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HomeMy WebLinkAboutXC2023-0372 - PermitsCity of Newport Beach Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 718-1888 newportbeachca.govlcivic 1-1 FL % Combination Type - ELEC MECH PLUM Work Class - Tenant Improvement ��III�I[IIIII 2 3 IIPI 1111111111111111111 COMB Permit:XC2023-0372 X 0 0 3 7 2 Plan Check No: PC2023-2276 Issued Date: 03105/2024 Final Date, I Permit Status: Issued Inspection Area: 7 S PERMITS EXPIRE ISO 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: 853 NEWPORT CENTER DR Legal De , S6: P.BK 221,:PQ'30PAR 6 P.M. 221-30 PAR 6 POR OF PAR Description: COMM TI - "SWEETGREEN" 2786 SF Owner: IRVINE COMPANY Contractor VERTEX BUILDERS. LLC. Architect ERICA NELLES Address: 110 INNOVATION DRIVE Address:,, 10585 BLOOMFIELD STREET Address 1760 CREEKSIDE OAKS, 280 IRVINE, CA 92617 LOS ALAMITOS, CA 90720 SACRAMENTO, CA 95833 Phone (949) 720-2000 Phone: (714) 655-3051 Phone: Con.StateLie 1073980 State Lie Lie Expire: 03131/2025 Applicant: AUSTIN VANDERWOUDEN Bus Lie' BT30083590 Engineer: Address 515 FIGUEROA ST S, 1275 Bus LicExpire : 0212812025 Add r�ess LOS ANGELES, CA 90071 Phone: (213) 233-2147 Workers' Compensation Insurance Phone: Carrier:., STATE COMPENSATION INSURANCE FUND OwnerlBuilder: Policy No: 9296746 Designer: Address W.G. Expire.: 2/12/12025 Address Phone: P hone: Code Edition 2022 Fire Sprinklers Construction Valuation $570,000.00 Type of Construction III-B Fire Hazard Zone NO Added/NewITI sq. ft. Bldg 0 Occupancy Groups: ><BX 0 No of Units : I I Alteration sq. ft. Bldg : 2,786 Bldg Height: I i No of Stories Added/New sq. ft. Garage ft. 0 0 TOTAL sq. Building Setbacks Flood Zone: X Use Zone: PC - North Newport Center d% PROCESSED BY: SPECIAL CONDITIONS: HAULER: BC HAULING A. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that i am exempt from the Contractors' State License Law for the reasons)I 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 issuance, also requires the applicant for Ithe 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 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 Inot more than five hundred dollars ($500). Q 1, as owner of the property, or my employees with wages as their sole compensation, will do U 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 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). 1 am exempt from licensure under the Contractors' State 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 I have built. as an owner -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 Business and Professions Cade, is available upon request when this application is submitted or at the following Web site:http:/Iwww.leginto.ca.gov/calaw.htm1. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION i hereby affirm under penalty of perjury That i am licensed under provisions of Chapter 9 (commencing with Section 7000)of Divisia 3 of the Business and Professio C d d my license is in full force and effect. License Class License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION - WARNING: FAILURE TO SECURE WORMERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 15100,000), IN ADDITION. TO THE',, COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS 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 the performance of the work for which this permit is issued. Policy No. have 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' ranee carrier and policy number are: Policy Number Expiration Date of Agent Phone # ©] certify that. in the performance of the work for 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 agre that, if I should become subject to the w rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 42 Signature of Applicant ._ _ Date DECLARATION REGARDI IRUCTION LENt7'ING AGENCY I hereby 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). Lender's Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized to act an the property owner's behalf. I have read this application and the tnformation 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 or county to/�ant r the abo -ide ' ie roperty for inspection purposes. n n Signature of Property Owner or Authorized Ape:nt d t/1 ��„ c� �: Print Property Owner's or Authorized Agent's Name /-� 17nlv!o L / ACTION DATE BY DECLARATION Ot/COMPTiM- CE WITH. CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQIVID RULE 1403 PERMIT EXPIRED t SUBMITTED ASBESTOS NOT]FICATION TO PERMIT CA,vCE UEJ - - - PERMIT EX?'EfG'}ED - - - CtMD PLRMITFINAL - %-!G _Z A5BES'TOS NOTIFICATION I'NOTAPPLICABLE TO CERTIFICATE OF�PR�P65i„DDEMOtiTION OCCUPANCY155LIED ; SIGNATURE: Date 3i