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Home My WebLink AboutXC2023-0302 - Permits�aEwPORr City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XC2O23-0302 C p Community Development Department- Building Division y 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-1928 ' = Permit Counter Phone: (949) 71 B-1888 Issued Date : 10109/2023 .r. newportbeachca.gov/civic Final Date: cq[/Fp0.N�P Combination Type - ELEC MECH PLUM Permit Status: Issued Work Class - Tenant Improvement 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 : 265 NEWPORT CENTER DR Legal Desc : P BK 221 PG 30 PAR 6 P.M. 221-30 PAR 6 POR OF PAR Description : COMM TI "GORJANA" 1252 SF Owner: IRVINE COMPANY Contractor: HARDESTY & ASSOCIATES INC Architect : JAMIE POLADIAN Address : 110 INNOVATION DRIVE Address : 711 W 17TH ST #D2 Address : 3 WHITWORTH ST LADERA RANCH, CA IRVINE, CA 92617 COSTA MESA, CA 92627 92694 Phone: (949)720-2000 Phone: (949)723-2230 Phone: (949)833-1930 Can State Lic : 634021 State Lic : C-036678 Lic Expire : 12/31/2023 Applicant : MARY HENDERSON Bus Lic : BT30080070 Engineer : SCHROEDER MARK Address : 18600 MACARTHUR BLVD SUITE 300, SUITE Bus Lic Expire : 11/30/2023 Address : 16969 VON KARMAN #240 300 IRVINE, CA 92606 Irvine, CA 92612 Phone: (949) 833-1930 Workers' Compensation Insurance Phone: (949) 474-0502 Carrier: EVEREST NATIONAL INS CO Owner/Builder : Policy No: CA10002508211 Designer Address : W. C. Expire : 12/8/2023 Address Phone: Phone: Code Edition : 2022 Fire Sprinklers : YES Construction Valuation : $350,000.00 Type of Construction : III-B Fire Hazard Zone : NO Added/New/Ti sq, ft. Bldg : 0 Occupancy Groups : M No of Units : 0 Alteration sq. ft. Bldg : Bldg Height : No of Stories : 1 Added/New sq. ft. Garage : 0 TOTAL sq. ft. 0 Building Setbacks Flood Zone : X Use Zone : PC - North Newport Center PROCESSED BY: SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) 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 in 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 Divlsion 3 of the Business and 'rofessions 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 fora permit subjects the applicant to a civil penalty of of more than five hundred dollars ($50D). 1 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, lusinass and Prntassions Code: The. Contractors' State License Law does not apply to an owner of properly who, through employees' or personal effort., holds or improves the properly, provided that the oprovements 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 nproved for the purpose of 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 Dishy to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' Slate License Law). I I am exempt from Iicensure under the Contractors' Slate License Law for the following reason: iy my signature below I acknowledge that, except for my personal residence in which I must have resdod for at least one year prior to completion of the Improvements covered by this permit, I cannot lagaltj ell a structure that I have built as an owner -builder if it has not boon constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and 'rofessions Code, is available upon request when this application is submitted or at the following Web site: http:ltw w.leginfo.ca,gov)calaw.html. 'signature of Property Owner or Authorized Agent.__.___.__._...__._...._._._.,,.___..._._,._,_.._._.._.._...____.._______....._,..._..._.._._,._____.___.—._.,..»_........»_...-.,,., Date .ICEN'.SED CONTRACTOR'S DECLARATION hereby affirm under penalty of penury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of D' tsion 3 QQf the Business and r1n fessio Cod (and license is In full force no effect. License Class License No Date — _%i Contractor SlgnatursJ--. VORKERS' COMPENSATION DECLARATION 47/ IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGES UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNOREO THOUSAND DOLLARS 16100,0001, IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR 1N SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury, one of the following declarations: 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 fir D manes of the work for which this permit is issued. Policy NO. In 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' cent pensatior uravnce carrier and policy number are: ;artier Policy Number Expiration Date Jame of Agent I Phone At :1I certfy that, in th=perjury work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' comp nsalion law of California, and agre hat, If I should becarkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ilgnalure of APVlica- )ECLARATIQN RECTION LENDING AGENCY hereby affirm undeat there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, ChA Code). .tinder's Name Lender's Address 3y my signature below, I certify to each of the lollowiny: I ale the property owner or authorized to act on the property owner's behalf. �J I have read this application and the information I have provided is correct. m/(/�//' I agree to comply with all applicable city and county Ord' antes d state laws relating to building construction. I authorize representatives of this city or county to ant ab ,•id u d pmnertyfor'nspectlon purposes, ii nature of Property Owner or Authorzed Agen Print Property Owner's or Authorized Agents Name Date ACTION DATE. RV CLARATIONOF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY 4 :GULA -IONS PART 61 OF TITLE, 40 AND AQMD RU},E 1403 / r FF.NMii CAACFCf FD i PEPoLSii ET'TENDEO ( PEAPINT FINAL (1^Z t1 6�:; ASBESTOS NO ICA O 1^5 NOT APPLICABLE TO CEAT'IFICA7E OF sill POSED DE U GO / - OCCUPANCYISSUED 519N41VRE�r /1