agreement (NCMB No. 1)