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Home My WebLink AboutXC2023-0356 - PermitsaEWPo�T City of Newport Beach IIII'IIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XC2U23-o35s 0 Community Development Department -Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-2206 > S Permit Counter Phone: (949) 718-1888 Issued Date : 10/03/2023 n. newportbeachca.gov/civic Final Date: Cq(IFORN�P Combination Type - ELEC MECH PLUM Permit Status: Issued Work Class - Tenant Improvement Inspection Area : 7 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: 1901 WESTCLIFF DR, STE 9 Legal Desc : N TR 4225 BILK LOT 4 TR 4225 LOT 4(AND SELY 110 FT Description: COMM TI -"RANGE SPORTS THERAPY" 1600 SF Owner: BUMHAM WARD PROPERTIES LLC Address: 1100 NEWPORT CENTER DR STE200 NEWPORT BEACH, CA 92660 Phone: (949)760-9150 Applicant: SCOTT R BRUNNER Address : 22952 MILL CREEK, STE 150 LAGUNA HILLS, CA 92653 Phone: (949)760-9150 Owner/Builder : Address : Phone Code Edition : Type of Construction Occupancy Groups: Bldg Height : Building Setbacks Flood Zone Use Zone : 2022 V-A B X CG - Commercial General PROCESSED BY: SPECIAL CONDITIONS: Contractor: EDBONANNI Architect: Address : 15132 BOLSA CHICA ST Address HUNTINGTON BEACH, CA 92649 Phone: (714)892-0123 Phone: Con State Lie : 642139 State Lie : ..... , Lie Expire : 04/30/2024 Bus Lie : BT30082725 Engineer Bus Lie Expire : 10131/2024 Address Workers' Compensation Insurance Phone: Carrier : Policy No : EXEMPT Designer: SCOTT R BRUNNER - W. C. Expire : Address: 22952 MILL CREEK, STE 15& LAGUNA HILLS, CA 92653• Phone: (949)760-9150 Fire Sprinklers : NO Construction Valuation : $90,09a.0Q ; Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 No of Units : 1 Alteration sq. ft. Bldg : 1,600 No of Stories : 2 Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 0 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 items) (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 lie 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 penalty of not 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 far 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. hands 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 properly who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). J I am exempt from licensure under the Contractors' Slate License Law for the following reason. ._----- _.......-. By my signature below t 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 legall, ;ell 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 a copyof the applicable law, Section 7044 of the Businoss and orofessions Code, is available upon request when this application is submitted or at the following Web site:http:liwww.leginfo.ca,govicalaw.html, Signature of Property Owner or Authorized Agent _ Date LICENSED CONTRACTOR'S DECLARATION hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Seca 0 f Div lion 3 of thABeas a ro ions ode, and. my license is In full force and effect. License Class License No D Cor Signature NORKERS' COMPENSATION DECLARATION YARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO O E HUNDRED THOUSAND OLLARS fit 00,000J, IN ADDITION TO THE �OST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: Id 6 and will r.i, i.la n a corllfccafe 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 �arrrance of the vro•k tar which €his permit is issued. Policy No. and will mdintain 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' compensationce carrier ar,d policy number are: Policy Number Expiration Date Name of Agent _ Phone if !I ,^rtiry IN, In performance of the work for w Ich this permit Is issued.. I shall not employ any person in any manner so as to become subject to the workers' dampen tion laws of California, and agre hot of I shoul come su o the war r com en ation provisions of S 0 of the Labor Code, I shall forthwith comply with those provisions. "'y lure A 1 am_ __ _ ..______m.. - _�. )LCLtr. TION REGARDING C ' ' 'ION L DING AGENCY _...__ he eh+ aThrm under penalty of erfury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 30 7, Civil Code). _enders Name Lender's Address 3y my signature pbelow, I certify to h of the f iny: I ammthe property owner or authorized to ant 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 and co ordinances and state laws relating to building construction. I authorize represenialives of this city or c unty to ter ab a identified property for inspection purposes. B nature of Property Owner ar Aulnchz Age. rinl Property Owner's or Authorized Aqent'cmar7 D to ACTION i DATE BY ARATION COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS P T 61 OF TITLE 40 AND AOMD RULF PERMIT EXPIRED LJT3 MiTTF,D ASBESTOS NOTIFICATION TO PERMIT CANCELLED '.._ E LJEPA .... _ ... ._.....,... _. PERMIT EXTENDED ..._.._ .___... ___ .._.. _ ......._.. _.. _ OMD P[RL11T FINAL yl �Z� Z,� f[ f�,�s A$ge57 NOf IFICAI'ION IS NOT APPLICABLE TO CERTFtCATE Of I P OEMOUTION OCCUPANCYLSSUED I G