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Home My WebLink AboutXC2022-2041 - Permits�ewPoRr City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XC2022-2041 D� �m Community D velopment Department - Building Division x C 2 0 2 2 2 0 4 1 y y 100 Civic Carter Drive, Newport Beach, CA 92660 Plan Check No: PC2022-2738 r = Permit Counter Phone: (949) 644-3288 Issued Date : .r Inspection Requests Phone: (949) 644-3255 Inspection Area : 7 °4crcoR"`P newportbeaclica.gov/inspections Combinatio Type - ELEC MECH PLUM Work Class Tenant Improvement PERMITS EXPI E 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCT[[ N RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 5000 BIRCH �ST, 4TH FL Legal Desc : P BK 181 PG 13 PAR 5 Description : CC - UP RADES OF 4TH FL COMMON AREA -LOBBY, CORRIDOR, RESTROOMS 1866 SF Owner: JOHN HANCOC K LIFE INSURANCE COMPANY Contractor: COASTLINE DEVELOPMENT INC Architect Address : USA 865 S FIGUERC A ST STE3320 Address : 13911 ENTERPRISE DRIVE Address LOS ANGELES CA 90017 GARDEN GROVE, CA 92843 Phone : (714) 265-0250 Phone Phone : Con State Lic : 485187 State Lic Lic Expire : 01 /31 /2024 Applicant: JESSICA SMA KER Bus Lic: BT30075860 Engineer: Address : 4770 CAMPUS DR, STE 100 Bus Lic Expire : 07/31/2023 Address NEWPORT BEACH, CA 92660 Workers' Compensation Insurance Phone: Phone: (805) 444-8677 Carrier: COMPWEST INSURANCE CO owner/Builder: Policy No: WCV550542500 Designer W. C. Expire : 1/1/2024 Address Address : Phone: Phone: Code Edition : 2019 Fire Sprinklers : YES Type of Construction : V-E Fire Hazard Zone : NO Occupancy Groups : B No of Units : 0 Bldg Height : No of Stories : 6 .� Building Setbacks yi Flood Zone : X 3, t • t Use Zone : PC I- Koll Center PROCESSED BY: SPECIAL CON DWYER SUSAN M 4770 CAMPUS DR NEWPORT BEACH, CA 92660 (949)851-3080 Construction Valuation : $143,000.00 Added/New/TI sq. ft. Bldg : 0 Alteration sq. ft. Bldg : 1,866 Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 9 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 item(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 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 licensure 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 Density of not more than five hundred dollars ($500), rl I, as owner of the property, or my employees with wages as their sole compensation, will do i all of or U portions of the work, and the structure Is not Intended or offered for safe (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 or Graving that it was not built or improved for the purpose of sale). 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 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), I am exempt from licensure under the Contractors' State. License Law for the following reason: y Y 9 9 P y personal residence in which I must have resided at least one year prior B m signature below I acknowledge that, except for m y p or to completion of the improvements covered by this permit, I cannot legal) sell a structure that I have built as an owner-buildar if it has not been constructed in Its entirety by licensed contractors. I understand that a copy of the applicable law, Section 704A of tho Business and Professions Code,, is available upon request when this application is submitted oral the following Web site:http:ltwww.leginfo.ce,gov)calaw.btmi, Signature of Property Owneror 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 700 f Division 3 of the. Business and Profess IT C ,and my 1(cerise is In full force and effect. License Class License No Date 3 -24 Contractor Signatu WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI E ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 07G6 OF THE LABOR CODE, INTEREST, AND ATTORNEY'$ FEES, hereby affirm under penalty of perjury one of the following declarations: 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 th ormanca of the work for which this permit is issued. Policy No, I ave 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' compensatiol insur nce carderamd policy number are: er Policy Number Expiration Date Name of Agent Phone N ❑I cartify that, in the pedor 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 California, and agre that, if I should become su jact to a we compensa ' provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �� Signature of Applicant oat L 3 - � DECLARATION REGA ING C STRUCTION LENDING AGENCY I hereby affirm under p Ity rjury that there is a construction lending agency for the performance of the work for which this permit Is issued (Section 3 7, Civil Code). Lenders 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 ided is correct. I agree to comply with all applicable city and county o dina ces and state Taws relating to building construction. I authorize representatives of this city or cow ty, to ante h a -Identified property for inspection purposes. \ Signature of Property_ Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name 05l-( NA v1 I Date 2- 7 2-2 ACTION DATE BY DE ATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY LATIONS PART 51 OF TITLE 40 AND AOMD RULE 03 PERMITEXPIRED I StlbMITTEDASBFFT')S NOnFICATION TO PERMIT CANCELLED --( PERMIT EXTENDED j, (tMD PLRACT FINAL 'J, ASaE5T05 NUl'1 FIqA1UN IS NOT APPOCABLE TO CER71F1CAE6F v PR POSEODEMOLITI OCCUPANCYISSUED E RfGNAT1,111€: