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Home My WebLink AboutXC2023-0081 - PermitsaEWPORT City O D4 @ Commun > �n D 100 Civic U Y Permit Cc newportb c9CrFO0.N�P Combing Work Cl. PERMITS NO CONSTRI Job Address: 20350 B' Description : COMM - Owner: NEWPORT Address : 2141 ROSE EL SEGUN Phone Applicant: JOHNTHOM Address: 22609 ANZA TORRANCE, Phone: (310)994-29, Owner/Builder: Address : ewport Beach DII IIIIII I IIIII IIIIIIIIIIII III IIIIIIIIIIIIII I II COMB Permit : XC2023-008� Development Department- Building Division 7( C 2 0 2 3 0 0 8 1 )nter Drive, Newport Beach, CA 92660 Plan Check No: PC2023-0602 iter Phone: (949) 718-1888 Issued Date : 06/27/2023 :hca.gov/civic Inspection Area : 3 m Type - ELEC - Other 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 1 ST Legal Desc : P BK 385 PG 30 PAR 1 'LACE FRONT SWINGING DOORS W/ AUTOMATIC DOORS GHTS MEDICAL OFFICE LLC Contractor : DAN TAMAS %NS AVE #610 Address : 7860 1107 EAST ELM AVE, #2 CA 90245 FULLERTON, CA 92831 Phone: (714)931-9199 Con State Lic : 1039806 Lic Expire : 05/31/2024 Bus Lic: BT30081792 /ENUE Bus Lic Expire : 06/30/2024 490505 Workers' Compensation Insurance Carrier : Policy No : EXEMPT W. C. Expire: bA 1- 5 s tl yw b `69e.O ' 0 t1 Architect: JOHN THOMAS Address: 22609 ANZA AVENUE TORRANCE, CA 90505 Phone: (310)994-2948 .. State Lic : • •+� Engineer: BEALL RICK �. Address : 3900 COVER ST LONG BEACH, CA 90809 Phone : (562) 985-3200 . . Designer Address Phone: Phone: Code Edition : 2022 Fire Sprinklers : YES Construction Valuation : $15,6ec.Oo ' Type of Construction : 11-13 Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 Occupancy Groups : B No of Units : 0 Alteration sq. ft. Bldg : Bldg Height: No of Stories : 2 Added/New sq. ft. Garage: 0 TOTAL sq. ft. 0 Building Setbacks Flood Zone : X Use Zone : SF-7 - Santa Ana Heights Specific Plan PROCESSED BY: SPECIAL 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 ftemts) 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 he permit to file a signed statement that he or she is licensed pursuant to the provisions of theContractors' State License Law (Chapter 9 (commenting with Section 7000) of Division 3 of the Business and Irofessions Code) or that he or she is exempt from licensum and the basis for the alleged exemption. Any violation of Section 7031 Z by any applicant for a permit subjects the applicant to a civil penalty of iot more than five hundred dollars ($500). 1 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 Tlprovemants 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 buff or n roved 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 ply 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). I am exempt from licensureunder the Contractors' State License Law for the following reason: _ iy 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 Cannotlegallt all 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 copy of the applicable law, Section 7044 of the Business and Irofessions Code., is available upon request when this application is submitted or at the following Web site:httpJ/www.leginfo.ca.govicalaw.htmi, dignatum of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sect' 700OLof Nislon/g f B mess and Prof s' my license is in full force Ind affect. License Class License No Data-y��%f-r ' o ctor Signature PORKERS' COMPENSATION DECLARATION EARNING: FAILURE Tr, SEaJRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000)• IN ADDITION TO THE :DST OF COMPENSAVON DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. harebv a,Tirm under penalty of perjury one of the following declarations: .d I have and w11 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, edormaece of the v'ork for which this permit Is issued. Policy No. have and will. maima!n 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' rF. nee ardor ar.d poll�y number are: _ Policy Number Expiratio of Agent Phone # Date �Prlifv Thal, in the pertormance of the rk for w cn this permit is issued, I snag not employ any person in any manner so as to become subject to the workers' compensation laws of Cal€Forma., and agre '9�-Ls�h_ �a' mP slrttject to the ork s' c ens lion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ^� of scant C'_1C4?ION R_GARCING CONNi}ING AGENCY !reby 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). )der s Name Lender's Address 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 1 have provided is correct. I agree to comply with all applicable city and County ordinances and state laws relating to building construction. authorize representatives of this cit county to enter the above -identified property for inspection purposes. �/ '�,p ,,,,,//�}� /7 /F nature of Property Owner or Aul zed Agent Print Prooertv Owner's or Authorized-Aaen"Me !/ \ /Tr T / a'� f `vim_ "' Deta T) ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE OwtY ( �S j REGULATIONS PART 61 OF TITLE 40 AND AOMD RUIE v 1403 EXPIRED PERMIT FINAL lRtUPANCYlO O55UED �O,/h ^L// S1BA EOE EMOLITI Aj I5 APPLICABLE TO ,Z>