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Home My WebLink AboutXC2022-1924 - Permits�EWPO�T City of Newport Beach II III I I II I II I III III I I II II 04 b COMB Permit : XC2U22-1924 Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2022-2154 Permit Counter Phone: (949) 644-3288 Issued Date : 10/1212022 s Inspection Requests Phone: (949) 644-3255 Inspection Area : 7 °9clroae�r newportbeachca.gov/inspections Combination Type - ELEC MECH PLUM Work Class - Tenant Improvement 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: 620 NEWPORT CENTER DR, 7TH FL Legal Desc : P BK 295 PG 33 PAR 1 PARCEL MAP 295-33 PAR 1 POR OF PAR N `•.r C-�0Tk Description: COMM TI 12,350 SF "LUGANO DIAMONDS" ADMIN OFFICE I j L- Owner : 620 NCD LLC Address : PO BOX 2450 NEWPORT BEACH, CA 92658 Phone : (949) 720-2156 Applicant: HOLLY M GRAVES Address : 18 MULHOLLAND CT MISSION VIEJO, CA 92692 Phone: (949)697-9401 Owner/Builder: Address : Phone: Contractor: WEST BROADWAY BUILDING CO Address : 4590 MACARTHUR BLVD, STE 500 NEWPORT BEACH, CA 92660 Phone: (650)283-5329 Con State Lic : 1005485 Lic Expire : 10/31/2023 Bus Lic : BT30060127 Bus Lic Expire : 08/31/2023 Workers' Compensation Insurance Carrier: STATE FUND Policy No : 9142275 W. C. Expire : 10/5/2023 Code Edition : 2019 Fire Sprinklers : Type of Construction : I -A Fire Hazard Zone Occupancy Groups : B No of Units : Bldg Height : No of Stories Building Setbacks : Flood Zone : X Use Zone : PC - North Newport Center PROCESSED BY: I ' SPECIAL CONDITIONS: ROBER'i'S V✓AS1 F TO HAUL DEBRIS Architect : ALGAZE NELSON Address : 6083 BRISTOL PKWY CULVER CITY, CA 90230 Phone: (213)929-1400 State Lic : CO21090 Engineer: CORNELIA DIRPRES Address : 16501 SCIENTIFIC WAY, 200 IRVINE, CA 92618 Phone: (949)594-0076 Designer Address Phone : YES Construction Valuation : NO Added/New/TI sq. ft. Bldg 0 Alteration sq. ft. Bldg : Added/New sq. ft. Garage: TOTAL sq. ft. Bldg : $679,250.00 12,350 0 12,350 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 checkrnark(s) I have placed next to the applicable ltem(s) (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 tho 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 fieensurc 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 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 improvements are not Intended or offered for sale. Ir, 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)- 0 I, as owner of the property, are exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law dOBS 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 I am exempt from licensure under tale Contractors' Stale License Law for the following reason: _ _ __ B m y signature below I acknowledge that, except form personal residence in which I must have resided for at one • ear prior to completion of the improvements y y 'g g p y p y p p p covered by this permit, i cannot legally 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 site.http:Ilwww.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 D00 of Division 3 of the Business and Prof Sian id m Icens Is In full force and effect. License Class License No Date U /2 Contractor. Signature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUa45CT AN EMPLOYER TO CRIMINAL PEr LT@S AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR 3N SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FOES. I hereby affirm under penalty of perjury one or 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 Cade, for Ih p N x mance of the work for which this permit is issued. Policy No. Erl n ve 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' Compensation insure ce carrier and policy number are: Policy Number Expiration Date Name of Agent Phone # DI 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 t0 the Workers' compensation laws of California, and agra that if I should become subject to w rears' coTpgpsajon provisions of Section 3700 of the Labor Code, I shall forthwith comply With those provisions. Signstureof Applicant �� ? k Date //Z, DECLARATION REGARD: STRUCTENDIN AGENCY 1 hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued(Section 3097, Civil C Lender's Name Lender's Address By 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 t has pr rty for inspection purposes. �� authorize of Property rD ertOwner or Authorized A a � C' Print Property Owner's or Authorized A ent's N t C1r'C �� Date 1 /2 T2 ACTION DATE l DECLARATHON4 OF CONIANCE WITO CODE OF FEDERAL FOR OFFICE USE ONLY REG OLATIONS PART 51 DF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED _ I suaMITTED ASBESTOS NOTIFICATIONTO PERMIFCANCELLED EPA , ..... .-...- . ._._. _.._ _ . __ _ ..._ __ _ _ _ .....-..-. PERiatT EXTENDED _ _ nQMD PC-fl'vliT FILVAL 4/^!/'73 ENSBESTOS NOTIFICATION IS NOT APPLICABLE 10 CERTIFICATE OF PROPOSED DE CLITION OCCUPANCYISSUBD SIGNATU