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Home My WebLink AboutXC2023-0417 - Permits041. City of Newport Beach IIIIII I IIIII IIIIIIII IIII III III III II COMB Permit:XC2,023-0417 Community Development Department- Building Division100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2023-2534 Permit Counter Phone: (949) 718-1888 Issued Date: 04/04/2024 newportbeachca.gov/civic Final Date: Combination Type - ELEC PLUM Permit Status: Issued Work Class - Alteration 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 : 1600 JAMBOREE RD Legal Desc : P BK 33 PG 50 PAR 1 P M 33-50 FOR PAR 1 Description: COMM- REMOVAL OF HYDROGEN FUELING EQUIPMENT, DEMO PORTION OF CMU ENCLOSURE, INSTIL(1) GAS DISPENSER. MINOR SITE IMPROVEMENTS 6100SF Owner: ERICKSON INDSTS INC Contractor: FASTECH Architect Address : 3861 WISTERIA ST Address: 7050 VILLAGE DRIVE # D Address SEAL BEACH, CA 90740 BUENA PARK, CA 90621 Phone: Phone: (714)523-0194 Phone: Con State Lic : 794519 State Lic Lic Expire : 05/31/2025 Applicant: JIMMY TOETZ Bus Lic: BT30026458 Engineer : FIEDLER GROUP Address : 299 EUCLID AVE N, 550 Bus Lic Expire : 01/31/2025 Address : 2322 N 3RD ST PASADENA, CA 91101 LOS ANGELES, CA 90057, Phone : (213) 201-2528 Workers' Compensation Insurance Phone: (213) 381-7891 , Carrier: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA Owner/Builder : Policy No: UB9T3675712326G Designer: • . , , Address : W. C. Expire: 11/1/2024 Address Phone: Phone: ... Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $250,000.00 Type of Construction : II-B Fire Hazard Zone : NO Added/NewlTI sq. ft. Bldg : 0 Occupancy Groups : H-3 No of Units : 0 Alteration sq. ft. Bldg : 6,100 Bldg Height: No of Stories : 1 Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 0 Building Setbacks Flood Zone : X Use Zone: PC - Big Canyon PROCESSED BY: SPECIAL CONDITIONS: I hereby affirrn under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indica led below by the checkrnark(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 he 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 'rofessions 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 lot more than five hundred dollars ($500), I, as owner of the property, or my employees with wages as their sole compensation, Will do L) all of or l portions of the work, and the structure is notintended 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 mprovements 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 mproved 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 ipply 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 hcensure under the Contractors' State License Law for the following reason: 3y 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 ;ell a structure that 1 have built as an owner-bui{der 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 Business and Irofessions Code, is available upon request when this application is submitted or at the following Web site:htfpliwww.leginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Agent Date _ JCENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectletin 7 ) 9f via! 3 of the Busin as d Professiops'C�tde� and. my icense is in full force and effect. License Class License No D 'i p' Contractor gnature \i(/Lf1KJ1 VORKERS' COMPENSATION DECLARATION / , 7 rARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO' ONE HUNDRED THOUSAND DOLLARS (S100,000), IN ADDITION TO THE :OSTOFCOMPENSAT'CN PAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, hereby affirm unds-,n4nalty of perjury one of the following declarations: 1 haves and wilt 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 the errormance of the .:xk for which this permit is issued. Policy No. 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' carrier rind policy number are: Policy Number Expiration Date cf Agent — Phone .D_ Certify that. in the performance of the work for which this permit is issued. I shall notemploy any person in any manner so as to become subject to the workers' Compensation laws of California, and . ;t :.,hould core ub ect t e workers' b@ " q. 1be n -G pensatlon provisions of Section 3700 of the Labor Code, I shall forthwith comply with the provisions. mature of Al C .vw r'� eC�f/L, J\-�D�t/e / ireby affirm under penalty of`pefjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). mdei s Name Lender's Address my signature below, I certify to each of the Following: I am the property owner or authorized to act art 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 county ordinances and state laws relating to building. construction. I authorize representatives of this city bounty toeater the above -identified property for inspection purposes, nature of Property Owner or AuthorizedI% � Print Prooertv Owner's or Authorized AGent`s.Nama C PERMIT EXPIRED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCVISSUEO REGULATIONS PART 51 DF Trf 40 AND AOMO RULE 1403 ISNOTAPPLICABLE TO FOR OFFICE USE ONLY