Loading...
HomeMy WebLinkAboutXC2023-0445 - Permits�gWPORr City of Newport Beach II IIIIIII IIII II I IIIIIIIII II II IIIII II COMB Permit : XC2023-0445 D� A Community Development Department -Building Division X C 2 0 2 3 0 4 4 5 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : 0809-2022 Permit Counter Phone: (949) 718-1888 Issued Date : 10131/2023 newportbeachce.gov/civic Final Date: Combination Type - _ _- ,y.. __ Permit Status: Issued Work Class - Other - Inspection Area : 8 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 : 798 DOVER DR Legal Desc : P BK 1 PG 50 PAR 1 PM 001-50 PAR 1 FOR OF PAR Description : "'RENEW EXPIRED PERMIT X2022-0883" COMM CELL SITE "AT&T" Owner: CHURCH NEWPORT HARBOR LUTHERAN Address : 798 DOVER DR NEWPORT BEACH. CA 92663 Phone: Applicant: JERMAINE TAYLOR Address: 3300 IRVINE AVE NEWPORT BEACH, CA 92660 Phone : (909) 917-1727 Owner/Builder : Address : Phone Contractor: CIK POWER DISTRIBUTORS LLC Address : 240 W W GROVE AV ORANGE, CA 92865 Phone: (657)554-0278 Con State Lie : 969729 Lie Expire : 08/31/2024 Bus Lie: BT30073771 Bus Lie Expire : 12/31/2023 Workers' Compensation Insurance Carrier: SENTINEL INSURANCE COMPANY LTD Policy No: 72WEAQ10518 W. C. Expire : 10/12/2024 Code Edition : Fire Sprinklers : Type of Construction : V-B Fire Hazard Zone Occupancy Groups : U No of Units : Bldg Height: No of Stories Building Setbacks : Flood Zone : X Use Zone : PC - Newport Harbor Lutheran Church PROCESSED BY: S7 SPECIAL CONDITIONS: Architect Address Phone: State Lie Engineer: HOLMES WELLS Address: 651 W GALENA PARK BLVD#101 IRVINE, CA 92614 Phone : (801) 990-1775 Designer Address Phone : NO Construction Valuation : NO Added/New/TI sq. ft. Bldg : 0 0 Alteration sq. ft. Bldg : Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 0 I hereby affirm under penally of perjury that t 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 ssuaTice, also requires the applicant for :he permit to filea 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 Drofessions Code) or that he or she is exempt from lieensure 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 time hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended or offered for sale (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 hnprovements 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 or sale). © I, as owner of the property, am exclusively contracting with licensed Contractors to construct file project (Section 7044, Business and Professions Code: The Contractors' Slate License Law does not apply to an owner of properly 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 lcensure under the Contractors` Slate License Law for 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 cannot legally sell a structure that € have built as an owner -builder if it has not been constructed in its entirely by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is LICENSED CONTRACTOR'S DECLARATION p.1lwwW.leglnfo.ca�gov/calaw.html. p q pphoat' Is submitted i at ll IDwing Web she:htt Signature of Property Owner or Authorized Agent "� I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and rofessiD�n. b tense its in full force and effect. License Class License No Date CC -I-?, `2,OZ?i Contractor Signal �- WORKERS' COMPENSATION DECLARATION WARNING: FAtLU RE TO SECURE WORKERS' COMPENSATION COVERAGE 13 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000L M ADDrrION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEWS FEES. I herehy affirm under penalty of perjury one of the following declarations: El 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, pefgrmance of the work for which this permit Is issued. Policy No.. and will maintain workers' compensationinsurance,. as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' carrier and policy number are: Policy Number Expiration Date 1a of Agent certify that, in the performance of the I( I should become subject- `W@ C. Iature or Applicant 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 nGensation.pLoviftea of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date (2>c� �j\ t 7 I hereby affirm under penalty of perjury that there Ise construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code) Lenders Name Lenders Address By my signature below, l 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 tiod-coLuoty ordinances ands a laws rotating to building construction. I authorize r^mprs..enlatt3ves of this city o my Loan r th - d property for inspection purposes. Si nature of Property Owner or Authorized A Print Property Owner's or Authorized Agent s Name AC. FIQA DATE BY 1 DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 of TITLE 40 AND'AQMD RULE 1403 PFRMirhxpiRei; ( ?),,AITT'ED A5BESTOS NOTIFICATION TO PEVM!7 CA.fVCELLEU EPA PERM!? EXRNC 57 ! AQMD PERMIT FINA! 9 E3.'t9 nFICATION I'. OTAPPLICABLE TO CERTfFlLATE rCrrPArcyrssarto