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Home My WebLink AboutXC2023-0281 - Permits��EWPp�T City of Newport Beach 0 9 Community D velopment Department - Building Division } 100 Civic Cen er Drive, Newport Beach, CA 92660 n Permit CounterPhone: (949) 718-1888 �i z .y,. newportbeach a.gov/civic o'<, F-a", Combination Type - ELEC MECH PLUM Work Class Tenant Improvement PERMITS NO CONSTRU iiiiiiiiiiiii1ii it COMB Permit : XC2023-0281 Plan Check No : PC2023-1813 Issued Date : 11/07/2023 Final Date: Permit Status: Issued Inspection Area : 7 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 5000 BIRCH iT, 7TH FLOOR Legal Desc : P BK 181 PG 13 PAR 5 Description: COMM TI TO TH FLOOR LOBBY, CORRIDOR, AND RESTROOMS. 1761 SF Owner: JOHN HANCOC USA Address : 865 S FIGUERC LOS ANGELES, Phone : (949) 757-0397 Applicant: JESSICA SMAR Address : 4770 CAMPUS NEWPORT BEA Phone : (949) 851-3081 owner/Builder: Address : Phone Code Edition : 202 Type of Construction : I -A Occupancy Groups: B Bldg Height: Building Setbacks : Flood Zone : X Use Zone: PC PROCESSED BY: SPECIAL CONDITIONS: LIFE INSURANCE COMPANY Contractor: JLC ASSOCIATES INC ST STE3320 A 90017 STE 100 CA 92660 Kell Center Address : 3198 A AIRPORT LOOP DR COSTA MESA, CA 92626 Phone: (949)241-4430 Con State Lie : 645576 Lie Expire : 05/31/2024 Bus Lie : BT30D53881 Bus Lie Expire : 01/31/2024 Workers' Compensation Insurance Carrier: INS CO OF THE WEST Policy No: WVE504521604 W. C. Expire: 1/1/2024 Architect: SUSAN DWYER Address: 4770 CAMPUS DR NEWPORT BEACH, CA 92660 Phone: (949)851-3080 State Lie : C033724 Engineer Address Phone: Designer: Address Phone : Fire Sprinklers : YES Construction Valuation : $134,900.00 Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 No of Units : 0 Alteration sq. ft. Bldg : 1,761 No of Stories : 10 Added/New sq. ft. Garage; 0 TOTAL sq. ft. : 0 OWNER -BUILDER DECLARATION t hereby affirm under penaltyof perjury that I am exempt from the Contractors' State License Law for the reasori 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 eunstrueL, alter, Improve, demolish, or repair any structure, prior to Its issuance, also requires the applicant for !the permit to file a signed statement that no or she is licunsed pursuant to the provisions of the Contractors' State License Late (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 'Professions Code) or that he or she is exempt from iiceosure 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). 111, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, BUSIne.SS and Professions Code: The ContractorsState 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 of proving 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). El I am exempt from licensure under the Contractors' State License Law far 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 ranDw-fe-9d1l, sell a structure that I have built as an owmor-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 Busino and Professions Code, is available upon request when this application is submitted or at the following Web site:http:liwww.leginfo.ca.gov/calaw.html� Signature of Property Owner or Authorized Agent Data LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) f Division 3 of the Business and Profs Code, If ull force and effect. License Class License No Date T 3 Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORx ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SU84ECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 4100;000), IN ADOrtICN TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR 1N SECTION 370E OF THE LABOR CODE, INTEREST, AND ATTORNEY"s FEES. I 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 th, performanceofof the work for which this permit is issued. Policy No. LI have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' compensatior u surance carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent _._ Phone A ❑I certify that, in the performance of the work fo which this per Is. issued, I shall not employ any person in any manner so as to become subject to the workers' compensation Laws of California, and agree [hat, if I should become subjec to the worker ompensatio visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant /Date/u%' DECLARATION REGAROf ' - ION LENDI AGENCY T r' hereby affirm underpenalty 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 By my signature below, 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 1 have provided is correct. I agree to comply with all applicable city and county ordinances and stal s relatw o building construction. I authorize representatives of this city or county to nt he above -id ' ied props for inspection purposes. % Si nature of Pro ert y Owner or Authorized Agent Print PropertyOwner's or Authorized A em's Name 2 1 Datsf% Z ACTION DATE BY DECLA A ION OF CO E W'ITH CODE OF FEDERAL FOR OFFICE USE ONLY RFGULATIONS.PART OFT. . 40 AND AQMD RULE. 1403 PERMiTEXPiRED _ I SUBMITTED ASBESTOS_ NOTIFICATION TO PEAM __ _ ��--I(C�PA D _i7 CANCELl—EQ I uA PERMiT FkTENDED QM fICA�E OF (G(JJ��//// � �lASBESTOS NOTIFICATION I5/Nr/�yAPP B to CERrf OCCUPANCY ISSUED Ilboii✓ 5I NATURE E/ /O,;, 1/ V