HomeMy WebLinkAboutXC2023-0472 - PermitsCity of Newport Beach
Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone: (949) 718-1888
newportbeachca.gov/civic
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Combination Type - ELEC MECH PLUM
Work Class - Tenant Improvement
COMB Permit : XC2023-0472
Plan Check No : PC2023-2832
Issued Date : 02/12/2024
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 : 3501 JAMBOREE RD, 1250
Description : COMM TI 'TRIAS" 2062 SF
Owner:
SK HART BAYVIEW LLC
Address :
PO BOX 11623
SALT LAKE CITY, UT 84147
Phone :
(949) 823-9330
Applicant:
JOHN GRESKO
Address :
27762 ANTONIA PKWY
LADERA RANCH, CA 92694
Phone:
(949) 456-2052
Owner/Builder
Address :
Phone:
Legal Desc : N TR.12528 BLK LOT 3
Contractor: CONAM BUILDING CO
Address : 903CALLE AMANCEER #210
SAN CLEMENTE, CA 92673
Phone:
(909) 498-1003
Con State Lie
: 698311
Lie Expire :
10/31/2025
Bus Lie :
BT30066464
Bus Lie Expire : 03/31/2024
Workers' Compensation Insurance
Carrier: SENTINEL INSURANCE COMPANY LTD
Policy No: 72WEAAB4SZQ
W. C. Expire : 4/21/2024
Architect: JOHN GRESKO
Address: 27762 ANTONIA PKWY LADERA RANCH,
CA 92694
Phone :
(949) 456-2052
State Lie :
Engineer:
YOUNG ROGER PAUL
Address:
18400 VON KARMAN AVE #100
IRVINE, CA 92612
Phone :
(949) 252-1022
Designer:
Address :
Phone:
Code Edition :
2022
Fire Sprinklers :
YES
Construction Valuation :
$400,000.33, ,
Type of Construction :
I -A
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg :
0
Occupancy Groups :
B
No of Units :
0
Alteration sq. ft. Bldg :
2,062
Bldg Height :
No of Stories :
6
Added/New sq. ft. Garage:
0 -
TOTAL sq. ft.
0
Building Setbacks
Flood Zone :
X
'
Use Zone :
PC - Bayview
,
0:�
PROCESSED BY:
SPECIAL CONDITIONS: HAULER: IRS DEMOLITION
OWNER -BUILDER DECLARATION
I hereby affirm under penally of perjury that P. am exempt from the Contractors' Slate License Law for the reasons) indicated below by the checkmafk(s) I have placed next to the applicable Rennie)
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 signedstatement that he or she is licensed pursuant to the provisions of the Contractors' State. License Law (Chapter 9 (commencing with Section 7000) of Division 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
rot more than five hundred dollars (3500),
1 1, as owner of the property, or my employees with wages as their sole compensation, will de L) 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' Slate 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 thepurposeof sale).
1 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
3ppfy 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),
nI am exempt from Eicensure 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 legalh
sell a structure that I have built as an owner -builder if it has not been constructed in its entiroty 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 site'http:liwww,leginfo.ca.govlcalaw.html.
Signature of Properly Owner or Authorized Agent..___ Date
LICENSED 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 Profes�on ndgty Inset force
and effect License Class Licensa No Datc2 2 /2 Contractor SignatureT/
WORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL susjECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS (Sl 0,001n, IN ADDITION TO THE
COST OF COMPENSAT[ON, OAMAGES 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:
1 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 IT
performance 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'
ranee carrier and policy number are:
Policy Number Expiration Date
is of Agent 1-11011e R
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 becomesubject to the workers` compensation laws of California., and
if I should become subject to the worlcers' cpaipensalion proviqlars. of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
Date �l / 2 / Z l
heroby affirm under ^enalty of perjdythat there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code)
Finder's NameLender's Address.
y r„y slgnatun, bel0', I certify to each of the following:
I am the pr,,I, erty jwner or authorized to act on the properly owner's behalf.
I Nave read mis application and the information I have provided Is correct.
I agree to comply with all applicable city and Coolly erdinancas and state laws rotating to building construction.
I authorize I epresontatives of this city or county to enter th -Idf Nfied property fo�r'rs„astion purposes. a
Date
ACT'ICN DATE
BY I DECJA'1KTl ON OF COMPLIANCE WITH COOE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PA'R,T 61 OF TITLE 40 AND A4NID RULE
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