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Home My WebLink AboutXC2022-1861 - PermitsCity of Newport Beach ��EWPpRT Community Development Department- Building Division > - - 100 Civic Center Drive, Newport Beach, CA 92660 >C� Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 Cqt/Fn0.N�P newportbeachca.gov/inspections Combination Type - Work Class - Tenant Improvement COMB Permit : XC2022-1861 Plan Check No : PC2022-1821 Issued Date : 08/22/2022 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 : 1301 DOVE ST, 200 Legal Desc : P BK 120 PG 27 PAR 1 Description: COMM TI -DEMO PRIOR TO TI 21642 SF Owner: 1301 DOVE OWNER LLC Contractor: COASTLINE DEVELOPMENT INC Address: 2101 ROSECRANS AVE STE3270 EL Address: 13911 ENTERPRISE DRIVE GARDEN SEGUNDO, CA 90245 GROVE, CA 92843 Phone: Phone: (714)265-0250 Con State Lie : 485187 Applicant: HOLLY GRAVES Lie Expire : 01/31/2024 Address : 6083 BRISTOL PKWY CULVER CITY, CA 90230 Bus Lie: BT30075860 Phone: (949) 697-9401 Bus Lie Expire: 07/31/2023 Workers' Compensation Insurance Owner/Builder: Carrier: COMPWESTINSCO Address : Policy No : WCV550542500 Phone: W. C. Expire : 1/1/2023 Code Edition : 2019 Fire Sprinklers : 10 Type of Construction : I -A Fire Hazard Zone : No Occupancy Groups : B No of Units : 0 Bldg Height : No of Stories: 10 Building Setbacks Flood Zone Use Zone : PROCESSED BY X PC - Newport Place M SPECIAL CONDITIONS: WASTE MGMT TO HAUL DEBRIS Architect: ALGAZE NELSON Address : 6083 BRISTOL PARKWAY CULVER CITY, CA 90230 Phone : (213) 929-1400 State Lie Engineer: Address Phone: Designer: Address: Phone: Construction Valuation : $200,000.00 Added/New/Ti sq. ft. Bldg : 21,642 Alteration sq. ft. Bldg : 21,642 Added/New sq. ft. Gar Niii ,�1�Tc�ram' INSFa �^ OWNER -BUILDER DECLARATION I hereby affirm under penally 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) (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 the 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 Professions Code) or that he or she is exempt from licensors 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). 0 I, as owner of the property, or my employees with Wages as their sole compensation, will do (,)all of or (_) 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). ❑ I, as owner of the property. ant 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 Improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law), Q I and exempt from licensors 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 Iegalh sell 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 Professions Code, Is available upon request when this application is submitted or at the following Web she:http://www.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 !!E o Divise 3 of the Business and P fe slo P Code, an license is I II force and effect. License Class License No Date Z..� Contractor Signature WORKERS' COMPENSATION DECLARATION NARKING: FAILURE 70 SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINALTIE AHtlCIVIL PINES VP TO ONE HUNDRED OUSAND DOLLARS (E100,000). IN ADDITION TO THE COST 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: J_Lhave and will maintain a certificate of consent to self -insure for Workers' compensation, issued by the Director or Industrial Relations as provided for by Section 3700 of the Labor Cade, for th -�a,rrfj11orm ce of the work for which this permit is issued. Policy No. eve rid 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' compensadol ns mnc carrier and policy number are: trier Policy Number Expiration Date Jame of Agent Phone # —11 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 Califomla, and agre hat, if I should become subject to the workers' nsalion provisions of Section 3700 of the Labor Code, I shall forthwith comply With those provisions. �7 n 31gnature of Applicant /7 �!"� .�.�._.�..� Data _....., 7ECLARAT1pN REGI R2IN RI CTI LENDING AGENCY hereby affirm under penalty o erjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, ivil Code). -anders Name _ Lender's Address — 3y my signature below, I certify to each of the following: I am the property owner or authorized to act on the properly 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 at laws relating to building construction. I authorize representatives of this city or counh/ nter a above-i �Iy�1 pro , art far inspection purposes. 3i nature of Property Owner or Authorized Agent Pont PmpaOwner's or Authorized Agent s Name ACTION DATE By A - ARATION Of OMPLIFlNC[WIT}ICODE OF FEDERAL FOR OFFICE USE ONLY .GULATIONS PART Bt OF TITLE 40 AND AQMD RULE 3403 PERMIT EXPIRED 15UBMITTE0 ASRE3TOS NGT. F.CAT C N TO — _ — PERMlTCANCELLED OEPA All required alarms, latches gates and fences which Serve as part of spool%spa barrier, shall P€RM1fEXTENDEO gt,Ap be in place prior to approval to fill pool/spa & shall remain In place & be maintained for the PERMITFINAL f / ( BE57U5 NUT IPICATIUN IS tyOd`7{PPLICABLE TO life of the pool. CERTIFICATE OE %7 �rL �j� R POSED DEMOLITION (�/�J// OCCUPANCY 155UEO SIGNATVRE i