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Home My WebLink AboutXC2023-0091 - Permits�gWPOQT City of Newport Beach II IIIIII IIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIII I II COMB Permit : XC2023-0091 Community Development Department- Building Division n 100 Civic Center Drive, Newport Beach, CA 92660 X C 2 0 2 3 0 0 9 1 Plan Check No : PC2023-0675 u S Permit Counter Phone: (949) 718-1888 Issued Date : 05/05/2023 a.. newportbeachca.gov/civic c��/FORN�P Combination Type - ELEC MECH PLUM p +?_ Inspection Area : 7 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 : 1200 NEWPORT CENTER DR, STE 270 Description : COMM TI - SPEC SUITE 3295 SF Owner: IRVINE CO Address : 111 INNOVATION IRVINE, CA 92618 Phone : (949) 720-3100 Applicant: HOLLY M GRAVES Address : 18 MULHOLLAND CT MISSION VIEJO, CA 92692 Phone: (949)697-9401 Owner/Builder : Address : Phone Code Edition: Type of Construction Occupancy Groups Bldg Height: Building Setbacks Flood Zone Use Zone : PROCESSED BY: Legal Desc : P BK 316 PG 3 PAR 3 Contractor: PACIFIC TUSK BUILDERS CORP Address : 1100 QUAIL ST #213 NEWPORT BEACH, CA 92660 Phone: (213)999-5696 Con State Lic : 946368 Lic Expire : 04/30/2024 Bus Lic: BT30038640 Bus Lic Expire : 03/31/2024 Workers' Compensation Insurance Carrier: INS CO OF THE WEST Policy No: WSD5041971 W. C. Expire: 7/1/2023 Architect : ALGAZE NELSON Address : B083 BRISTOL PKWY CULVER CITY, CA 90230 Phone : (213) 929-1400 State Lic : CO21090 Engineer: Address Phone : Designer Address Phone: 2022 Fire Sprinklers : YES Construction Valuation : $113,121.00 V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 E No of Units : 0 Alteration sq. ft. Bldg : 3,295, , No of Stories : Added/New sq. ft. Garage: 0,- TOTAL sq. ft. : 0 , X PC - Corporate Plaza West > • . SPECIAL CONDITIONS: E)WNCK-LYUt LI_l LIME LMr[HI IUVI 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 Item(s) 3eotan 7031.b, 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 e 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 DEvision 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 at more than five hundred dollars ($500).. 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 70", usiness 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 nprovements 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 I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Slate License Law does not poly 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 Lave). I am exempt from licensure under the Convactors' State License Law for the following reason:- y 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 legal ell a structure that I have built as an owner -builder if it has not been constructed in its entiroty by licensed contractors. I undorstand 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:httpaivronv.leginfo.co.govtcalaw.html. signature of Property Owner or Authorized Agent DateY,�_____-,��_ .ICENSED 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. Professions Code, and my license is In full force nd effect. License Class License. No Date_S10 9I27 Contractor Signature 1f--iM.900 '� VORKERS' COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (e1DO.000), IN ADDITION TO TH OST OF COMPENSATION DAMAGES AS PROVIDED FOR IN SECTION 3116 OF THE LABOR CODE, INTEREST, Me ATTORNEY's FEES. hereby affirm underpenalty of perjury one of the following declarations: I I have and will maintain a certificate of consent to self'Taure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for I erfor lance, of the work for which this permit is issued. Policy No. �i 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' eompensati, isurance carrier and policy number are: )arrler - Policy Number Expiration Date Name of Agent "'- ]I certify that, in the performance of the work for which this permit is issued. I shall notemploy any person in any manner so as to become subject to the workers' compensation taws of California, and agre iat, if I should become subject to the workers` Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. gnaalure of Applicant sR ton �- _ �— Date_ IECLARATION REGARDING CO STRUCTION LENDING AGENCY 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 Code). Ender's Name Lender's Address ly my signature below I certify to each of ilia following: I am the properly ewrier or authorized to act on the property owner's behalf. I hPv= read this aoplication and the Information I have provided is correct. I agree to comply with all applicable city and comity ordinances and state Paws relating to buildingconstruction. i auti Inrize representatives of this city or county to enterthe above -identified property for inspection purposes. Sidnature of Properly Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name 21 t DATE. BY DECLARATION. OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 51 OF TITLE 40 AND AQUID RULE i 1403 eXPIFED { (SUBMITTED ASBESTOS NOTIFICATYON TO __._.... PERLIIT FINAL $'I—ZS t SBESTOS NOI'9ACA1lON IS NOT APPLICABLE TO CERTIFICATE OF PROPOSED DErOOLITION .� SIGNATURE: OCCUPANCY ISSUED i /iCGr/ Date